Social Media and Advocacy (4 Nov 2026)

SPEAKER_00 0:00

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SPEAKER_01 0:32

Hello and welcome to this episode of Career Conversations brought to you by the Trainees and Members Committee of the Royal College of Physicians of Edinburgh. I'm Dr. Heather Kennedy and I'm a member of the Trainees and Members Committee. Today I'm delighted to be joined by Dr. Amy Perkins, consultant dermatologist at NHS Fourth Valley and honorary clinical lecturer at the University of Glasgow. You may have listened to our previous episode discussing Amy's specialty of dermatology. This episode focuses on Amy's other work in public health advocacy and social media. Welcome Amy and thank you for joining me again. My absolute pleasure. Thank you so much for inviting me. So to kick us off, in addition to working as a dermatologist in the NHS and being an educator, what are your other roles and interests?

SPEAKER_02 1:20

So I love dermatology, first of all. I think it's such a vibrant, mixed specialty. And it's really allowed me to open so many other doors over the past few years and it's really empowered me in that way. So with the past few years, I've had a few strings of my bow. I think the main thing that has really taken off over the past few years is my interest in social media and how that can be used for good. I always think that social media is in eco-parts the best thing in the world and the worst thing in the world. You know, we all know how dangerous social media can be. It is never out of the news. But at the same time, just imagine if we could harness all the good, all of the wonderful things that we can get from social media without the bad. Now, obviously, this is a pipe dream. Like this is never gonna happen. But even if we can achieve a fraction of the benefit, it's just an incredibly powerful tool with some incredibly strong drawbacks. So I've got very involved in the world of social media over the past few years, and my main passion in that way is tackling misinformation related to skincare and dermatology. I think dermatology is so interestingly placed in that world because many members of the public, and indeed some doctors, blur that line between what is skincare and beauty and what is actually a dermatological disorder. The classic example being acne. So, for example, I was talking about this in the radio yesterday in how many people wouldn't necessarily go to their GP for help with acne, and they're not really aware that this is a medical problem, this is an inflammatory disorder. But we are now so bombarded with content on social media from influencers and the like and brands saying, oh no, all you need to do is buy this cream, buy this cleanser, and your spots will magically. Now, importantly, brands do have a role, and there are certainly some amazing over-the-counter products that can help. But the problem is that if you haven't had your skin assessed, like we could be missing something else. So acne has a huge psychological burden. And I think the fact that people are going to social media for their initial help and relying on people who are not healthcare professionals, that just has such a worrying undertone for me. And people are ultimately ending up in dermatology clinics having spent enormous amounts of money on products and various other bits and pieces like light therapies and so on that were just never going to work. So I think social media has a really powerful role here. So I started working with OpenAI as an external contractor in November 2023 to November 2025. And over that time period, I learned so much about not just AI, but also how teams can work together effectively, how we can communicate well in not just kind of in our departments, but also internationally and what we can learn from different cultures. And that was something that I did not expect to learn in that capacity. So it was such an enriching experience. I also work with the Royal College of Physicians, I'm on the board of examiners in the part one exam for dermatology, which I love. It is so interesting, it is so perfectly suited to my brain because essentially what we do is kind of nitpick through all of the questions and just make them as perfect as we possibly can. And I also work with the team who ensure the security of the exams to try and minimise the risk of anyone cheating and so on. So I've just recently got involved in that due to my interest in AI, because of course this is becoming an increased risk to how well the exams are conducted. So that's been a really big passion. I also work with the skin cancer charity Skins, that's SKCIN, as one of their ambassadors. And this has really come about because in dermatology, my major passion is skin cancer prevention, because this is something I think is really missing from the NHS. Everyone knows that sun can contribute to an increased skin cancer risk, but it's more than that. About 85 to 90% of skin cancers are preventable. Like that is enormous. And it's estimated that £750 million per year is spent on the management of skin cancers in the UK. Like that is colossal. Can you imagine if we managed to reduce that even by 50%? Never mind 90%. You know, it's enormous. So I spend a lot of time talking to many people about the importance of protecting your skin in the sun, correcting various myths and so on that have been exacerbated by social media. And the Skin Cancer Charity are an amazing organization who work with schools. They have an amazing program called Sun Safe Schools, which basically involves schools signing up to inform them and educate pupils who attend on how you can protect your skin from a very young age. So that's something I feel really, really passionately about, and it's extended into lots of different roles. I work a lot with the media in various components. So through my work with social media, that has opened lots of doors into talking on the news, talk on the radio quite a bit, and with various international agencies. And yeah, it's something that I feel really passionately about. Of course, it does have its pros and cons. I think I'm sure a lot of people have various derogatory comments because I think some people can think that if you're in the media, that there is an element of self-promotion. And of course, you are aware of people saying that to an extent, but ultimately it's something that I've always felt really passionately about because social media is the way that we can get the message across. And of course, you take the good with the bad, and the amount of benefit, the amount of people that contact me on a regular basis to say that I and the skin cancer charity have contributed to their changes in behavior, or you know, they've done a course that's skin run and they have been able to flag a potential skin cancer, and you know, someone has gone to the GP to have it checked. It's just amazing. It's so amazing to hear. And of course, there's the trolling, there is a huge anti-sunscreen community on the internet, and there's also a large community of people who just flat out deny that UV can cause skin cancer. So, of course, that can be hardgo. And you know, of course, your work is constantly with you, your work is constantly on your phone with social media and so on. So there's a lot to deal with, a lot to juggle, but it altogether gives me the dream job, honestly. This is the job that I have genuinely wanted my entire life. So sometimes I moan, but then I catch myself and then I'm like, no, do you know what? This is what I've worked for.

SPEAKER_01 7:30

Wow, it sounds like you're very busy with all of those different things. I don't quite know how you managed to fit it all in, but that all sounds really interesting and exciting. And like you say, you've learned different things from each aspect and developing different parts of your career and your interest in dermatology in the world, not just in your NHS role. And you touched on briefly there's some of the challenges of social media. And I think a lot of doctors, myself included, feel quite daunted with the prospect of engaging with the wider public on social media about health-related topics, particularly when tackling misinformation and perhaps dealing with a fallout of going viral or experiencing trolling. And I just wondered how this has affected you and what advice you'd have, and in the context of what your role is in social media as a doctor.

SPEAKER_02 8:16

Of course, yes. The first thing to say is social media is weird. As humans, we are not designed to deal with thousands of people seeing what we're up to, and it is such a weird world that this is now the reality. And I am so conscious of that. You know, I will take a random photo and I'll put it on Instagram, and then people will like and comment and ask about my day. It's so interesting. It's like a very strange world we're in. And there's so many parts to this. So, as I said, the main reason I got into social media was to really tackle the widespread misinformation that is out there about skincare and dermatology. And there is lots of evidence to suggest that if you don't just post about medicine and you also post about your life, people trust you more. Okay, so we call this like developing parasocial relationships. And we can all relate to this to an extent. So I'm sure many of us, anyone who uses social media, you will probably have followed someone at some point and you kind of become interested in them. You kind of get this vested interest. Oh, I wonder how they got on at that thing they were going to do. Oh, I wonder how their pet dog is doing, you know, all these things. You've never met someone, but you become interested in them. And if something bad happens to them, you feel bad for them. So we call this like parasocial relationships, and we know that parasocial relationships are a huge source of trust and especially important for the medical community. So this is where it gets weird. Like so when I first started posting about dermatology, I posted purely medical content. I would post about, oh, how do you recognize a bad mole? How do you know a sunbed is not good for you, all these sorts of things. And you know, people were engaging a little bit, but it was mainly my friends and kind of well-meaning colleagues and so on. But the weird thing is that when I started posting more about my life and kind of not just the doctor, but the human behind it all, that's when things really started to take off. And that's where people begin really to trust you. And that is strange. You know, that is a weird phenomenon that's so specific to our times. And, you know, don't get me wrong, it's very empowering when people begin to take you seriously in the world of social media because it's a hard nut to crack. But that comes with its sacrifices. You know, I'm very conscious that whenever I post a picture of my partner or my family, I'm putting that photo off of them on the internet. And you know, and many, many people who they don't know will see that. And so, of course, you need to always think about making sure they're okay with it, getting their consent. And of course, just because they're okay with it now, it doesn't mean they'll be okay with it six months from now. And then at the same time, I'd be posting maybe about my flat and my surroundings. There's the security issues to think about. You know, many people have had issues with stocking and so on. So, you know, there's so many wider implications to consider. And of course, patients come in and they follow me and they've seen what I'm up to. And you know, that is again another slightly uncharted territory to navigate. And of course, you need to maintain that relationship with your patients, and it's a strange thing to handle.

SPEAKER_01 11:13

That sounds like a lot to navigate and a lot to be aware of, and as well as the navigating social media and as doctors, how do you advise that we can improve our digital literacy?

SPEAKER_02 11:24

So, digital literacy is one of my favorite topics. I find it fascinating because really many of my friends, family, colleagues don't want to engage with social media, and that's fine. That is absolutely fine. I would never pressurize anyone to put their life online. But we cannot ignore the fact that the majority of our patients are engaging with social media. And even if they're not personally using social media, they will have friends, family, other members of their community who are engaging with social media and relating their influences onto our patients. So social media is impacting everything in our life. I think it's estimated at the moment that around 60 to 70% of the world are using social media. And average screen time is over two hours a day. Like that's huge. And the majority of health information that young people get now is from their screens, from social media. They are not going to a library and looking up a healthcare textbook, are they? You know, they are going online, they're Googling, they're looking at what their influencers are up to. And this is why I think it's so important that we all are aware of this. And I think a big thing is validating our patients' experiences. So, for example, a very common situation for me is that I might have a new patient with eczema. Say, for example, they're in their 20s. They might have had eczema since they were a baby. It's something they've grown up with their whole life. They have often relied on creams from their GP, they've maybe bought a few creams themselves, and maybe they've been bullied, they've always felt a bit self-conscious of their skin, and their skin has really become a huge part of their identity. As they've got older, they started using social media, TikTok, Instagram, and seeing other people who have skin that looks like theirs. And these people, you know, influencers who have eczema are sort of telling the would-be patients about their own experiences, they're seeing what products work for them. Now, sometimes these people on social media are talking about medical interventions like methotrexate or drugs or light therapies, so on and so forth. But a lot of the time they're not. And a lot of the time they're talking about things that have no evidence and might actually even cause harm. So when this patient then turns up in a dermatology clinic, they arrive with so many preconceived ideas. And in maybe the olden days, so say for example, 10-15 years ago, a patient might come in and they might not know very much about eczema. They might not know very much about treatment options, but now it's very common that they know so much. And some of it might be totally factual and evident-based, but lost of the time, a lot of what they kind of talk about is not grounded in evidence-based medicine and has been driven by external factors, anecdotal evidence, and so on. And it's my job, and indeed all of our jobs, to unravel that, but crucially maintain the relationship with our patient. So, of course, there are many challenges to this. This takes time. A standard new patient dermatology appointment is meant to last 20 minutes. But I had a new one this week that I ended up staying with him for 45 minutes because he had the very common situation in his 20s, all of these similar ideas. He'd looked at buying things online to inject himself with that he thought might work and so on and so forth. And if we were thinking about cutting corners and saving time, the easiest thing, the tempting thing might be to say, nope, we're not doing that, we're just gonna do what I see. But we all know that's not good medicine, but we've all been in a situation where that's the easier thing to do. And of course, I'm sure we're not proud of it. But sometimes that is the easiest thing to do, and you know, we don't want to do it, but we just do. But I always, if I can, try and spend more time on that in a consultation. Yes, it makes me run late. But I think the maintaining that rapport is so important, validating what they've been through, understanding that this has dominated their life for such a long time.

SPEAKER_01 15:03

That's really interesting. I think as part of our role and responsibility as a doctor, in conjunction with digital literacy, is understanding what's out there in the realm of our own specialty to then understand the context that the patient is coming to us and having discussions with us. So then we can frame things in the context of what they are knowing and understanding from their own feelings.

SPEAKER_02 15:24

Yeah, so I don't really post on TikTok that much professionally, but I do use TikTok. I always think of it as my kind of like spy glass. So we talk about the algorithm, and the algorithm is basically what we are programmed to see on our social media. So everyone has a slightly different algorithm, and it all depends on how long you watch something for, how often you like things, who you follow, what they follow. So everyone's algorithm is slightly different. So I've deliberately set up a very different algorithm on my TikTok so that I am fed lots and lots of anti-sunscreen and pro-sunbed content and tanning hacks ways. So that's kind of my like little spy way to see and keep a tab on what's going on. And you know, it's shocking. It really is kind of mind-blowing. But I think it's so important to have that awareness because so many of us don't.

SPEAKER_01 16:11

Wow, that's super interesting to think about that different narrative that's depending on what you look at and what you're interested in. And thanks, Amy, for sharing your experience of using social media as a medical professional. And as you mentioned, you'd spoken with colleagues at different points during the process of raising public health concerns via social media. And I think it'd be good for our listeners to also refer to the GMC guidelines on using social media as a medical professional to help guide how we can interact with the online community. We'll include that in our show notes as well. And you mentioned there about sunbeds, and I believe you've been quite highly involved in highlighting the danger of sunbeds and irresponsible sunbed advertising in the UK, in I guess, more your public health advocacy role. And can you talk us through about how you became involved in this and what steps you took?

SPEAKER_02 17:04

Yeah, of course, delighted. So I think for a long time, I think I've taken umbrage at the fact that people don't stand up for things. And of course, the older we get and the more senior we get in our career, the easier this becomes. And I think I very much have my parents to thank for this because they've always encouraged me to stand up for what's right. And, you know, it's not always easy. And of course, you often get some pushback on this when you challenge things. But I think for me it has been so rewarding because of course you need to know what you're talking about. Like you need to be sure you're not going to make a fool of yourself. But it all really started when I began working in dermatology as a clinical fellow because I was so struck by how commonly people were coming in with skin cancers having used sunbeds. And many of them didn't know that sunbeds are have a known link with skin cancer. And many of them would have all these preconceived ideas that they were, you know, protecting their skin, it was helping their skin and so on and so forth. So, you know, from that I began to think no one's really talking out about this. And I began thinking about it a lot, and I began to see these adverts really catching my eye and really becoming really alarming me, to be honest, because these adverts were making all these sorts of claims saying, use our sunbeds, it will boost your vitamin D and it will reduce your risk of heart disease and it will make you live longer, it will make you lose weight. Pretty much every single health claim they were making it. And the thing is, like the problem is that when there are partial truths, marketers can pounce on this. So vitamin D being the obvious example. So we know that we get vitamin D from EV lights, you know, our skin produces it, but there's a big caveat here. It's a big balance. EV light is such a carcinogen, and skin cancer, whilst most skin cancers don't kill people, the burden on quality of life, and of course, for many people, the mortality is enormous. Skin cancer management costs NHS 750 million pounds per year. That is colossal. And I really began to feel passionate about this. And when I saw these adverts saying that sunbeds were good for you and were actually kind of doing the opposite of shortening your life, I contacted the advertising standards authority and complained about them. So, to be honest, I didn't really think too much of this. I think I was just feeling a bit raging that day and I was like, oh, I know what something needs to be done, and I'll just, you know, do this. I felt like a bit of a kind of angry person that day. I submitted it actually anonymously because, you know, I was a bit nervous about what the sunbed industry might say or do if they thought I was kicking up a sink. And then a few months later, I began to get more involved in the kind of media side of medicine. And I mentioned to a journalist that I had made this complaint. And you know, as soon as I mentioned it, I completely regretted it because she was so interested. And I was like, oh no. And she said, like, I want to run a story on this. And I thought, no, I'm gonna get into so much trouble, maybe I've done something wrong, maybe some bits are good for you, you know, all this sort of thing spinning around my head. And so that got published in a newspaper last summer, shortly after I'd made the complaint. And then, of course, things started to heat up a bit because actually it was really quite unusual that someone had made a complaint like this, especially not a dermatologist. And so things kind of gained a bit of momentum. At the same time, I started working with the Scottish Government and the Sunbeds Safety Group to try and lobby for sunbeds to be banned in Scotland and the UK in general. And in September of last year, I received word from the Advertising Standards Authority that they had indeed banned all these adverts making claims that sunbeds were good for you. So this was insane. I cannot even explain. So this email came through on a Monday, and of course, it was top secret before it got launched, etc. So I was just walking around and I was, oh my gosh, and then there were all these news outlets that were really interested because it was going to be a major change to the advertising structure of some beds in the UK. And then it went live, and it was a lot of pressure. There was quite a bit of trolling, mainly from people saying that I was taking away their ability to get better from all these purported health claims that were being made, which obviously was a bit disheartening because that was the whole point. And from then, you know, I've really been vocal about encouraging other people to stand up for what's right in this capacity. And you know, the advertising standards authority were honestly amazing. Like fair play. I did not know what to expect, but they went through this with such a fine-taste comb. They combed through all of the evidence in a really scientific way and said, Oh, yeah, categorically, there is no evidence that sunbeds are good for you. And like these health claims are totally misleading. So, actually, as a result, I really encouraged many, many people across media platforms to complain about other adverts that were kind of making similar claims. And there were loads more that were approved in January of 2026. And in February, actually, now the entire guidance for sunbed regulation has changed. So a huge Win, but a tiny drop in the ocean. You know, there are so many adverts on social media. The amount of tanning content that is coming up on a daily basis is overwhelming, like totally crazy. And the vast majority is paid commission. So really, where kind of influencers are, you know, being paid to promote a soundbit company or tanning agents. And your tanning agents and accelerators are a whole different ballgame, but you know, it's all part and parcel of ultimately kind of ways to supercharge your own ability to get skin cancer.

SPEAKER_01 22:29

Wow. I think that's amazing that you took that step to stand up for what you thought was right and putting your head above the parapet must have been really scary. But sounds like it's been so rewarding to see how things have gone through and the change that you've personally made and how that has spread. And I'm sure our listeners will have seen different things online or in the wider traditional media that have raised concerns for them in terms of public health issues or misinformation. And I wonder what advice you'd have for your fellow resident doctors or medical students who wish to raise awareness of health issues.

SPEAKER_02 23:06

Because it's the right thing to do. And there aren't enough brave doctors in our society. And you know, if you're brave, you are the one that can really make a difference. And this comes across not just misinformation, but just general teamwork communication. I has another situation that really made a huge impact upon my career. This is a few years ago, shortly after I'd started working as a clinical fellow in dermatology. I was working on call. So I was working on the weekend. And of course, we've all heard the kind of usual cliched jokes about dermatologists, like derma holiday, and so on and so forth. And that's old news. Water off a duck's back. But it can be a bit demoralizing when you've worked incredibly hard in your specialty and someone puts you in this box of just doing a specialty because you want a chill of life. And that's unfortunately something that happens very commonly. So anyway, I once on call on a weekend and I went into hospital after being called in to examine someone's rash in a medical unit. And I walked in, there was a consultant there, a team of resident doctors, and some nurses. And the consultant in front of everyone said, Oh my goodness, dermatology's here. You clearly don't have kids, otherwise, you would have stayed at home. And I just looked at him and I said, I'm sorry, can you repeat that, please? And then he said, Oh, are you going to hit me with your handbag? And I honestly just couldn't believe it. So I kind of walked away, took the patient's notes, went to go and see the patient, sorted that out. Luckily, you know, the patient wasn't too complicated because I was completely distracted. I mean, talk about incivility. And I sorted the patient out, handed over to one of his colleagues because I couldn't look at him. I was so furious. And then I went home and I was mulling this over. I just couldn't stop thinking about it. It just made my blood boil. And at the same time, one of my good friends had recently suffered a miscarriage. And I thought, oh my gosh, like if he had said that to her and made this kind of quip about not having kids, like that would be devastating. And you know, I don't have kids, but that's by the by. It's just totally irrelevant. It's such an unprofessional comment to make. And the impact that had on me, not just for that patient I was about to see, but in my, you know, personal life, if actually, for the rest of my own call. And I got to a few days later and I thought, well, I need to speak about this because it's not right. So I spoke to some of the consultants in my own department, and they rolled their eyes and said, Oh, that's terrible, awful, as you know, very common. And I said, Well, I kind of want to speak to him because it's not right. And he probably doesn't realise how much it's upset me and others. And people were saying, No, no, don't do that, don't do that. Why would you do that? He'll just get angry and I'll probably complain and you know, report you whatever. I said, Well, what's he gonna report me about? You know, I haven't done anything wrong. And then so I then wrote a letter and I was really, really careful about it because this guy was a consultant. I had not long finished CMT, I was in my first year as clinical fellow, so obviously really quite kind of junior in my overall career as a doctor. And I explained to him and I said, this is what happened. And since then, it's kind of dominated my thoughts. I don't have kids, but I am very aware that this is something that it's a big part of a woman's life. And of course, you know, as with many women my age, you're constantly talking about whether or not you want to have kids and implications that might have on your career. And I said, you know, to have that whistled down to a joke really upset me. And I said, without knowing anything about my private life, as of course you don't, how could you know that? But at the same time, you cannot make these sweeping generalizations. At the end of the day, he had asked me to come and see a patient and I had done my job, and that was that. And then he'd then gone on to say this clip about me hitting him with my handbag, which just seemed even worse, and you know, just kind of littered with all these kind of gender stereotypical things that we don't want to introduce into the workplace. And I explained all this to him just how much it upset me and how I really thought that he should reflect upon it, because not only had he said it to me, he had also said it in front of a team of nurses and resident doctors, and the impact, it probably upset them too. And it was huge for me, and I was really nervous as I sent that letter. And I thought maybe he's going to ignore it. He'll probably ignore it. He might send a letter to my consultant saying how insubordinate I am and how terrible I am and whatever. But do you know what? I was so pleasantly surprised. He responded really quickly, hugely apologetic, and had really reflected upon it even before I sent that email. It was very clear that he had known he'd made a mistake, and we had such a productive conversation, really, about how we could both move forward. And he offered to meet up in person. I wasn't really wanting to do that, but it really was such an enlightening experience, I think, for both of us, because I had kind of written him off as a quote unquote bad person. And he wasn't. He had made a silly mistake and he hadn't really acted correctly in that moment, but he'd clearly learnt a lot from it. And what really impressed me is that with my permission, he then forwarded on the letter that I had sent to him, to all of the nurses and resident doctors that had been present to demonstrate that this was an appropriate thing for me to have done and I was correct in having challenged that interaction. So the reason I'm telling this story is that I think this was a really nerve-wracking thing for me to have done. And ultimately many of my colleagues, including senior colleagues, told me not to do it. But for me, it was such a rewarding experience, and I learned a lot by myself during the process. I think the person in question learned a lot about the process, and you know, absolutely fair place. He couldn't have acted in a better manner in terms of reflecting upon what had happened. So I think hard things aren't easy, but they're worth it.

SPEAKER_01 28:52

I think that's really interesting. Like you say, hard things aren't easy either in the workplace, standing up for incivility and making sure that we're communicating kindly to each other and to our patients, and then transferring that into the online world as well, like standing up for what is right and being consistent, clear, kind, and evidence-based in our communication is really important. And I think you've given us lots to think about. It's been really thought-provoking for me in terms of where I am as a clinician in the physical and the online world, and for our wider profession as well. So I'm sure our listeners will be considering their role in social media and public health advocacy going forward. So thank you so much for sharing your experiences and advice with us, Amy.

SPEAKER_02 29:36

My pleasure. Thank you so much for having me.

SPEAKER_01 29:39

And for our listeners, you can check out our other episodes in our career conversations podcast, where we cover different medical specialties as well as other aspects of a career in medicine, like this episode with Amy. We also have many interesting cases and clinical topics on our sister podcast, Clinical Conversations. Thank you for listening.