Best Practices: Austin Chiang
The President and Founder of AHSM and Director of Endoscopic Bariatric Program at Thomas Jefferson University Hospital on the common misconceptions about gastroenterology and how to build a professional social media practice.
Dr. Austin Chiang is a triple board-certified, dual ivy-league (Harvard, Columbia) educated and trained gastroenterologist and advanced endoscopist. He’s passionate about empowering patients with accurate medical information online, as well as guiding healthcare professionals on how to build their own trusted and effective social media practice. Read on to learn how Dr. Chiang got started in medicine, why he chose gastroenterology and advanced endoscopy, and why he believes it’s crucial for patients to find accurate and trustworthy medical information online.
How did you get started in medicine and how did you choose your specialty?
Getting into the field of medicine was a pretty natural process for me. When it came time to decide on which career to pursue, I knew that medicine would resonate perfectly with my interest in science as well as with my problem-solving and service-oriented personality.
Landing on my specialty was a longer process of discovery. I went into medical school with an open mind, but because of the many physicians in my family I had, at least initially, a somewhat skewed perspective of what medicine was really like. One of the key questions we ask ourselves in medical school is: “Do I prefer something surgical or medical?” Reflecting on this question made me realize that a part of me really enjoyed the procedural aspect of surgery, but that I also gravitated toward the problem-solving thought process that internists have in approaching the patients and conditions they treat. Initially, I considered pulmonary critical care, because I really enjoyed my experience working in the intensive care unit. I also considered interventional cardiology, but ultimately decided on gastroenterology, which has provided me with the perfect balance between procedural work and cerebral problem-solving.
Within gastroenterology, I would say that I have the most procedurally oriented subspecialty as an advanced endoscopist. We deal with the most complex cases, which often involve less invasive approaches to conditions that have been previously treated surgically. And as technology continues to advance in medicine, we’re able to manage more and more conditions endoscopically.
What are some of the most common misconceptions about gastroenterology and endoscopic weight loss?
The most common misconception about gastroenterology is that all we deal with is the gut, but I also treat pancreas, bile, and liver conditions. There’s so much variety in the field, and nowadays it’s so sub-specialized that there are gastroenterologists devoted to liver disease, liver transplants, inflammatory bowel diseases and celiac disease, as well as gastroenterologists who focus on procedural care, like treating various complications of cancer.
Endoscopic weight loss is relatively new, but it has already become a niche in and of itself. One of the common misconceptions is that it’s so fresh so that we still don’t understand enough about it. Of course, like everything in medicine, we could always know more, but a lot of these procedures have been done for quite some time. In fact, some of the devices used in bariatric endoscopy that have only been approved by the FDA in the last five years (like intragastric balloons, for example), have been used overseas for well over a decade.
Another common misconception is that the weight loss resulting from these procedures isn’t durable. But the data shows that many of these procedures, like endoscopic suturing, have provided durable weight loss for up to five years (the longest period of capturing data currently on record). On top of that, many assume that bariatric endoscopy is only for people who want to lose weight and haven’t had any other procedures done, but the fact of the matter is that we often treat complications of bariatric surgery. Because of this, our field is a good compliment, not competitor, to bariatric surgery, since we help them out with complications on their end, and vice versa. Plus, our procedures are indicated for patients with a slightly lower BMI (30–35), which enables us to capture another segment of the population that is obese and can benefit from these solutions.
How has the field of obesity medicine advanced in recent years?
There’s always controversy when it comes to weight loss. What makes the field even more challenging is that everything needs to be individualized for the patient. For example, when we argue that some diets are better than others, we have to stop ourselves from approaching it as a population-wide intervention, and approach it instead as a case-by-case solution that’s catered to the individual and their specific needs and underlying conditions.
Generally, there’s a lack of consensus when it comes to obesity medicine, but that also means that there’s an opportunity for us as healthcare professionals to discover the best solutions, devices, or procedures on the horizon. And as technology gets even better, we’ll continue to see more effective and creative devices offered.
Also, I think our improved understanding of the body and gut microbiome in the future will play a part in terms of learning what contributes to weight gain and weight loss. It’s all very exciting!
What inspired you to start the Association for Healthcare Social Media (AHSM) and the #VerifyHealthcare movement?
My underlying motivation has always been understanding how the general public gets their medical information. Early on in my training, it became clear to me that patients were getting their information outside of the clinical space. Patients receive a lot of their medical information from the internet and social media, and ultimately there’s a lot of information out there that’s inaccurate. Also, from a physician’s perspective, there’s very little existing guidance on how to use social media to communicate effectively and safely. For example, there’s no best practices when it comes to things like whether or not it’s appropriate to post patient images (not necessarily images of their likeness, but photos of their radiographic images, for example). Lastly, how do we go about making sure that the people who are online and talking about health are trustworthy?
The Association for Healthcare Social Media (AHSM) ultimately stemmed from the hashtag campaign, #VerifyHealthcare. The campaign was inspired by the disturbing trend we noticed of people misrepresenting themselves as dentists, doctors, nurses, or other healthcare professionals online. Sometimes these people were students, but often they were not in the medical field at all. We soon realized that there are a lot of self-proclaimed experts online spreading misinformation that could not only be harmful, but also potentially delay appropriate care for the patient.
I’ve spoken openly about an account and online personality called the “Medical Medium,” whom a lot of celebrities endorse and who has published several books, but the majority of his claims are never scientifically backed and are often very problematic. Those of us working in the hospital have seen patients who, inspired by personalities and accounts like these, have either discontinued their medication or opted for a home remedy over the more appropriate form of care that could, in some situations, help prevent the progression of certain diseases. That’s really what got us thinking about how we could encourage other healthcare professionals to get online and communicate effectively and responsibly with their patients and community.
Our mission is to provide guidance and define best practices around healthcare in social media, but we also want to advocate for our contributions to social media. Right now, medical professionals are not incentivized to contribute to health journalism and social media (though we may be incentivized to contribute to medical journals). Hopefully, we can all spend a little more time in the future on speaking to the public and meeting them where they are.
What advice would you give to a physician just starting to build out their social media presence?
It’s important to define what you want to achieve with social media, and to use that goal to select one platform over another. There are many different platforms out there, all with their unique audiences and practicalities. Ask yourself: “Who is my audience? Is it other health professionals, trainees, or the general public?” Defining your main goal and audience is important, and will help you to be consistent with your messaging.
Once you’ve outlined your goals, start with one platform and test out the waters to see if it’s manageable. If so, then you can consider branching out. Also, be sure to identify role models in your field and communicate with them on those platforms. I constantly say that social media has to be social; you can’t expect things to go viral simply by posting — there has to be a conversation. It’s all about relationship and network building!
Lastly, social media shouldn’t be a popularity contest. Yes, it’s easy to get caught up in that mindset because of the focus on likes and followers, but being a healthcare professional on social media is really about connecting with your audience (whether big or small) and engaging with them in a helpful and authentic way.
Vital Signs
The most rewarding moment of my career so far was… It’s often the small things, especially for those of us who work in procedural fields. When I see a patient for a follow-up visit and they express how they’re finally able to do the things that they were never able to — that’s the most rewarding. For me, it’s all about helping my patients reach their fullest potential.
Favorite meal? Anyone who knows me knows that I love noodles! I feel a little conflicted confessing this, since I’m often encouraging people to eat less carbs, but there are good alternatives out there!
Best hangout in Philadelphia? I’ve only been in Philly for two years, but both the food and museum scene here are incredible.
Preferred social media platform? If I had to pick one, I would say probably Instagram. I’m also new to TikTok, but I’m liking it a lot.
In another lifetime, I’d be a… a music producer. I have a musical background (my minor in college was music), and I play the classical violin. I listen to all types of music now (though Top 40 is my main thing!), and could definitely imagine myself working in a music studio in another life.
Learn more about Dr. Austin Chiang here and follow him on social media @austinchaingmd!
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