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Good Practice: So, You Want to Be an Influencer?

As a physiotherapist, you may feel you have the knowledge and passion to engage directly with the public and your peers. You feel you have the charisma and the skill set to find a significant following on social media. You feel you are ready to start spreading some physiotherapy knowledge or research and you want to build a social media campaign that will enhance your own professional brand or support your clinic’s brand… but are you ready to do this within the professional expectations set out by the Code of Ethical Conduct and the Standards of Practice?

Physiotherapists utilize social media for varying reasons but usually the main drivers are knowledge translation, personal exposure to opportunity, professional advocacy, or advertising/creating more business.

Unfortunately, health-care professionals don’t always make the best decisions regarding the use of their social media accounts.2 In this section we will discuss scenarios in which physiotherapists begin to stray outside the expectations of the College.

Spreading Mis- or disinformation

I am sure you are all shocked and appalled that some people on social media use their platform as a way to spread misinformation (pause for gasp from the reader). As previously discussed in a College Conversations Podcast and a Good Practice article, this is not new and the physiotherapy profession isn’t immune to it either. Even when it is not exactly misinformation, social media content from health professionals doesn’t always contain quality advice. A recent study found that health professionals with the largest followings on TikTok do not offer advice that reflects the current consensus guidelines for acute non-specific back pain.3 The most viewed videos involved content that provided very little educational content and did not provide any content that aligned with best practice. This isn’t to say there isn’t great social media work being done by physiotherapists, just a reminder that it is easy to stray into content that will create more views at the sacrifice of providing the best educational message to users.

Superlative Language and the advertising verification tool

Is this another article where I write about misuse of superlative language in advertising? You bet, because this time it’s about recognizing that the advertising verification tool will soon be implemented to help screen and identify the many advertising misadventures that we see online. The tool is designed to screen website and social media accounts to verify that advertisements and promotional activities are in alignment with legislation and College requirements. One of the main issues we see is the use of superlative language in the promotion of services. So all the “experts” and “best physio in ….” will have to adjust their content to fall within the performance expectations found in the Standards of Practice.

Handling Disagreements Professionally

One of the things that guarantees some hits on your social media feed is to create a disagreement with someone who currently has significantly more followers than you. The online debate arena can get heated pretty quick and as we all know, it is so much easier to type and send something hurtful then it is to say the same thing to someone’s face. It’s a common tactic of social media influencers to create a spirited debate online to draw in commenters and professionals to help them create a bigger audience.4 Debating research and aspects of physiotherapy practice can be a way to create positive change within the physiotherapy profession, but it must remain respectful and in keeping with the Standards of Practice and Code of Ethical Conduct. It is still common enough to see these debates fall into name calling or cyber-incivility.5 If you are choosing to spend time debating online, keep in mind that the public is watching and as regulated health professionals you must demonstrate eProfessionalism in all your actions and work to uphold the public’s trust in the profession.

The Kardashian Factor

The Kardashian Factor is a published term which recognizes that “The increases in followers is conversely related to the quality of the research.”6

Posting without constraint and outside of professional expectations could lead to posts containing poor quality of content and posts that stray further from the truth in order to see an uptick in your followers. While for some this is their life goal, it is key to recognize that this cannot be you. According to the Standards of Practice, you as a physiotherapist must post content that is “accurate, verifiable, and true.”

Buzz Vs. Truth

This happens all too often in the media. An obscure research article says somewhere in the discussion that drinking wine/coffee/milk/tea or eating butter/beef/tomatoes/eggs will give you longer life or a shorter life.7 Media often reports information found in initial studies that haven’t undergone repeat trials. This often leads to a misrepresentation of the true scientific findings that are either confirmed or refuted in the follow up studies or meta-analysis. It is your responsibility to be a voice of reason and to use your platform to promote information, treatment options, or products that are grounded in scientific, peer reviewed, and physiologically plausible evidence.8

Gifts and the Promotion of Products or services

Influencers can be paid a lot of money to promote products or services to their followers. While most platforms have rules that state the user must disclose if the item/service was gifted or if it is an ad, there are still those who will promote an item in the hopes of creating a partnership with a brand. Is endorsing a product or service (related to physiotherapy or not – such as a skincare product or diet tea, etc.) as a physiotherapist ethical?

Followers could interpret this type of promotion as: “This health-care professional said this tea works” or “This health-care professional says this serum will make me look younger.” What about promoting something physiotherapy-related, such as a brand of elastic tape? The follower may believe they need that brand of elastic tape for their condition or injury, even though taping is not part of the treatment plan created by their own physiotherapist.

The Advertising and Conflict of Interest Standards of Practice both include language highlighting the importance of not engaging in the promotion of products for financial gain. Physiotherapists must recognize that using their professional status and the credibility afforded by their professional status for purposes unrelated to physiotherapy, such as being a social media influencer, could constitute a conflict of interest.


Each person has their own reasons for using social media to build their brand or carve out a place for themselves to be recognized. Regardless of the reasoning, it is up to you as a regulated health professional to follow the expectations laid out in the Standards of Practice and Code of Ethical Conduct and it is up to you to recognize when you or the organization you work for are posting content that is in contravention to those expectations. There is nothing wrong with being an influencer, just keep in mind that you are a physiotherapist and when speaking or identifying as a physiotherapist, must meet the obligations set out by the legislation and regulation of your profession.
  1. Chretien KC, Goldman EF, Beckman L, Kind T. It's your own risk: medical students' perspectives on online professionalism. Acad Med. 2010 Oct;85(10 Suppl):S68–71.
  2. Zheluk A, Anderson J, Dineen-Griffin S (January 19, 2022) Analysis of Acute Non-specific Back Pain Content on TikTok: An Exploratory Study. Cureus 14(1): e21404. doi:10.7759/cureus.21404
  4. De Gagne JC, Cho E, Yamane SS, Jin H, Nam JD, Jung D. Analysis of Cyberincivility in Posts by Health Professions Students: Descriptive Twitter Data Mining Study. JMIR Med Educ. 2021 May 13;7(2)
  5. Cook C, O'Connell N, Hall T, George S, Jull G, Wright A, Girbés E, Lewis J, Hancock M, J Orthop Sports Phys Ther 2018; 48(1):3–7.
  7. Draft Standards of Practice – Evidence-Informed Practice

Page updated: 09/03/2023