Jump ship or fight misinformation? Physicians debate staying on Twitter 

Many physicians and healthcare leaders say they plan to stay on Twitter to counter medical disinformation amid concerns about changes to the platform's content moderation policy after Elon Musk's $44 billion takeover

After months of uncertainty and legal challenges, the Tesla CEO closed the deal to acquire Twitter Oct. 27. The move ended Twitter's nine-year run as a public company, with the platform now subject to fewer rules, The New York Times reported. Mr. Musk had long criticized Twitter's content moderation practices, promising to loosen restrictions and promote free speech as the new owner.

While it's still unclear exactly how policies may change, Mr. Musk said the company will form a "content moderation council with widely diverse viewpoints" and that, "No major content decisions or account reinstatements will happen before that council convenes." 

The looming policy changes have sparked concerns that Twitter will see a surge in hate speech and disinformation, with many public figures saying they will part ways from the platform as a result.  

A study from researchers at Montclair (N.J.) State University found a significant influx of "vulgar and hostile" tweets in the hours immediately after Mr. Musk's takeover. In the week leading up to the acquisition, there were a maximum of 84 hostile tweets per hour. In the 12 hours after, that number spiked to a total of 4,778. While there have not yet been official changes to content moderation policies, the findings suggest "certain users were celebrating a reduction in perceived constraints on the platform," researchers said. 

Many Twitter users have also taken issue with a new $8 subscription fee to keep the blue checkmark on verified accounts and a mass layoff of about 50 percent of the company's workforce, including several content moderation roles.  

Despite a growing list of companies withdrawing from advertising on Twitter — which includes Pfizer, according to The Wall Street Journal — most physicians and healthcare leaders say they're staying to fight misinformation. 

"The easy thing to do would be to abandon using Twitter, but that's not the right thing for us to do at this time," FDA Commissioner Robert Califf, MD, wrote in an Oct. 31 Twitter thread. "More than ever before, it's important that [the] FDA continues to use Twitter for good and do everything in our power to protect the public from potential harm."

Deciding the benefits outweigh the risks, Dr. Califf said the regulatory agency will maintain its presence on the app and "continue to post accurate health information" and "continue being a resource to every consumer needing info about products we regulate."

Christopher Longhurst, MD, chief medical officer and chief digital officer at UC San Diego Health, said there are many reasons to stay, and Eric Topol, MD, founder and director of Scripps Research Translational Institute in San Diego, said it's "essential" that #ScienceTwitter and #MedTwitter stay put, reasoning that there isn't a "suitable alternative for reach." 

Others have tentatively said they will continue to use Twitter but added their other social media handles in case they leave Mr. Musk's platform. 

Megan Ranney, MD, dean of Brown University's school of public health, tweeted Oct. 28, "Staying for now. But also on Insta, just in case. thanks for the ride so far, friends. Let's keep doing good together."

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