The conversation with a senior colleague
A senior colleague, a doctor I admire, said to me once that posting on social media is beneath the profession. He may be right.
He trained me to believe that good aesthetic medicine reaches patients through other doctors, through referral networks built over decades, through the quiet authority of a clinic that does not need to advertise. He pointed out, accurately, that the loudest voices in aesthetic medicine on the internet are rarely the most qualified ones. He worried that joining the feed would dilute the standard.
I think about that conversation every time I post. And then I post anyway. Here is the argument for why.
What the senior view gets right
There is a real cost to doctors leaving the referral network for the feed. The referral system rewards careful work over showy work, because referring doctors compare notes and the quiet failures get noticed. The feed, by design, rewards engagement. A doctor who optimises for the feed will eventually optimise for engagement, and engagement is not a quality metric in medicine.
There is also a generational dignity in the older view. The senior doctors who never posted spent their careers letting outcomes speak for them. Their patients found them through other patients, slowly, on the basis of work that lasted. That model produced some of the best practitioners in the field. The case for honouring it has not weakened.
The mentor argument is correct in its terms. The terms have shifted under it, and that is the part the argument no longer covers.
Where the patient actually is
The patient who walks into the clinic today did not come from a referral network. She came from a search bar and an algorithm. Before she met me she had spent hours on Instagram, weeks on TikTok, and a determined evening on Google. By the time she sits in the consulting chair, her sense of what is possible, what costs what, and who to trust has already been shaped, mostly by accounts that are not run by doctors.
If a qualified voice is not on her phone, an unqualified one is. The market does not leave a vacuum. The non-doctor injector who runs a slick account, the influencer-clinician who treats aesthetic medicine as content, the brand-owned page that reads like a doctor's account but is not, those are the voices her sense of the field is being built from. Silence carries weight in that environment. It functions, in effect, as a vote for whoever else is talking.
The mentor view assumed a patient who would find her doctor the way doctors found their teachers. That patient still exists. She is increasingly outnumbered.
The composite case that made the decision
A patient came in for revision after a complication from a treatment she had received elsewhere. The details do not matter and could identify her. The pattern matters: a non-doctor practitioner had injected a filler product in a sensitive anatomical region using technique appropriate to a less sensitive region, and the result was something I spent weeks helping her recover from with the help of colleagues.
What sat with me afterwards was not the complication. Complications happen and they get managed. What sat with me was that she had found the practitioner online, had been reassured by professional-looking content, and had no easy way to tell that the account she was learning from was not run by a doctor. There was no qualified voice in her feed offering a counterpoint, because the qualified people had decided this was not their lane.
I went home that night and decided it was my lane, if only to put one more qualified voice in the algorithm. What changed in me that night was less a conclusion than a quiet concession.
The line a posting doctor has to hold
The senior view becomes a kind of warning, and the warning is correct: if a doctor posts the way a marketer posts, the senior view wins by default. So the standard has to be higher than a silent doctor's standard, not lower.
That means no theatre. No before-and-after performance. No outcome guarantees. No naming brands. No riding trending sounds for a quick reach win. No content that turns a treatment into a status object. The posting doctor has to be willing to publish slowly, post less, refuse the kinds of content that perform best, and stay boring on the topics where boring is the honest answer.
The dilution the senior view warned about only happens if the doctor lets it. The discipline of refusing the easy post is the work that justifies posting at all. How this clinic thinks about it is built around that discipline.
If I ever cross that line, I would rather hear it from him than from anyone else.
