The concerning rise of the social media DMG

Photo by National Cancer Institute on Unsplash

I call them Dr Menopause Guru (DMG) and I’m watching them on social media and I’m worried.

First of all, have we learned nothing from history – recent or otherwise – about blindly trusting in people who talk a good game? I’m not saying we shouldn’t trust them, I’m just saying we shouldn’t blindly do so. 

Rather than living in some sort of perpetual Groundhog Day of “oh this person really seems trustworthy and credentialed” and handing over our personal power, I’m suggesting we pay attention to experts while also acknowledging that trust takes time to build, these are humans too, and it will be up to our own discernment to decipher who is on-the-take or in-it-to-win-it. (On-the-take, in-it-to-win it people are very good at making it seem like they are not, after all)

I can never be sure of course, but when someone grows a huge following with a 360 approach then takes a hard pivot to talking about hormone therapy for everything, including prevention of disease, it does make one wish you could get a look at their accounts, you know what I mean?

When someone is clearly making bank in private practice and irresponsibly fear-mongering and making big claims on social media, it is a clear conflict of interest. When separate doctors start using the same messaging all of a sudden, those words are coming from somewhere, and they should be declaring where that somewhere is. If a medical professional is a One-Note Nelly, it’s an orange flag. If they don’t adjust their advice or reflect a range of views (and people) or correct themselves when they are wrong (social media is famous for people switching gears and pretending that’s what they’ve always said the new thing they say), it’s red. If they are a Betty Bully? The flag is on fire. 

But tell that to social media. Social media loves all of the above.

Even if there is no real or perceived conflict of interest, I’m also concerned about a doctor who decides to tailor content to grow their following. It’s one thing when a civilian documents “my HRT journey” and sees their numbers growing; it’s another when a physician hyper focuses like that. Of all people out there, it feels like they should be telling us what we need to know, not what we want hear.

What I find shocking is how many times people will tag one of the DMGs in the comments when they come across a more nuanced menopause discussion, or see something they don’t agree with, or I say I don’t know what to think about something yet. Like the DMG is going to ride in on a big white perimenopausal horse – da da da daaaaa – and save us all from menopause misinformation. This awe and reverence for doctors happens to me too, and I’m in the business of professional discernment, or at least I was before my profession began to melt down. (I’ll admit it’s tempting for me to want to focus on DMGs, too, because of what that will do to boost my following, right?)

While I was thinking about all this, I came across the above post by the organizational psychologist Adam Grant on Instagram, and it hit just right.

The more I learn about this confounding subject that is the menopause transition, the more I can see the gaps in each DGM’s professional knowledge (while acknowledging the chasms in mine) and it freaks me out. I don’t want to be able to notice that big doctor on social media who doesn’t seem to understand the difference between progesterone and progestin, yet I can and do – far too often. We all have this issue, being humans and not computers, but doctors aren’t always the best at admitting it, at least in my experience. (Talk to any nurse about this sometime if you doubt) Then there are outdated recommendations from their own guiding bodies, the pervasive influence of Pharma and insurance companies compromising everything, their own biases and short-sightedness... the list goes on.

Take just one example: American psychiatrist Dr Jennifer Reid, who wrote a piece called A Fresh Outlook on Menopause for Psychology Today recently, and doesn’t appear to understand the difference between life span and life expectancy, writing “…prior to the 1900s, women simply didn’t live long enough to enter post-menopause”. (So why was Aristotle talking about menopause then? How did a French physician come to give it the name menopause in 1821? I scream to her, and the copy editor asleep on the job, and also to no one.) 

The list of reasons any one human should not be the sole provider of all our information on something – no matter how much time they spent in school, no matter how much experience they have, no matter how great they sound – goes on and on. 

So what to do? To avoid being sucked in by false perimenopause prophets? I follow a range of people, and keep an eye on what they do and say. I develop a stable of trusted experts (more on that soon, exciting stuff) who are humble, calm, who are agreeable even as they don’t always agree; who favor nuance over polarity, know their stuff, and aren’t afraid to say “I think” and “we don’t know” once in a while. 

Who are too busy to pick fights with people, or dismiss them, or worse, and do it with glee on social media. 

I look for people who I disagree with, too. That’s important.

The other side of this is that it’s just great all this information is flowing, when there was so little for so long, and that so many doctors are sharing it responsibly and being rewarded for it. We’d just do well to remind ourselves that the loudest people with the biggest followings don’t always have all the answers. In peri/menopause, and in anything.