Everyone will tell you to check a surgeon's board certification. Almost no one will tell you to check his comment section.
I will — because before you ever sit in a doctor's consultation room, you will sit in his social media. That is the modern waiting room. And if what happens in some of these comment sections happened in a physical waiting room, no one would tolerate it. Not the doctor. Not the staff. Not for one afternoon.
So why is it tolerated online?
The profession has written guidelines for itself — the AMA's Code of Medical Ethics speaks to online professionalism, and the plastic surgery societies require truthful communication. But those documents were written by doctors, for doctors, and they live where patients never look. Meanwhile, patients are looking somewhere else entirely: at the room underneath the videos. When I scroll a doctor's page — and I scroll many — here is what I'm reading.
Is there respect in the room? For the patient in the photo, who trusted her surgeon with her image. For the doctor himself. For the celebrity whose face has become the day's topic. For the message the post claims to carry. A comment section where any of those is fair game for cruelty is telling you what that page is really for.
Does the doctor go past the first three or four comments? Watch closely — rarely. A quick reply at the top, where visibility is highest, then silence while real patient questions stack up below, unanswered. Presence at the top of a thread is marketing. Presence at the bottom is care.
Who is actually answering? Staff and content creators run many of these accounts, and I understand why — surgeons belong in operating rooms. But count the canned responses. “Please call our office to schedule a consultation,” pasted beneath a frightened question about a complication, is not education. And whoever holds the phone, the name on the account holds the responsibility. You cannot outsource your character and keep your reputation.
Is this page about a following, or about education? Content that teaches serves patients. Content built to make people argue in the comments — bait, controversy, a celebrity offered up for dissection — was never made for patients. It was made for numbers, and a medical degree does not change what that is.
And watch the doctors visiting other doctors' pages. The drive-by praise dropped on a viral video — arriving while the post is surging, never returning to the conversation or to the patient questions stacking up beneath it — is a billboard, not collegiality. If that is what engagement means over there, ask yourself what it means on his own page.
I know what that room costs to keep clean
Not long ago, I was asked to weigh in publicly on a conversation about Demi Moore's appearance. I wanted it to be educational — never a diss on the actress. Facebook pushed the post far beyond my community, and the comments came in by the hundreds. Some people were misinformed but open, and for them I offered education. Others were vile, a dog pile feeding on itself. I deleted those comments, blocked the people behind them, and stayed up long into the night keeping the room clean.
It cost me. Engagement — even ugly engagement — is what the algorithm feeds on, and when I removed it, my reach fell. For being responsible, I was penalized. The platform rewarded the frenzy and punished the person holding the mop.
A following kept by tolerating cruelty is not a following that trusts you — and trust, not reach, is what fills a consultation room.
That is what is wrong with social media: there is no social responsibility built into it. It is part of the reason The Regan House exists — a place with no algorithm to please, monitored around the clock, where education works the way it was always meant to: in service of safe and responsible decisions, and safe and responsible surgery.
Some of the finest surgeons I know already run their pages the way they run their practices — answering patiently, correcting misinformation gently, protecting the people in their comments the way they protect the people in their care. Their comment sections look like their waiting rooms. That is no coincidence, and it is part of how I vet: credentials get a surgeon to the table. Conduct decides whether we look further.
Because if we can't do this safely and responsibly, then we shouldn't be doing it at all.
— Mary Regan