Throughout much of history, physicians served as “gatekeepers” of medical knowledge.
Today, before setting foot in a doctor’s office, "most people begin their health journeys online, with either Google — a more traditional search engine — or YouTube, which is most popular for video content,” according to cardiologist Garth Graham, MD, director and global head of healthcare and public health at Google Health and YouTube.
Graham’s team is responsible for “getting higher-quality health information across YouTube, which is the second-largest search engine in the world,” he told Medscape Business of Medicine.
Graham sees information as “another social determinant of health,” in the US and worldwide. As millions rely on online content to guide healthcare decisions, he believes physicians play a critical role.
Family physician Mikhail Varshavski, DO — better known as "Doctor Mike" — agrees. "For the longest time, the medical community discouraged us from being on these platforms, saying we should publish research and speak at medical conferences," he told Medscape Business of Medicine. "That created a vacuum where patients were actually seeking care."
Varshavski, whose YouTube channel has 15 million subscribers, compares today's social media landscape to a “hospital” that initially had no physicians.
"Grifters and snake oil salesmen stepped in and started running it successfully and profitably. Now we're playing catch-up because we're desperately interested in ‘staffing’ the ‘hospital,’ so patients get their questions answered accurately and appropriately."
Power in Numbers
Health-related video views on YouTube have surpassed 1 trillion, Graham said. "The number-one thing we hear from physicians worldwide is they're interested in scaling health information. Physicians go into medicine to help people, and they can often help thousands more with a video than in person.”
For Rena Malik, MD, urologist and pelvic surgeon whose channel has nearly 3 million subscribers, that realization began with a patient who underwent successful cancer surgery but was repeatedly readmitted to the ICU because she didn't know how to care for her newly constructed bladder.
“I realized that we could have done the most successful surgery, but if we didn't teach the patient how their life would change after surgery, we had failed," Malik said. She also recognized that many patients spent hours traveling to appointments, taking time off work, arranging childcare, and paying for parking to learn information they could have received at home.
Already using social media for academic education, Malik spent 6 months creating consumer-oriented YouTube videos. At the end of the experiment, she had more than 1000 subscribers and was reaching more people online than in clinic, so she continued.
Psychiatrist Eric Bender, MD, gained widespread attention after appearing in GQ Magazine’s Breakdown series, in which experts analyze how their professions are portrayed in movies and television. He was surprised when his video drew over 11 million views.
"Many people are reluctant to talk directly about mental health, although they're eager to learn more about it," Bender said. "But if you frame it in the context of their favorite TV shows, films, or comics, more people are willing to learn. It's an opportunity to destigmatize mental health, and that’s a large part of what I do on my channel."
Bender sees his YouTube channel, which has about 31,700 subscribers, as "a fun, creative way to provide meaningful education" and a satisfying complement to clinical practice.
Building Credibility
Graham encourages physicians to apply for inclusion in YouTube's Health Sources shelf, which highlights verified medical channels based on credibility principles developed by the National Academy of Medicine.
"When someone searches for a medical condition, those vetted channels appear first," Graham said. "It's one of the ways we're elevating authoritative health information."
If you're included in the program, YouTube places a tagline under your video — “From a doctor licensed in the US” — to indicate that the creator is a verified medical professional whose content was officially approved by YouTube Health as coming from an authoritative source.
No Physician-Patient Relationship
Physician creators must clearly distinguish education from medical care.
Graham cited the AMA Code of Medical Ethics, stating that a physician-patient relationship begins when a physician starts serving a patient's medical needs. Educational videos should make clear that they provide general information rather than individualized medical advice. Included verbiage should encourage viewers to consult their own physicians about individual situations.
This becomes particularly important when viewers seek advice in the comments section. When appropriate, physicians can direct viewers to their own practice, while avoiding any response that could establish a physician-patient relationship.
Michael Sacopulos, JD, a Terre Haute, Indiana-based healthcare attorney, elaborated.
"Videos discussing general health topics don't constitute the ‘practice of medicine,’" he said. "But answering specific questions, reviewing someone's lab results, or making individualized recommendations can."
Graham also cautions against responding to angry comments from current or former patients. "Remember HIPAA. Don't acknowledge that the person is or was your patient."
Protecting patient privacy extends beyond the comments section, Varshavski added. Physicians may be tempted to share memorable clinical stories, but they should change surrounding details so that no one can identify the patient and patients cannot recognize themselves.
Sacopulos, co-author of Tweets, Likes, and Liabilities: Online and Electronic Risks to the Healthcare Professional, added that photographs of patients require consent — even for educational presentations. Older consent forms may not adequately address today's social media platforms. “Certainly, livestreaming surgery or another procedure should be avoided,” he emphasized.
Augmenting Income
For many physicians, YouTube can help build a practice, establish a professional brand, and generate additional income.
Once creators meet YouTube's eligibility requirements for the YouTube Partner Program, they can earn advertising revenue, as well as income from channel memberships, YouTube Premium revenue sharing, livestream features, and viewer contributions. Many physicians also use their channels to promote books, courses, or other products.
"Providing accurate educational content can build trust and authority," Graham said. "A single video can make a physician known for that topic. Even though YouTube is global, it still has local impact."
That was the initial impetus for cardiologist Sanjay Gupta, MD, of York Cardiology, York, UK, to launch his channel, which now has 536,000 subscribers. He wanted to attract patients after being newly appointed as a consultant in an area with many established practitioners.
"I thought posting online would set me apart," he told Medscape Business of Medicine. It worked. Within 2 years, his videos were drawing patients to his practice. But over time, his motivation shifted to helping viewers better understand cardiology and providing a “gentle database of gentle videos” to help them understand themselves in relation to their health conditions.
Many physician creators receive sponsorship offers, which can be lucrative, “and there’s nothing wrong with that, but transparency is essential,” Graham emphasized.
Accepting brand deals or sponsorships comes with responsibility, noted Varshavski, who turns down 99% of sponsorship opportunities — representing tens of millions of dollars annually — because they involve medically questionable or ethically problematic products. "When we do accept a sponsorship, we vet it thoroughly to make sure it's something we can stand behind, both for myself as an individual and as a medical authority."
AI and Deepfakes
As physician creators become more recognizable, they also become more vulnerable to misuse of their identities.
With the rapid growth of AI, physicians should routinely monitor their digital footprint for unauthorized use of their names, images, or voices. Graham recommends using tools such as Google Alerts to detect use of your likeness. Physicians whose likeness has been stolen should “immediately contact YouTube surrounding copyright and privacy violation tools, so we can expedite a Digital Millennium Copyright Act (DMCA) takedown, which is the copyright owner’s formal request to remove unauthorized copies of their work from the platform.”
He recommended branding videos with a distinctive logo or watermark, not only to strengthen physicians' identities but also to make it more difficult for others to impersonate them.
Companies have cloned Varshavski’s image and voice to promote products he would never endorse. His team uses YouTube’s Likeness Detection feature to identify unauthorized videos and report them for removal. Malik has faced similar problems, with scammers using AI-generated videos and fake Facebook accounts to impersonate her practice and sell supplements. Although YouTube has been responsive in removing fraudulent content, eliminating deepfakes across other platforms has often required outside companies that specialize in online content removal.
Sacopulos described deepfakes as one of the most challenging legal issues facing physician creators. "It's a little like Whac-A-Mole," he said. "You deal with one situation, and five more may pop up." Commercial deepfakes can sometimes be addressed through legal action. But videos falsely portraying physicians expressing opinions they don't hold can be harder to combat. His best advice is to continue monitoring and have unauthorized content removed as often as possible.
Tips for Physician Creators
Background and core equipment. Launching a successful YouTube channel doesn't require a professional studio and high-end gadgets. "You can be pretty successful with a modern smartphone, a wireless microphone, and good lighting," Graham said. Then, as the channel grows, creators can invest in more sophisticated equipment.
But “if you’re filming in your clinic or medical practice, make sure the viewer can’t accidentally catch a glimpse of an actual patient because that’s a HIPAA violation,” Sacopulos warned.
Consistency and commitment. “Just as patients want to know you’ll consistently show up for their medical appointments, viewers want you to ‘show up’ by providing content at consistent intervals,” Graham said.
Maintaining this commitment requires a significant investment of time, Malik added. This can be “hard to balance with clinical practice — even a part-time practice — and with family and other life activities, so only do it if you actually enjoy doing it."
Catchiness, appeal, accuracy. Focus on producing catchy, evidence-based content. Graham encourages physicians to think strategically about discoverability. Clear, searchable titles and compelling thumbnails help viewers find educational content, while the first 15 seconds of a video can be “critical” in determining whether they continue watching. “You don’t want to waste too much time on a long generic bio at the beginning. Instead, immediately show viewers what they’re going to get from the video.”
When considering how to frame the content, Varshavski suggests “thinking about being a consumer yourself and understanding what drives your own clicks and attention. Then apply that understanding to the videos you create.”
YouTube offers the option of creating shorter- and longer-form videos, Graham noted. “Once people have found you through a short-form video, you can direct them to longer-form videos on your main channel.”
Reciprocal Relationship
Having an online following can create a sense of community. When Malik and her husband were diagnosed with breast and colorectal cancer, respectively, within a day of each other, she shared the news with her audience. "There was such an outpouring," she recalled. Viewers offered prayers and encouragement, recounting their own experiences. During an “isolating time,” they provided comfort and support.
Gupta posted videos of himself sitting by the bedside of his father, who had dementia and was dying. “It was a very traumatic time,” he said. “Whilst I watched over him at night, I made videos about dementia and how hard it is for carers who look after people with dementia.”
Gupta recorded his father’s eyes “lighting up” when he played clips of music his father sang to him when he was a child. “I wanted people to know there are glimmers of hope, even in hopeless situations, little memories we can ignite. It helped me remember we can be kinder to ourselves and to others, and show a gentle way of dealing with some things we might have no control over.”
Public Health Role
Far from being an inappropriate role for a physician, YouTube content creation is “an opportunity to make a difference,” Varshavski said. “Even a single experience — caring for a patient in anaphylactic shock on an airplane — led me to encourage the FAA for all airplanes to be equipped with EpiPens.” Another major initiative Varshavski has driven is teaching cardiopulmonary resuscitation (CPR). “We set a Guinness World Record with the American Heart Association teaching the most people CPR at one time,” he said.
He wishes someone had told him at the outset “how important and valuable this mission would become.” Although he always believed in it, he’s come to realize over the past decade that “it plays an enormous role in public health.” Varshavski hopes to “continue wearing the term ‘influencer’ proudly, and achieving phenomenal things.”
Sources in this article reported no relevant disclosures.
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