Physician and Biomedical Scientist Harassment on Social Media During the COVID-19 Pandemic

Introduction

Advocacy on social media is not without risks. In a survey conducted before the COVID-19 pandemic, 23.3% of physicians reported personal attacks on social media, primarily for public health advocacy on topics including firearms, vaccinations, and abortion access.1 While the Surgeon General2 encourages physicians and scientists to use social media to address misinformation,3 concerns for harassment remain.4-6

To our knowledge, no study has examined online harassment of physicians and scientists during the pandemic. We surveyed physicians, biomedical scientists, and trainees who experienced online harassment during the pandemic, particularly relating to dissemination of COVID-19 public health information.

Methods

Northwestern University Institutional Review Board deemed this survey study exempt from review and informed consent because all responses were anonymous. We followed AAPOR reporting guidelines.

Survey design mirrored a prior study1 and used a collaborative consensus process to develop questions regarding online harassment. Participants were recruited through Twitter using a standardized message (eFigure in Supplement 1). Inclusion criteria included US residence and self-reported profession as a physician, biomedical scientist, or trainee. Participants self-reported demographic information on age, gender, and race and ethnicity. Responses were collected from July 18 to August 21, 2022 (eMethods in Supplement 1). Comparative statistics were calculated with 2-tailed χ2 analyses using Stata, version 17.0 (StataCorp LLC), with P < .05 considered significant.

Results

Of 1028 survey views, 359 respondents met the inclusion criteria. Most respondents (120 [33%]) were aged 35 to 44 years (203 females [57%], 140 males [39%], and 16 [4%] identified as transgender male or man, transgender female or woman, gender nonbinary, or self-described gender). In all, 238 respondents (66%) reported harassment on social media (Table 1). Of these individuals, 210 (88%) reported harassment due to advocacy, 107 (45%) reported harassment on the basis of gender, 65 (27%) race or ethnicity, 31 (13%) sexual orientation, 15 (6%) due to disability, and 74 (31%) due to other self-described reasons. Women and other genders were more likely than men to report harassment based on gender (88 [67%] and 7 [58%] vs 12 [13%], respectively; P < .001). Additionally, 9 of 11 Black respondents (82%) reported harassment based on race or ethnicity vs 14 of 27 Asian respondents (52%) and 26 of 174 White respondents (15%) (P < .001). Harassment based on race or ethnicity was reported by 9 of 13 (69%) Hispanic respondents vs 56 of 225 (25%) non-Hispanic respondents (P < .001).

Of 359 respondents, 228 (64%) reported harassment related to comments made about the COVID-19 pandemic, 111 (31%) reported being sexually harassed, and 66 (18%) reported their private information had been shared (ie, doxxing). One hundred forty-four respondents provided open-ended responses. Representative themes of harassment are shown in Table 2, which highlights extreme threats and impacts on mental health. A total of 228 of 359 participants (64%) reporting any online harassment reported the pandemic changed the way that they use social media. Those using social media to post public health messages were more likely than those who did not to report online harassment (220 of 313 [70%] vs 18 of 46 [39%]; P < .001).

Discussion

Physicians and biomedical scientists experience high levels of harassment online, a problem that appears to have been worse during the COVID-19 pandemic.1 Social media plays a role in disseminating medical and scientific knowledge to the public; however, high levels of reported harassment may lead more physicians and scientists to limit the way they use social media, thus leaving propagation of misinformation unchecked by those most qualified to combat it.

Study limitations include potential nonresponse bias, self-selection bias, and recall bias, as participants were asked to recall any instances of harassment, whether remote or recent. At a time when physicians and biomedical scientists need support and their advocacy is vital to the national interest more than ever before, they are being badgered, doxxed, and sexually harassed. Institutions and companies should support those who are attacked and provide mechanisms to reduce harassment and provide accountability.

Accepted for Publication: April 30, 2023.

Published: June 14, 2023. doi:10.1001/jamanetworkopen.2023.18315

Corresponding Author: Regina Royan, MD, MPH, Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, 211 E Ontario St, Ste 200, Chicago, IL 60611 (mroyan@med.umich.edu).

Author Contributions: Dr Royan and Ms Pendergrast had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. These authors contributed equally to this work and should be considered co-first authors: Dr Royan and Ms Pendergrast.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: Royan, Pendergrast, Woitowich, Trueger, Wooten, Arora.

Drafting of the manuscript: Royan, Pendergrast, Woitowich, Trueger, Jain, Arora.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Royan, Pendergrast.

Obtained funding: Royan.

Administrative, technical, or material support: Royan, Pendergrast, Trueger, Wooten.

Supervision: Trueger, Jain, Arora.

Conflict of Interest Disclosures: Dr Royan reported receiving salary support from the American Medical Association as an Assistant Editor for JAMA Network Open. Dr Trueger reported receiving salary support from the American Medical Association as the Digital Media Editor for JAMA Network Open. No other disclosures were reported.

Disclaimer: Dr Royan is an Assistant Editor and Dr Trueger is the Digital Media Editor for JAMA Network Open, but they were not involved in any of the decisions regarding review of the manuscript or its acceptance.

Data Sharing Statement: See Supplement 2.