Young adults following physicians on TikTok consider them more accessible, credible and altruistic than their own doctors, even when the physician-influencers are selling products. Moreover, the followers haven’t actually confirmed the influencers’ medical credentials. Those are the main findings of a new study co-authored by Suzanne Makarem, Ph.D., associate professor of marketing in the VCU School of Business.
“Young consumers are usually very literate when it comes to social media influencers and commercial intent,” Makarem said. “But when you have a physician on TikTok, that becomes something different. We’re already trained to respond positively to credentialed experts. Now we’re seeing them as ‘these doctors who have busy lives and already make a lot of money. They don’t have to be doing this; they’re taking the time to educate me.’”
“We call it the mere social media presence effect,” Makarem said. “What a physician influencer recommends may carry more weight than what their own doctor tells them. That should give us pause.”
Makarem’s line of research is consumer experiences with healthcare services. She and two colleagues targeted social media for investigation because it’s ripe for health and wellness influencers.
“Gen Zers turn to social media for health information at significantly higher rates than previous generations,” Makarem said, referring to those born in 1997 through 2012. “TikTok has emerged as especially influential for health information.”
For their study, Makarem and her colleagues narrowed their focus to 11 U.S.-based, licensed medical doctors with significant reach and impact on TikTok; in other words, “the mega influencers,” Makarem said. Reporting on her team’s findings, “We saw they’re a lot like other influencers but lean more toward the professional. They’re not singing and dancing like many others, but they do share personal information. And they’re likely to wear medical attire, even if they're not talking about medicine. Like, they're making a peanut butter and jelly sandwich in their kitchen, but they have a lab coat on.”
That lab coat and other accoutrements hold sway, Makarem added. “I asked, ‘Have you checked whether these physicians are actual physicians?’ And the response was, ‘No, but I’m sure. They’re wearing a stethoscope; there’s a diploma hanging on the wall; they have scrubs on. I don’t think they’d be lying about this.’”
Moreover, followers see the physician influencers “practicing what they preach,” Makarem added. “They show themselves at the gym, exercising, using their own products, their own supplements, showing the books they’ve written. So the influencers are making money,” Makarem said. “But the people following them are not reading commercial intent. And if they do recognize the commercial intent, they say, ‘Well, they have to; if they could do it for free, they would.’”
Another powerful aspect of social media, Makarem said, is comments from other followers. “If you’re reading things like, ‘Thank you, this changed my life,’ then you see the positive impact of the influencer on other people.”
“Young people really respect physicians who are on TikTok,” Makarem said. “They say things like, ‘The doctors are competent. They’re experts but they explain things to me in easily understood terms. They’re accessible.’ And we found that the followers have very high adherence. They buy the products; they follow the advice.”
It’s a startling contrast, Makarem said, to the followers’ reported experiences with their own doctors. “We’d ask and they’d say things like, ‘My physician isn’t interested in preventative medicine. He wants me to keep coming to see him because that’s how he makes money. I have to make a co-pay to see him and then I get information I can’t understand.’”
Makarem says her study highlights the importance of educating consumers to verify credentials and also to recognize commercial intent no matter who’s doing the selling. Meanwhile, she adds, physicians who’ve shied away from social media may want to reconsider. Of all the health and wellness influencers on platforms, only about 17 percent are conventional medical professionals such as doctors, dentists and nurses, according to a study by the Pew Research Center.
“There’s room for them,” Makarem said. “I'm sure there’s resistance because of liability, and because something could be true today but not tomorrow and they don’t want old advice on record. So I understand why physicians are reluctant, but it is a way to be effective. Social media is a very effective platform.”
Makarem’s paper, “When Doctors Become Influencers: How Social Media Presence Disarms Persuasion Knowledge and Shapes Consumer Behaviors,” was published in the Journal of Consumer Affairs. You can read it here.