Thursday, November 13, 2014

My Tweet went viral, now for the Mea culpa

On the afternoon of Tuesday, 11 November 2014, a small part of the twitterverse exploded.  Dr. Oz of America's Doctor fame asked for questions via Twitter using the hashtag #OzsInBox.  The adage of be careful what you wish for came true, and numerous physicians whom I follow tore into him, quickly making it a trending topic.  Mixed in with 95% tweets meant to tweak his nose and make fun of him where about 5% serious questions.  The majority of tweets were quite hilarious.

Seeing all the fun they were having, I decided to give it a try, and asked a semi serious question after midnight:

I have always wondered why Dr. Oz has not been censured or disciplined for his lack of scientific and medical morality on his TV show by his colleagues at the medical school where he holds the position of Vice Chair of Surgery.  I would like to think that if my institution had a MD that was spouting nonsense about miracle cures and melting fat away, they would be soundly denounced by their colleagues, privately and publicly.  Even if his speech is protected by the Columbia University Faculty Free Speech policy, he has an obligation, as a physician, not to mislead his viewers.

I forgot about it on Wednesday morning and went about my normal duties, occasionally checking twitter to see if someone had posted something funny.

On Thursday morning, my twitter inbox was getting busy.  Several people questioned my professionalism.  They stated that Twitter was not the appropriate platform for calling for a a fellow physician's firing;  especially since I had linked to the Columbia Department of Surgery's twitter account.  Being a relative twitter neophyte, I started answering some of the questions and tweets personally, not realizing that I was being baited by twitter trolls and others. 

Later that morning, my twitter inbox exploded.  The apparent cause was a USA Today article that featured my tweet.  My tweet was later picked up by also

My tweet has become the subject of several mini debates about professionalism, and I have decided not to take any further part in them, and hoping it will die a natural death. As of this writing, I am the 4th top ranked mention in regards to this topic.

My Mea Culpa...


In hindsight, my tweet probably should have never went out.  In the twitterverse, I have been accused of being mean, unprofessional, greedy, and not being a gentleman etc...


Gentleman is defined by Merriam Webster as: c (1) :  a man who combines gentle birth or rank with chivalrous qualities (2) :  a man whose conduct conforms to a high standard of propriety or correct behavior. 

While I have never met the man personally, I cannot make a judgement of his personal conduct.  A such, I should not have accused him of conduct unbecoming a gentleman.  I was trying to make a humorous play on the phrase "conduct unbecoming of an officer and gentleman."  I certainly think his public conduct leaves much to be desired, but in a polite and civil society, it was low blow, and for that I am sorry.   Like others, I should have mocked the behavior, not the man.


Tagging the Columbia Med Department Surgery's twitter account also was a mistake. I should have used the hashtag #ColumbiaMed or #ColumbiaSurgery or something similar, not their actual twitter handle.  With all the retweets and mentions, I probably inundated their twitter feed and made their social media team have a heart attack.  The @ColumbiaSurgery twitter tag is designed to present the best of what they have to offer, not a platform for ridicule.  In an attempt to make things right, I did post the following apologies earlier on Thursday AM:

For the record, I do apologize to the professionals at Columbia Department of Surgery for involving them.


This accusation actually bothers me the most. I have always tried to be a professional and collegial with my colleagues.  I am still struggling with the issues raised about physicians criticizing other physicians, privately and publicly.  Many medical blogs refer to not publicly criticizing another physician because it undermines the confidence of our patients.  I certainly don't do that in person, so why would I do it on twitter? My approach in person is to talk to them one on one, and it is usually about a mistake, or something missed that caused an error.  Universally, all physicians take that kind of critique at heart, and vow to do better next time. I certainly do.  One of my favorite phrases is that when it comes to patient safety, I have no ego.  I have called out MDs who I think are gaming the system, but do so in a much more professional way.

Twitter has opened up a new paradigm in terms of professional interaction on all sorts of levels.  It's great during medical conferences to discuss breaking news and controversial studies.  But again, this is using twitter to critique the topic, not the person.  Instead of using my "professional and official" twitter account which is @drsunilksahai, perhaps I should have used my personal private citizen account @sunilkumarsahai to post the tweet.  That way, it would have been me, as a private citizen commenting.  I know I am the same guy, but one account is meant for more medical news and professional interactions, than the other.  That way I can use my personal account to tweet about my cable company, airline snafus, and humorous memes that don't have a natural fit on the professional side.  I'm pretty sure my medical followers don't want to hear about my latest interaction with @att.

However, I am not sure the same can be applied in Dr. Oz's case.  He is not making medical mistakes on patients he treats and has a physician-patient relationship with.  He is promoting pseudoscience to his viewers who have put their trust into him.  I think the two are very different matters.  As of this writing, I don't have a good answer to that.  Other physicians and bloggers do a much better job at criticizing Dr. Oz than I did, so I will leave it to them from now on.

The Tweet I Should Have Tweeted: (updated 11/14 AM)



  1. There was nothing wrong with your original honest and accurate tweet. The only wrong I see is you feeling bullied and pressured into writing this post feeling the need to water down your much-needed honesty.

    We need more doctors like you to speak out against this quackery. It's not fair that Dr. Oz is allowed to wave his credentials around as he promotes snake oil for a profit. What about the risks to the general public? What about all of the doctors and doctors in training who have to deal with the fallout from this? There is nothing wrong about calling out unprofessionalism when no one else is. News outlets and comedians can only do so much. It's time his peers start speaking out against him and Columbia Surgery for allowing this dangerous spectacle to go on as long as it has.

    Does the profit from having a famous doctor there really override having their reputation tarnished by his mindless for profit promotions?

    I find it sad that a doctor like yourself is made to feel bullied to the point you cant be honest about bad medical advice, and feel the need to put a PR filter on. You're a doctor to help people, to save lives, to be honest about what is making people sick. Please be the honest doctor we need and continue to speak out, publicly and honestly.

    When a good doctor is afraid to speak out about what is wrong in medicine we are all in danger.

  2. Dr. Sahai, I think that your post was entirely warranted - though I certainly understand why you wrote this post. I was really interested in the number of posts that doctors created - Dr Oz clearly struck a nerve with physicians! As an FYI, you're prominently featured in my analysis of the phenomenon at ( I'm glad that you were honest ... and your ICD-10 tweet was hilarious!