I started creating health content online in medical school. I realized I could reach thousands of people in seconds and share medically accurate information with students around the world. For example, I made a video showing how deep an injection goes for vaccination. The public is both fascinated and afraid of injections, but dispelling the rumors that a massive needle could go as deep as your bone goes a long way in vaccine adoption.
During my emergency medicine residency, though, things changed. What had been seen during my interview process as a strength and skill set became “high risk” overnight. I was told that continuing to post on social media could jeopardize my career.
That warning did not come because I was spreading misinformation or blurring professional lines. By that point, I had already spent years creating content for health care professionals across levels of training, from students to practicing clinicians. It was part of how I taught, how I shared ideas, and how I participated in the broader medical conversation.
I tried to challenge the system, but my appeals fell on deaf ears. The message was clear: Public visibility carried institutional risk, including the very real possibility that I could lose my job or training slot.
Fear of employer consequences is one of the primary reasons physicians pull back from public engagement online, according to a 2021 scoping review published in the Journal of Medical Internet Research. That tension has become one of the least discussed barriers in the fight against health misinformation. We don’t have a shortage of qualified clinicians who can communicate clearly online. We have a system that makes speaking publicly feel professionally dangerous.
Health misinformation is a public health problem. According to KFF, more than half of U.S. adults say they get health information from social media at least occasionally, yet fewer than 1 in 10 trust most of what they see.
In response, policymakers, regulators, and public health leaders all have called for more credible voices online. The previous White House administration made that case directly, inviting me to participate in a roundtable for health care social media as one of the voices on the front lines of this issue. During those meetings, the administration stressed the value of continuing to add more qualified voices on digital channels to fight the volume of misinformation being shared.
At the same time, federal scrutiny of digital health communication and advertising has increased, particularly as more medically inaccurate information circulates through social platforms outside traditional channels.
But calls for more participation online miss a key constraint. Nearly 4 of 5 physicians are now employees of hospitals/health systems and other corporate entities, according to the latest statistics. As W-2 workers, they don’t enter the public square as fully independent actors. Their speech is shaped by the institutions that employ them, the communications policies those institutions impose, and the risk tolerance of the legal and administrative structures above them.
Adam Goodcoff, the chief medical officer at HealthCentral, says hospitals need to relax restrictions that suppress responsible physician communication.Ivan Piedra Photography/ADWEEK
Hospitals and health systems have understandable concerns, among them liability, reputational damage, and unprofessional behavior. Posts can be clipped out of context or interpreted as official positions. Anything that could create friction with regulators, partners, or the public becomes a risk.
That concern is often justified. There have been high-profile cases of indiscretion, from widely publicized incidents in a New York City ER to the recent cases involving medical trainees.
So, institutions respond by creating vague policies, broad restrictions, slow approval processes, and a culture of caution that leads many physicians to decide it’s safer not to engage at all. While few clinicians are told outright that they are forbidden from speaking, many are given enough signals to understand that speaking freely may come at a cost.
Meanwhile, online information ecosystems do not tolerate silence. When credible clinicians pull back, the space does not remain empty. More often than not, it becomes a vacuum filled by whoever is willing to post first, loudest, and most confidently.
You can see the consequences across nearly every major health topic online. Conversations around GLP-1 medications are often shaped more by hype and personal branding than by evidence. Vaccine discussions continue to be distorted by bad-faith actors and overconfident non-clinicians. Supplements, hormone optimization, longevity products, and trendy diagnostic tests often gain traction long before the evidence catches up — if it ever does.
This absence of physician voices is not due to lack of care, interest, or even time. It is happening in part because many physicians work inside systems that make public medical communication hard to do safely, quickly, and consistently.
That is the policy disconnect. Leaders, including within health systems, say they want more trusted experts to participate online. But they rarely create the structure, protection, or training needed for those experts to actually participate. We keep treating this as an individual choice problem when it is clearly an institutional one.
If hospitals want to be part of the solution, they need to loosen the kinds of restrictions that suppress responsible physician communication while still maintaining reasonable guardrails.
First, they should create explicit safe harbors for educational content. Physicians should be permitted to discuss general medical education, correct common misinformation, explain evidence, and comment on broad public health issues without case-by-case approval.
Second, hospitals should move away from default pre-approval models for routine educational content. Social media moves too quickly for that to work. A system built around delay is a system that loses the conversation. Requiring physicians to route posts through a communications approval process, often staffed by people without clinical training, doesn’t just create friction. It slows the flow of credible information when patients need it most.
Third, institutions should make a clear distinction between personal professional speech and official brand communication. Not every physician post is a hospital statement. A disclaimer should be enough in many cases, but health systems often act as though any public-facing physician speech is automatically institutional speech. That assumption is both outdated and counterproductive.
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Finally, hospitals should recognize digital education as legitimate professional work. If institutions believe informed patients and better-informed clinicians matter, then public-facing education should not be treated like a hobby or a liability. It should be supported as part of modern medical leadership. In some cases, hospitals may even need a certain level of tolerance to the minor public disagreements that may arise from content posted online.
None of this requires hospitals to give up oversight. It requires them to stop treating physician communication as a threat.
I now work full time as chief medical officer at HealthCentral, and I know firsthand how much demand there is for credible clinician voices online. Guardrails and physician voice can coexist. KevinMD built an independent space for physician voices when institutions wouldn’t, and the American Medical Association and Mayo Clinic have each created social media policies that explicitly protect physician speech. HealthCentral recently launched Drops, the first vertical video consumer app designed specifically for people living with chronic, serious, and rare conditions, built around clinically vetted creators as an alternative to the unfiltered content dominating mainstream social media.
The health information ecosystem is sick. Doctors can help heal it — but only if hospitals let them.
Adam Goodcoff, D.O., is chief medical officer at HealthCentral.