Here’s how doctors tweet medical advice — and what they’re not telling you

Dr. James Simon often tweets about sex, telling patients and other doctors how certain medications can make it more enjoyable. What he doesn’t say is how much the companies that make these products pay him for promotion and consulting work.

A STAT examination of hundreds of social media accounts maintained by health-care professionals finds that while they often tweet medical advice, they almost never disclose potential conflicts of interests. To conduct the investigation, STAT reviewed numerous Twitter lists of medical specialists, found doctors who are particularly active on social media, and scanned their posting history for tweets that promoted particular drugs or devices.

Those doctors were then cross-referenced against a federal database listing payments to physicians from the pharmaceutical and medical device industry in recent years. STAT also searched recent medical journals for disclosures listing the doctors’ current affiliations with drug companies.

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The fees listed below — for promotion, consulting, travel, and related expenses —cover a 17-month period from August of 2013 through the end of 2014. Fees paid in 2015 have not yet been made public.

Dr. James Simon, gynecologist, Washington, DC

Social media activity: Uses Twitter and Facebook to promote several drugs to treat menopause-related conditions, including Brisdelle, made by Noven Pharmaceuticals, and Osphena, made by Shiongi, Inc. He also promotes Addyi, a libido medication known as the “female Viagra,” made by Sprout Pharmaceuticals, a small company purchased last year by Valeant Pharmaceuticals.

Relationship with drug companies: Noven has paid Simon $142,000 and Shiongi has paid him $200,000. Simon worked part-time for Sprout on the development of Addyi and remains a consultant to the company. His fee for that work is unknown.

Comment: Simon said the extensive work he does for drug companies, including helping them develop drugs, would be too long to include as a disclosure in social media.

Representative posts:

#ADDYI is now available for premenopausal women! Learn about this first ever medical treatment for #HSDD: https://t.co/FjZKi0cBKA

— James A. Simon MD (@JamesASimonMD) October 20, 2015

Suffering from #HotFlashes? Talk to your doctor about non-hormonal prescription options. #DrSimonSays pic.twitter.com/FP5mAiT20J

— James A. Simon MD (@JamesASimonMD) September 9, 2015

Dr. Devin Garza, gynecologist, Austin, Tex.

Social media activity: Uses Twitter and Instagram to promote a robotic surgical technique, known as “da Vinci surgery,” which can be used for hysterectomies and other gynecological procedures.

Relationship with device company: Intuitive Surgical, Inc., maker of the da Vinci Surgical System, has paid Garza $252,000.

Comment: Garza said he considers himself a teacher, and is eager to educate other doctors and patients about the benefits of minimally invasive surgery using the da Vinci system. The company’s payments compensate him for his time out of the office, he said. He believes disclosure is important, but also feels patients on social media may not understand the complete picture if they only see the dollar sum and name of company, and might get the wrong idea.

Representative posts:

Have you heard of the da Vinci Robot? With the da Vinci® surgical method, we place robotic… https://t.co/QdBswuDXTo

— Devin Garza MD (@devingarzamd) February 17, 2016

Dr. Garza is proud to be a da vinci Surgeon. The da Vinci Surgical System is a sophisticated robotic… https://t.co/N7Ho0y8yWB

— Devin Garza MD (@devingarzamd) September 17, 2015

Dr. Seth Baum, cardiologist, Boca Raton, Fla.

Social media activity: Uses Twitter to promote the benefits of Juxtapid, a drug for inherited high cholesterol made by Aegerion Pharmaceuticals. He also promotes dietary supplements made by Vitamin Remedy, a company he founded.

Relationship with drug companies: Aegerion has paid Baum $ 130,000. He is the founder and director of clinical development at Vitamin Remedy.

Comment: Dr. Baum declined to comment.

Representative posts: 

Video: Familial Hypercholesterolemia (FH): Underdiagnosed and Undertreated https://t.co/FS50P9FNwt #knowFH #Cardiology #hearthealth

— Seth J. Baum MD (@SethJBaumMD) February 23, 2016

Blog post: Multivitamins and Multi-Minerals – A Simple & Inexpensive Insurance Policy https://t.co/ZRB1BUsktF #nutrition #healthcare

— VitalRemedyMD (@VitalRemedyMD) February 12, 2016

Dr. James Berenson, oncologist, West Hollywood, Calif.

Social media activity: Uses Twitter and other social media to promote Revlimid, a treatment for multiple myeloma made by Celgene.

Relationship with drug company: Celgene has paid Berenson $58,000.

Comment: Berenson declined to comment.

Representative posts:

This just in. My thoughts on treating patients with Revlimid. I talk about treatment options, current research… http://t.co/ZXxOPmzX

— James Berenson, MD (@myelomadoc) May 11, 2012

Dr. David Portman, gynecologist, Columbus, Ohio

Social media activity: Uses Twitter to promote Addyi, the female libido drug made by Sprout Pharmaceuticals, a division of Valeant.

Relationship with drug company: The company contracted with Portman as a consultant in 2015. The amount of the contract is not yet available on a public database.

Comment: Portman said social media can be complicated for physicians, “a brave new world” full of challenges. “I’m not being compensated to promote anybody’s product,” he said. “I’m being compensated for my expertise, and I hope my patients understand that.”

Representative posts:

First-hand Addyi patient reporting. Very informative and balanced account, straight from the right kind of source https://t.co/EL90SgzNc8

— David J Portman MD (@DportmanDavid) December 21, 2015

First ever FDA-approved treatment for #HSDD #Addyi a huge milestone for women and medicine @DrCastellanos @DrStreicher @DrLeahM

— David J Portman MD (@DportmanDavid) August 18, 2015