Peder Horner, MD: An Interventional Radiologist's Guide to the IR Twittersphere

Knowing your audience is extremely important. People are looking for Twitter users who are authentic, who have a unique voice, and have something new to share.

Peder Horner, MD
Diversified Radiology
March 2, 2018

Nine interventional radiologists (IRs) contributed to an enlightening guide[1] to the Twitter IR ecosystem recently published in the Journal of the American College of Radiology special issue on Social Media and Medicine. Among the authors was one of Strategic Radiology’s more active users of the platform, Diversified Radiology’s Peder Horner, MD, @IR_Doctor.

The paper explores the communication pathways IRs are using to connect with patients and advocacy groups, as well as with trainees, other IRs, and specialty physicians on Twitter, which provides a communication platform of unprecedented immediacy that surmounts geographic boundaries. It also identifies some of the benefits and goals that IRs are achieving: IRs have used Twitter to collaborate on manuscripts, recruit radiologists, educate patients, and enhance their personal practice.

One of the more compelling and ongoing goals is the effort to make patients aware of the need to remove retrievable inferior vena cava filters when possible (#filterOUT). Ever since the FDA issued a safety communication about retrievable  IVC filters in 2010, IRs have been trying to connect with those patients. The #filterOUT campaign was launched in 2015 as a way to raise awareness among patients who may have moved or changed their contact information, a topic on which Horner occasionally tweets.

The article also shared interesting facts and tips about professional Twitter use by IRs and IR fellows and residents that may surprise you. For instance, IRs appear to be among radiology’s most prolific and savvy users of the platform. Not only is their journal (@JVIRmedia) the most active Twitter account among all peer-reviewed radiology journals, more IR fellows and residents engage on Twitter than not. SIR’s resident and fellow section (@SIRRFS) has more than 1,900 Twitter followers and frequently shares interesting cases and news about educational events.

Horner, an engaging presence on the social media platform, agreed to discuss his experiences on Twitter with Hub readers.

Q: What precipitated your decision to open a Twitter account?

Dr. Horner: I’ve always been curious about social media. I noticed that some of my colleagues from around the country were sharing cases and talking about IR and radiology on Twitter, so I created an account for the professional side of my life and became active in the Twittersphere, following the influencers and watching what they did with Twitter. I began by posting cases and sharing some details about our practice that were unique. It was a slow burn that ramped up quickly when I got involved with medical Twitter [in December 2016].

Q. You and your co-authors caution that when engaging professionally on Twitter, it is important to maintain focus on why you chose to participate and what you hope to achieve.  Would you share your Twitter mission and goals?

Dr. Horner: I’ve done a lot of reading on Twitter and Social Media about how to make it as effective as it can be, and it really benefits from a narrow focus of content and audience. Knowing your audience is extremely important. People are looking for Twitter users who are authentic, who have a unique voice, and have something new to share.

Narrowing my activities to sharing cases, patient advocacy work, and compassionate care for patients helps keep my focus clear, so most of my posts are in that realm. It is professional and focused on cases that interest me and that I want to showcase and build for my practice. It turs out that there is a significant marketing aspect to this.

Q: Your JACR article outlined five communication pathways available to Twitter users (patients, advocacy groups, other IRs, other specialty physicians, and trainees). Do you focus on any of those audiences in particular?

Dr. Horner: My use of Twitter is primarily in networking with my colleagues around the world. My Diversified colleague Jennifer Kemp, MD, is also active on Twitter, and an unexpected result has been increased awareness and recognition of Diversified Radiology in the eyes of our colleagues in the United States. It has been an interesting way, from the professional standpoint, of marketing our practice. We are interviewing for a few IR openings, and we’ve had multiple people say, “I saw what you are doing on your Twitter account, it sounds like an amazing practice.” This was certainly an angle of exposure that I did not foresee.

Q: Have you had an experience Interacting with patients or advocacy groups on Twitter that you would share?

Dr. Horner: I had a patient come to me for a consult a few weeks ago. She had Googled fibroid embolization, found and researched me on the Internet, discovered my tweets about fibroid embolization, and realized I would be an expert. She came to see me without a referral from her OB-GYN doc.  Although my main focus is on professional development, sharing cases, and discussing them with my colleagues, there also is a nascent ability to reach patients.

Q: From following you, I know that you have a son and that you enjoy the outdoors. How important is it to express who you are as a person when establishing a Twitter presence?

Dr Horner: It’s fun to share a few personal details and those personal tweets tend to be on the weekends. I think they round out your online profile as a person. Doctors have a reputation for being dry people, so sharing a few adventure stories here and there about things I like to do and am passionate about outside of medicine gives an idea of who I am as a person.

Q: A point made in your article is the ability to build community of like-minded individuals across geographies on Twitter: Has that been your experience and would you share how building a broader community may have enriched your practice experience?

Dr Horner: Yes, the first would be getting to know the other IRs and radiologists. It has opened my eyes to practice differences around the country and the world in that people approach certain cases and clinical problems differently, not necessarily better or worse. I have learned a lot from these people.

Second, I went to a meeting in Washington recently and there were many people I interact with almost on a daily basis on Twitter but who I’d never met face-to-face. I had a half dozen new colleagues to hang out with, share stories and go to dinner with. It has really expanded my community and my interaction with like-minded physicians.

Third, Dr. Aaron Shiloh (@drshiloh), one of my Twitter colleagues—we call them tweeps—had an unexpected case outcome. He realized there was a need to share complications, as Twitter and social media are typically about showing only our great cases. so he invited some of his trusted tweeps from the IR community into a private direct messaging group on Twitter. This group has grown into an advice and support group of 50 IRs from around the world that are learning from and supporting each other in a safe, protected environment.

Q: Do you have any advice for those who are considering engaging in Twitter?

Dr Horner: I would recommend against posting anything political. It is not the right environment to discuss politics, and you would narrow your audience unnecessarily by wading into controversial issues, and politics in particular. An exception would be something about which you have a unique voice and perspective that would resonate with a large number of people. Obviously, inappropriate material and jokes are extremely unwise.

If you are going to post cases, patient privacy has to be protected and paramount. Each hospital has its own policy about this—some don’t want any doctors posting pictures, but most do. I strongly recommend against posting case pictures that occur on the same day or near the time of the post—a patient could raise a complaint because it would be somewhat identifiable. I usually wait a week or more before posting a case, and always with the utmost respect for patient privacy. No funny pictures that would be compromising even if no one knows who it is.  I think we need to be respectful and upright in our professionalism.

Defining your audience at the beginning—and revisiting that during the year—helps you fashion the presence you want on Twitter and the impact you can have on the community.


1. Wadhwa V, Brandis A, Maddassery K, Horner P, Shand S, Bream P, Shiloh A, Lessne M, Ryu R. #TwittIR: Understanding and establishing a Twitter Ecosystem for Interventional Radiologists and their practices. 2018. J Am Coll Radiol;15(1PB):218-223.

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