Credibility or popularity – The divide between publications and publicity!

This is my story. I do not know why any journal would publish this. But if you are reading this, I am sure they had their reasons.

Every practicing clinician has a vision for themselves, for their future. Many envision a great clinical practice with great paychecks, enough for a comfortable livelihood. Some want to make a difference by contributing to the profession and at the same time having a standing or “expertise” in the profession.

In my early days of practice, as a clinician, I was blessed to achieve some great results for my orthodontic patients. I also made it a point to document each step of the treatment for my own records and retrospective learning. As a young, inexperienced clinician back in the days, I always wanted to be popular in my profession. I somehow wanted everyone in my profession to know me. What can I say? I was young and dumb back then.

As time passed, with experience, my results got better and more predictable. One of my close friend called me one day and said “Hey! Why don’t you post your cases on social media? There are many great professional groups out there. You may get a lot of positive criticism and appreciation for your work.” I really liked the idea, but then, I was also very apprehensive regarding how the fraternity would react to my work. What if they’d mock at me, or my work? Such apprehensions are usually very common among clinicians who begin to post their work on social media.

For a couple of years, I was busy posting tens of hundreds of my clinical results on different professional groups on social media, gaining lots of appreciation and popularity, until one day, a very reputed and senior clinician sent me a message saying “Why are you wasting your resources on social media. Isn’t it better to publish them in peer-reviewed journals? It would help you in the longer run professionally. Getting “high” on social media popularity is just temporary. What remains, is your contribution to your profession, in terms of research and scientific publications.”

This made me think hard in terms of what my end goals were. Was it, to gain more popularity and court more patients’ through my catchy “Instagram” or “Facebook” page and publicize myself through my clinical results on social media?, or channel myself to be a scholarly academic, by gaining credibility for myself through publications in high quality peer journals? It was important to choose one of these, in the best possible objective manner.

Posting results on social media is quicker to produce and publish, and more accessible to people who are our target audience. However, without effective peer review or evidence to support results or conclusions on social media, they are assumed to be of lower academic quality than journal articles and it is true that feedback from good reviewers does improve the quality of our work.^[1] Such postings on social media tend to be written in a less scientific format and less organized manner, which may perhaps, mistakenly, also be taken to be an indication of lack of academic quality. It would definitely be easy to gain appreciation or popularity through this route; however, credibility and academic value of a researcher or clinician can be quantified only through robust interrogation of the results, usually seen in peer-reviewed scientific journals.^[2]

Writing about our results in peer-reviewed journals are the best way of communicating scientific evidence. At the same time, scientific evidence contributes to further research and development of the profession. Such literature also benefits teaching and clinical care as well. Apart from academic quality, reasons to publish may be many. Most compelling of them may be academic growth in terms of promotion, in a university setting or accreditation in the form of continual dental or medical education or better chances of acceptance of grant applications, etc.^[2]

However, if the main motive is on actually having an impact, directly on clinical practitioners and gaining maximum reach for our work, I’m not convinced that journal articles could help me do that as well as social media can. One can really be sure of this since; we live in the current era of technological advancement wherein, almost every individual uses social media in some or the other form, including clinicians and researchers.^[3] Social media is a great platform to gain visibility for one’s clinical skills, as the visibility of ones work is far more than the readership of any journal. Moreover, it is free for all. No subscription whatsoever unlike many peer reviewed journals. Many would say that, this is the best and easiest way to gain popularity and spread the reach of your work. But then again, does more popularity mean more credibility?

As an academic as well as a clinician myself, I struggle with, whether to concentrate on publishing in journal articles or social media posts. The obvious solution would be to do both journal articles and social media posts together. However, this is easier said than done.

Firstly, journals do not accept previously published work (even if published previously on social media). This means that if the same social media content needs to be published in a peer-reviewed journal, it needs to be totally refurbished before submission.

Of course, one could choose to get the content published in a journal first, but getting an article published in a high quality peer reviewed journal is a slow and exhausting process. It may take months or sometimes years from the initial draft preparation to final publication. Once published, one or more social media posts may be based out of the publication, but the issue is that these posts may be years out of date, which undermines the timely elements in them.

There is also this issue around how different audiences perceive the quality of literature in different ways. Academic or scientific audiences prefer results that are carefully balanced with an evidence based discussion with precise knowledge of data sampling and statistical evaluation of significance, which may culminate in an ambiguous or less actionable conclusion.^[4] Clinicians, on the other hand prefer clear, actionable conclusions that can be implemented in their practice immediately. In both cases, it is important that the conclusions be based on rigorous and robust interrogation of evidence.^[5]

Peer reviewed journals lend the advantage of demonstrating academic credibility of evidence far better than social media posts, while social media posts may be a better conduit for conveying actionable conclusions or clinical results to the unacademic, more clinical audience (without presenting all of the underpinning academic methodology and analysis).

It is true that the quality and quantity of scientific publications enable authors to gain recognition as “experts” in their field, as mentioned earlier, channeling themselves towards becoming leaders in their profession. The adage “Publish or Perish” is a very intimidating cue for a clinician or researcher to publish constantly. Despite cynicism alone, this phrase also demonstrates the value of scientific evidence. Generating results is just a small part of whole picture. If one does not publish the results, other researchers wouldn’t have the base to further build on it, thereby leaving the overall science stunted.

“But remember to give a little something back.

Give a little something back to the specialty that made you such.

Give a little something back, and it’s not just about money.

Maybe do a bit of research, write a paper, teach some,

And, give back some of your time, talent and treasure to your alma-mater.

Be generous! You won’t miss any meals.”- Steven Jay Bowman (paraphrasing Lysle E. Johnston, Jr.)

After a lot of introspection, here I am, a little wiser and much older, doing my bit, by getting my clinical results and research published in peer reviewed scientific journals, and at the same time, keeping myself very active and abreast on social media.

That’s because, I want it all. I want to be credible, and popular, both.