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Despite a promising launch, Threads -- the social media app that hopes to unseat Twitter as a dominant space for online medical networking and communication -- may not be ready to win over the medical community.

Threads, a networking platform created by Meta, launched on July 6 and appears to mimic Twitter's short-form messaging style. It reportedly surpassed 100 million sign-ups in its first week, according to Meta CEO Mark Zuckerberg.

Among new users were medical professionals, some of whom are members of the Twitter community known as .

HealthQuant, a company that tracks physician engagement on social media, shared data with 乌鸦传媒 that showed declines in posting and engagement from physicians on Twitter. Comparing June 14-July 13 periods this year and in 2022, the number of physicians posting on Twitter decreased by 13% (73,371 versus 63,957) and the number of physician posts decreased by 21% (3,420,696 versus 2,718,280), according to HealthQuant founder and CEO Greg Matthews.

"There are a lot of doctors who are on Twitter who also have established a spot on Threads," Matthews told 乌鸦传媒."Many of them are the same doctors that have been really, extremely, active and influential on Twitter."

"If you're looking to do a thumbnail sketch, I think you could actually say that a bunch of the doctors that were actively spending their time on Twitter a year ago have been spending it on Threads this year," Matthews added.

But a closer look reveals a more complex story, Matthews said: a tighter snapshot showed physician Twitter use increased every day over the past 4 days, and July 13 saw more physician tweets than the day Threads launched.

Threads Comes Up Short

Anecdotes suggest Threads is not meeting physicians' expectations as a Twitter replacement, Matthews noted. Physicians have complained that the lack of a search function on Threads has made it hard to find colleagues.

"If you're a member of the global nephrology community on Twitter, it's actually really easy to find those people because you can do meaningful contextual searches. You can't do that on Threads," Matthews said. "That is a pretty significant disadvantage."

Meta representatives say they are working on features to allow search functions in the future, he added.

Megan Ranney, MD, MPH, a emergency physician and dean of the Yale School of Public Health, agrees that Threads needs to do more.

"Threads is lovely, intuitive, and (thank goodness) primarily text-based," Ranney wrote in an email to 乌鸦传媒. "It does however feel like an 'MVP' (minimum viable product) -- the algorithms are not fully baked, the timelines leave something to be desired, and lack of a web-based application makes it tough to share the kinds of multi-post-threads that I loved to create on Twitter."

Threads will need to quickly find ways to connect and engage community members if it hopes to replace Twitter as the de facto online forum for medical professionals, Ranney added. Still, she emphasized, there's an urgent need to find a Twitter replacement.

"The volume of trolls and hatred is ever-growing, and the engagement is decreasing," Ranney said. "I'm really hoping that Threads has staying power, because I had come to rely on Twitter for its contribution to up-to-date medical and public health dialogue. The absence of a similar space would be sad for our health care and public health community."

Adding New Challenges

Finding a new home for the #MedTwitter community could lead to other challenges, said Katelyn Jetelina, PhD, who runs the "Your Local Epidemiologist" newsletter on Substack that became popular during the pandemic.

"It's hard to build a community that truly influences healthcare policy or changes individual behaviors from scratch," Jetelina told 乌鸦传媒. "And it's going to take time for us to really start fresh to find networks [and] build coalitions."

The slow rebuild means that Threads will likely be complementary to her presence on other platforms, Jetelina noted, but she is concerned that online public health conversations may become fractured.

"I have a really big concern about Threads -- that it's going to be deepening echo chambers, that certain people will go to Threads, and certain people remain on Twitter," Jetelina said.

"I personally think it's a time when we need to close these echo chambers rather than infiltrate them," she added. "And the scientific community can't just continue talking to the scientific community. We need to react, reach out, and be responsive."

Adding another social media account will be challenging for busy healthcare professionals, Jetelina observed. Her largest following is on Facebook, where she sees the most impact from her engagement, but she also has accounts on Twitter and Instagram with large followings as well. Adding Threads might be too much to ask, she noted.

Matthews noted that Twitter has a clear advantage of keeping the online conversation within the medical community easy to find and participate in, which will be a hurdle for another social media platform. Still, he recommends that doctors and other health professionals create an account on Threads with a handle that matches their Twitter account, in case more people switch.

Matthews also hopes that Threads or another platform will focus on the needs of the medical community directly, noting that a medical professional verification feature might be one way to gain success.

"I think the platform that does actually provide a way to credibly and objectively separate the wheat from the chaff in a public setting is going to do really, really well with doctors," he said.

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