December 14, 2018
3 min read

Social Media as a Creative/Disruptive Force in Rheumatology (or Why I Now Tweet)

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I have been reflecting on the amazing American College of Rheumatology meeting held in Chicago — also known as #ACR18, a hashtag that those of you in the social media universe immediately recognize as a metadata tag. For the rest of you who don’t recognize this as the hashtag of the meeting itself, I urgently counsel that perhaps it is time to join the ACR social media community. I believe you will enhance your intellectual return on investment in terms of self-learning while attending this meeting that we all love.

Think about it this way: I used to think of myself as more or less a voyeur at large meetings such as ACR, slogging my way through on a daily basis, seeking out what I hoped would be important and interesting to me. However, I continually felt like I was peeking through a tiny keyhole into a large room filled with thousands of presentations. Remember the meeting books that you ripped apart because they were so heavy, your back hurt just to look at them? Yes, I saw a few presentations and addresses but had very little idea of what was truly going on until months later when summaries and synopses would appear in print!

Leonard Calabrese, DO
Leonard H.

Advance to the early internet era when we could actually go online and read summaries of varying aspects of the meeting. These were generally produced in a studio and took many weeks to be delivered. I actually produced a series of ACR/EULAR rapid response CME programs through the Cleveland Clinic way back in the last century. I loved it, but it was nevertheless slow, laborious and expensive.

Can you remember when the international meetings began to do away with the program books and iteratively forced us to use apps (and USB drives) to follow the meetings? I do and remember this as being stressful, probably because my online skills were then lacking, and the early versions of meeting apps were terrible! Such a disruption!

With #ACR18, I would say we have now truly arrived. The app for the meeting was simply incredible: intuitive, easy to search, and you could see the slides so clearly! I was getting online praise from many for the slides I showed at my packed immune-related adverse event basic session — I didn’t even know they were being posted in real time!

I must applaud ACR for their forthright efforts to organize and advocate our social media activities. Additionally, I must give a big shout out to Jack Cush, who is the clear and titular leader in the rheumatology social media world! If you don’t believe me go to, search for #ACR18 and look at the “Top Influencers” list.

From a personal perspective, I found the ACR Twitter feed amazing and exhilarating. For the first time, I can honestly say I could feel the meeting move beneath my feet as I looked down to pick and choose what I wanted to know more about. Even while I was attending sessions, I was learning from websites such as Healio Rheumatology and RheumNow, who were pouring out snapshots of #ACR18, as well as providing deep dives with our key opinion leaders.


For those of you who are still resisting engaging in social media and still think of Twitter as the playpen of juvenile politicians (no one specific in mind, of course) or social gadflies telling you what they ate for breakfast, wake up and start reaping the benefits. I am urging you to join @LCalabreseDO, @HealioRheum and the growing legions of people in the rheumatology world who are creating a new space for rapid-fire creative thinking.

In closing, I want to parse a criticism I often hear (and probably one I formerly espoused) about science and social media — namely, that it is not a forum for critical thinking. I do believe that, unfortunately, we live in a world of fast learning, which scans but does not appraise, which values metrics not wisdom, and generally responds to facts by spitting more facts at you.

I certainly can see that those who live only with social media as their dominant source of knowledge and communication are vulnerable to these limitations and inadequacies. I strongly believe we desperately need to continue to protect and value slow knowledge in general and slow medical education in particular — which still puzzles over mystery, seeks wisdom over facts and cannot be acquired on Twitter. If you find this concept of slow medical education of interest, I would refer you to an elegant academic article on this concept by Joseph Zarconi, MD, and colleagues, published in Academic Medicine.

My position now is that I am increasingly convinced that fast learning can inform slow learning (though not replace it) and in a way these forces are not exclusive but more yin and yang: they are complementary, interconnected and interdependent. I encourage all of you to join me in finding the interesting things in real time with the “help” of technology, which includes social media, and then pick the things you are passionate about and engage them — slowly.

Disclosure: Calabrese reports serving as an investigator and a consultant to Horizon Pharmaceuticals.