Patient influencers: Walking an ethical line

Social media allows those living with medical conditions to share health anecdotes and advice to a wider audience, turning many patients into influencers within their condition’s community. Healthcare companies, in turn, have increasingly tapped into these networks by partnering with influencers on campaigns. Julie Croner of WegoHealth, a patient influencer talent agency, joins us to discuss the ethical dilemma that advocates face when compensated. We revisit the credibility issues around influencers’ sponsored content with journalist Suzanne Zuppello.

Show Notes + Transcript

 

Emily: I’m Emily Kumler and this is Empowered Health. This week on Empowered Health, we’re picking up in part two of our series on influencers. If you haven’t listened to last week’s episode, you might want to, but you certainly don’t have to. You can listen to this episode on its own. What’s interesting to me about this influencer phenomenon is that there are certainly people who set out to be influencers to make money and then there are people who set out to just be themselves and they end up developing a following and that allows them to make money and maybe they’re more careful about it. And we certainly see this on this podcast because we often hear from groups of people who are suffering from some medical condition. Or when we’re looking for sources — social media is a great way for us to find women who have come together and helped each other in a supportive fashion. And so we wanted to take a look at how the influencer phenomenon, let’s call it, like what happens in this sort of medical environment where you have people giving each other medical advice or shared experiences or suggestions on doctors. Right? So like when we did our endometriosis episode, a big part of that episode was about how women have collectively helped each other find doctors who are the best surgeons or doctors who will actually give you a proper diagnosis. That community that’s sort of like grassroots organizing is incredibly powerful and helpful to women. Now the flip side of that is what happens if you’re getting paid to talk about your experience is the very act of getting paid to do that too much of a conflict of interest. Does that then make you biased in some way? And this is happening. So I wanted to explore this and there’s a company called WEGO Health, which is a Boston-based patient influencer talent agency, and that’s their whole business model is they basically connect these patient leaders who are people who have experienced some sort of medical condition and it can be everything from breast cancer to arthritis to alopecia and so on with opportunities to share their experience with other patients or people who are going through the same experience or are interested in their experience for some reason. And they found that these influencers are incredibly influential, right? Which isn’t that surprising. People who are listening to their stories are probably looking for advice from people who have had the experience that they’re now finding themselves in and they say that eight in 10 of their followers say that they will sort of act on information that they’ve learned from this person. So that’s an incredibly powerful tool from a medical company who’s trying to share information about the treatment or a protocol or a surgery, whatever it may be, to have patients then go and be their advocates. This seemed a little troubling to me. I mean as somebody who does a lot of medical research and as somebody who’s a patient and a mom, the idea that I could come across people online who are telling me or recommending things to me and not really know that they’re being paid. I don’t know. I had a lot of questions about it. So I was excited that we were able to talk to Julie Croner who is the VP of the patient leader network of WEGO Health. She’s going to sort of get into the ethical dilemma part and also what her own experience was in terms of being recruited into this network. I feel traditionally this role was really played by big nonprofits, right? So you know the Multiple Sclerosis Foundation would have lots and lots of patients who it provided, you know, everything probably from education to also speaking opportunities or, I mean I feel like whenever you’re treated with an illness you are sort of in the waiting room. It starts right where you start connecting with other patients or people who are going through things. And I think social media has made that incredibly, you know, more accessible to people. But I feel like I have this initial knee jerk reaction to the idea that people are getting paid to share stories that, you know, I mean on the one hand, why should you not get paid? So it’s a little bit of an internal struggle for me, but I just sort of feel like there’s something that feels so vulnerable, right, about going through some sort of medical crisis no matter what it is and no matter what stage of life you’re going through it. Right? But the idea that you would be then sort of pimped out or whatever. Like even if it’s voluntary, you might look back on that and be like, I wish I hadn’t exposed myself that way. You know what I mean? I don’t know exactly. I think there is some anonymity with the social media. I mean obviously there’s a Facebook group for everything, right? But I do think you can kind of keep some of your information more private. Do you guys have a way of like, I don’t know, facing that or confronting that in your, in the mission statement or in something that sort of addresses that. Cause obviously the business model is about booking people, right? And sort of lining people up for these research projects.

Julie Croner: So when I think of influencers, I think of the traditional influencer, right? You know you look at their Instagram page, they have thousands of followers. Their feed is just beautiful and you want their life right? But whenever I think of, and a lot of people call them patient influencers, I actually hate that term. I do really love the term patient leader because I feel like the motivation for individuals who are sharing their story online, yes, it’s great to get paid. Right? But that’s not why the majority of them are doing it. The majority of them are doing it because they felt alone at one point. They didn’t know what to do. They didn’t have treatment options and they’re trying to help others realize that there are options. Here’s the information. So it’s actually a very big topic within the community because a lot of people will be like, I don’t want to get paid. I just want to share my story. That’s it. And that’s great. Like that’s fine. But the part where I start to think that people are sometimes taken advantage of is whenever you look at these patients as the experts that they are. I mentioned before how they share their story and the collective story. So they really are experts in their condition. So if you are paying a doctor to speak on behalf of a condition or you share their expertise or you’re talking to a consultant to come in to help work with your business process, you’re going to pay them. So why would you not pay someone who is an expert in their condition? Who is sharing their knowledge of, again, their own personal journey, but that communities? I do agree that there are sticky situations. I think there are situations where it’s not necessarily, you shouldn’t expect to get paid. Like for instance, if you’re working with nonprofits, I mean they don’t, a lot of those organizations don’t have a lot of funds and they rely on volunteers. I think that you have to be kind of smart about how you’re sharing your story. And another thing about your story, you really hold the key to what you want to share, right? So if you want to stay private you can only share certain parts of your story or you can share all of it. It’s really up to you. Whenever you think about influencers in the traditional sense and kind of go back to the FTC guidelines, no one is allowed to speak… you have to really share your experience. You can’t say that you liked the product if you didn’t really like a product and you have to be transparent. You have to be honest. If people don’t want to speak up and share their story about a certain topic or a certain product or a certain treatment or whatever we would never want that person to share it because that’s not being authentic.

Emily: Yeah that makes sense to me. I do wonder though a little bit, I mean we see this all the time with influencers, right? On like traditional influencers that are recommending vitamins or water or whatever and who knows if they’ve really used it and who knows? And it’s not FDA approved. Right? There’s all kinds of issues around that. The FTC is obviously really overwhelmed with social media and not doing, I would say, a great job of tracking it. Right. Or even enforcing some of that stuff. Do you guys offer training to people before they endorse the product?

Julie Croner: Yeah we do. We actually have, it’s called the WEGO Health platform and anyone who has an account with WEGO Health can come on. We have different courses on there for them to build up their expertise as patient leaders. So we have an FTC course, we have public speaking courses, we have, you know, sharing your story with the media, how to interject humor into your story. There’s a whole host of different courses that people can take.

Emily: And again, like not to be the sort of dark horse here. I feel like this is sort of my job. The other thing that I’m struck by is just obviously as a journalist, I completely respect the power of the personal story, right? And that we often talk on this podcast about the difference between scientific research and journalism, right? Which journalism is supposed to, you can tell the story of one person that’s a really powerful story that might then inspire really good, like a double-blind clinical trial, right? But those are very different mediums and they should be taken as different things. Right? And I think if, you know, coming from my lens, I can look at how journalism has changed over the 20 years that I’ve been reporting. And I can say things have become much more anecdotally focused. Right? So the individual story rules now over the sort of collective agreement, and I think that’s part of the problem. So you know, it’s interesting because I think if you’re speaking to a cohort of people who all share the same interests or the same disease or you know, whatever the affinity group is in a lot of ways that makes sense. Like they’re going to be a kind of already educated on things. Right? And so they’re all in it together. There’s a sense of comradery. Like it’s not just my story, it’s our story. And I think that is a powerful tool. But because you guys are not a nonprofit, right? And because there is a business interest in this and because we know pharmaceutical companies like love them or hate ’em are really powerful and their marketing is incredibly sophisticated. You know, I think that is sort of my next stop on this pessimistic train because there’s definitely—we know this from what was it like vaginal mesh? There was some medical device that we heard a lot of stories about. You know, and women were basically voluntarily going and paying out of pocket to have these things removed. The number of women that had actually had complications or died from this was very small. But I think that the blame that we heard was placed on lawyers who were like, there was a class action lawsuit or something. So they were in some ways fueling the fire on this. There were a couple of really awful stories and they led. And so those awful stories then made people make medical decisions that may not have been medically based. And I think we see more and more of that kind of thing. I mean I think that’s a really great example because it’s so extreme, but I sort of wonder about how do you curtail that. Because obviously your credibility is really important in the business. Right? And if people were to find out like, Oh well they just sort of work for pharma and they’re getting patients to say like, Oh, this drug was great because of blah, blah blah, but the drug actually has these negative side effects. That could put you guys in hot water in terms of longterm growth, I would imagine. So how do you counterbalance that?

Julie Croner: Yeah, so I mean I totally hear your point. And to be transparent. Like before I worked here WEGO Health, I wasn’t on the like I love pharma train at all. I was someone who I’m certified in holistic health coaching. I am someone who like overhauled their life of diet and supplements. And yes, I’d take medication when I have to. So I wasn’t sure how I was really gonna feel working with them. But I do have to tell you that we work with a lot of the brand teams at these big pharmaceutical companies and they’re people. And they really are invested in helping patients. And it’s been so wonderful, personally, for me to talk to them because it’s really transformed my view of the industry. So, yeah, with patients and their sharing their story, you’re a hundred percent right. There are the doom and gloom cases out there that are just like the worst imaginable. Whenever I first started bringing research or ideas to my doctors, they kind of rolled their eyes like, okay, here we go again. She’s been Googling, you know, and I really feel like you kind of have to take it with a grain of salt and you have to not just follow one person. You need to read a bunch of people’s stories and, and get the whole story. I think that the patient leaders that we gravitate towards working with the most are the ones who have a neutral bias against things. They’re, they’re not dead set on one thing or another. They see all, they see all sides. They’re really about sharing information globally with the community. So everyone has the information and they, they realize that there’s no one size fits all to people. One thing might work for one patient and it’s not necessarily gonna work for another. And I mean with these medications and treatments like that, I mean that’s across the board. Not all medication works the same in everybody. So whenever we are looking to recruit for these different opportunities, we keep that in the back of our mind. And if somebody is very holistic or very against one drug, or they’re very for another drug, we’re not gonna use them for those opportunities. But one thing that we make very clear and we stand by is that we want you to share your story and, and we don’t want to put words in your mouth and we don’t want to kind of taint your experience. People have the ability to say how they’re feeling and what they feel. And okay, now I’m just rambling…

Emily: No, I understand what you’re saying. I think for me it’s more of I’m thinking of it on the more on the business side of it. So if I have a whole database of patients who have all had breast cancer, right? And there are some who are like, Oh yeah, I was able to treat this by changing my diet. Or like I went to the shaman down the street and somehow my breast cancer never came back. I mean I feel like obviously if I’m a pharmaceutical rep who’s working on a breast cancer drug looking for the people who are going to be my spokesperson, I’m not going to hire those people.

Julie Croner: Right, right.

Emily: That’s why I think this goes back to the commercial interest part a little, right? Because if you’re smart and you’re trying to make some money maybe to cover your bills, right? I mean maybe you need the money and you have this experience, you’re going to know that the commercial interests are what’s driving the project. Right?

Julie Croner: Yeah. Yes. I agree. I would say though, so the way that our process goes is that if we have an opportunity, we post it on our platform. And anyone in the network can come and apply to it. But we really kind of weed out the individuals before we even tell them all the details about it. So I don’t want to lead someone on kind of like what you just said of like—not that I think anyone would ever make up a story or kind of craft their story to get it. But is that kinda what you were saying?

Emily: Well, yeah. I mean, I just sort of think I don’t know, what’s a good analogy? It’s like if you’re a model and you’re going to try out for—you’re auditioning for a movie that’s about you being a mom and you’re 16 you’re not like, that’s not going to be a good fit. And so there’s gotta be a little bit of that kind of casting that goes on. Right. And so then that’s where it sort of feels like it’s not like this is a connecting patients platform. Right? This is like a connecting businesses or I guess nonprofits that are looking for speakers for events and stuff like that. That I think is a really important part of this.

Julie Croner: Yeah.

Emily: You guys have a ton of people. I mean I feel like that’s another thing to point out is like over a hundred thousand patient leaders.

Julie Croner: Yeah. Across hundreds of condition areas. And honestly, I really mean it when I say they’re the most inspiring and motivated individuals that you’ll ever meet. And each of them is kind of doing it their own way. You know, some of them are going to Capitol Hill, some of them are using their business skills to work alongside healthcare companies as consultants. And you know, some of them are really playing with the digital space with their blogs and Facebook groups. And it’s just fascinating to see. And I’m so proud to call so many of them, my friends, I mean I’ve just built so many wonderful relationships over the years with these individuals.

Emily: And is there any kind of like open access for somebody who is going through an illness or a experience that they would like to connect with people that can they go on and find, connect with people individually?

Julie Croner: If you go to our website, you can actually search. We just added this feature in the fall. So every day there’s more and more profiles there. Not everybody’s profiles are public, but there is a directory search and if you went on and were looking for say for instance, breast cancer patient leaders or psoriatic arthritis patient leaders, you can go on there search and you can find people and you can see their social channels. You can kind of see their story and you can go follow them.

Emily: I mean, I feel like that might be helpful for people just to know that that’s a resource if you’re looking for people to connect with.

Julie Croner: Yeah. It’s invaluable in my opinion.

Emily: I guess my last question would be when you were sort of going through your own experience, how did you vet people? Like, how did you find somebody on Twitter who was saying something and like kind of know that they were credible in some way?

Julie Croner: Yeah, that’s a good question. So honestly, you have to follow them and kind of watch them. It’s almost like building a trust in a friendship, right? Like you start to follow them. You’re like, who is this person? Do I trust them? What are they saying? And, and I feel like you get a sense for are they really sharing their story for the right reasons or, you know, are they being unbiased or are they being very biased towards one thing or another. You’ll definitely see some people who do want to just make a living off of, you know, being an influencer and we’ll post everything from, Bandaids to Kraft Mac and cheese, whatever. Then you kind of have to take a grain of salt with what they say. For instance, if you’re looking to see if a Facebook group is the right fit for you, join it, kind of lurk. See the conversation, see how people are interacting. And the great thing about the internet is that if that one’s not for you could go and find somebody else. And I think that the hallmark trait of a really great patient leader, someone to really follow, is someone who is sharing not only their own story but information out there. So for instance, if they know that new treatments are coming down the line, they’re sharing articles or they’re finding different pieces of information from all around the community and sharing it out. Just to keep people in the know.

Emily: I think Julie makes a lot of really great points about why patients should be entitled to be compensated for sharing their health experiences and their stories. And I’m not completely against that as long as it’s sort of, I guess well-documented that it’s sponsored content. I think that’s really important. And I think this idea of how things are regulated is really like the crux of this for me. We have to be able to know what is being fed to us with these kinds of conflicts. I mean, this is what we see in the medical literature too. I want to know if somebody who has worked on a study is making a lot of money off of the results of that study or stands to benefit greatly from it. And in the same regard, it’s like somebody who’s selling something on Instagram, I want to know that that’s your business. It doesn’t mean I won’t buy it. It doesn’t mean that I won’t believe your medical story, but I just kind of want to know. I think we’re really at the very infancy of understanding all of this stuff. And so I was excited to hear that the FDA is actually just started two different studies that are going to look at how consumers interpret different kinds of influencer advertising marketing. And one of them is looking at 698 followers of an Instagram influencer with more than half a million followers. And they’re going to look at things like how do they respond to a fake endometriosis product. And what’s interesting is that they’re going to look at how the followers respond to the posts directly as paid ads versus like labeled indirectly with hashtags that are sponsored and you know, sort of all the various different ways that we have for showing that something is sponsored content, none of which has been even best practices. I feel like there isn’t a formulated way of doing that standardized way I guess I should say of doing that. And so the study aims to sort of examine the role of the endorsement and hopefully that is the very first step. Once we kind of understand how these ads impact people, then maybe we can finally get some regulation around it. I don’t know, to be honest, the whole thing just seems like we are way too slow-moving on this and it’s happening now. So I guess we need a study to understand it. I think we kind of understand it. I think we understand that it’s manipulating people. So we’re going to go back to Suzanne Zuppello who is a journalist and an expert on influencer marketing and the FTC regulations and rules. On all of this kind of stuff. We spoke to her last week as well. She knows a lot about this. Again, if you haven’t listened to last week’s episode and you’re interested in this topic, she explains a lot of this last week too. But here she is. I feel like one of the things that’s surprising to me in talking to you about all this stuff is that there hasn’t been—what is the most egregious case of this? Have people died? Are there incidents where you know people have gone and sued the companies. Because obviously if there’s a settlement you would know that there was a suit but you wouldn’t know what happened in it. But I feel oftentimes in history, the way the government will get involved is because something really big happens. Right? Like it’s a catastrophe of some sort. Or that like the influencers maybe aren’t actually using these products. Right? But if they are they have a terrible reaction. Have there been stories like that?

Suzanne Zupello: I haven’t come across anything. And as far as I know when it comes to something that could cause harm the person has either not used it or they’ve used it and been a success story and like maybe their post was contingent on that, but they could also lie. There is nothing preventing a person from being genuine about the experience that they had with it or if they use the product in general. I haven’t heard anything about a major class-action lawsuit against an influencer or a company that somebody bought products from because of social media advertising. I think where we really need to be focusing on though is, and this is at least where a doctor comes in as the barrier is the advertising that we’re seeing so much on social media when it comes to a prescription drug that you need to get from a doctor, or this surgical techniques. I keep harping on this one surgical technique because I found it because I’ve had a double mastectomy. And you know, you have to talk to a doctor about those things first. And if you’re a doctor that you trust and that you’ve hired to care for, you doesn’t believe in it, doesn’t see the evidence there, then there’s at least that layer of protection. But there’s also, you know, anybody could have a reaction to any product and it could just be an allergy. And so there’s a lot of, I want to say leniency here when it comes to, you know, going after fit tummy Tea to say, you know, it gave me ulcerative colitis. It’s not going to do that. But it could damage your organs if you’re using it constantly. I imagine we will see bigger cases against some of these companies soon.

Emily: Well because I feel like the egregiousness of lying, right? It’s usually something that’s pretty clear cut in the justice system. Right? Cause it’s fraud. I think if people are making false claims about things than that, that sort of needs to be remedied. If they’re just selling stuff like you know, if somebody is selling you, I feel like water is the thing that seems so silly and obviously water is a big seller, but like you know, and then like claiming that it has some sort of fountain of youth qualities and it doesn’t, but it’s just water so it’s not going to hurt you. Then it’s sort of like you’re the fool. Right. But even that, I feel like it used to be that companies were not allowed to lie in advertising. I feel like it’s really interesting that we’ve sort of gotten to the point where it’s really buyer beware and it’s really about people like the government not being able to catch up and the companies themselves sort of taking that and running with it. Right? Rather than be like okay, let’s set a new standard for how we’re going to self regulate so the government doesn’t have to get involved. Which would be sort of more proactive thinking. I think from a business perspective anyway. They’re like, let’s just grab our market share as quick as we can and be as manipulative as possible about it. And it just feels terrifying.

Suzanne Zupello: Yeah. I mean, unfortunately, in the cases in the past where we’ve wanted companies to self-regulate, I’m pretty sure that’s what led to like the, the Boeing crashes was they were supposed to be regulating themselves and they cut corners and they didn’t. And so when we put it on people whose end game is to please shareholders, please investors turn a profit, it becomes much more complicated. Unfortunately, I think it’s always been buyer beware. We just haven’t been cognizant of it because the ads that we were getting were in a magazine spread or on TV and you were clearly being advertised to. In conversations that I’ve had with representatives from the FDA, they said that they rely on people submitting reports to them, reporting different posts, reporting adverse reactions to different products. And most consumers don’t know that they can do that. They can just go to the FDA and say, Hey, this influencer posted about, you know, whatever pill. And I took it and it did this to me. They’re really relying on us to filter out some of this bad stuff for them, which I think is really interesting because most people don’t know that they can do that or that they should be doing it.

Emily: And are there any big watchdog organizations who are on this?

Suzanne Zupello: As far as I know, no. I know that the FDA is really trying to amp up their ability to monitor this. I haven’t seen a big organization that is policing this industry. And I think there should be. So if they’re listening get in touch with me, I’d love to participate. But we need somebody that’s a consumer protection organization that’s maybe a nonprofit that’s there just to look out for people. It’s unfortunate that that’s the position that we’re put in, but it’s a very real need I think. I mean I keep going back to when Mark Zuckerberg last year testified or the year before in front of the Senate and they didn’t even realize that Facebook makes money because they sell ads. So if they don’t even realize that they’re selling ads, then of course they’re not going to know that there are ads that need to be policed and monitored super carefully because they’re dangerous and misleading to people who are in vulnerable situations.

Emily: I used to cover tech for PC World covering Congress and it was like the craziest job because it was literally these two bodies were speaking different languages. They were so far apart and that was like a hundred years ago. So I can only imagine, I mean I remember somebody saying to me like, Oh, we wrote this spyware bill using language from your story. And I was like, for Christ sakes. That is the most unsettling thing I’ve ever heard. Yeah, I’m trying to figure this stuff out. And you know what I mean? Like just everything was backwards and it made me realize the private sector is always like, let us solve the problem because we’ll be faster and more agile and we’re thinking about the future and how we can sort of prevent problems but also not sort of suffocate the market that we’re trying to create. And Congress has just been like shut it down. Right? Or we don’t understand. Keep doing business as usual. It’s like there’s gotta be something in between because things are moving really fast.

Suzanne Zupello: Again, going back to consumers, just being careful, you need to double-check where you’re getting this information from because even not every health writer or health journalist is going to be the person who’s going to want to dig and pick things apart. Like I’m just such a glass half empty person that I’m always looking for the catch when I’m researching something that seems a little too good to be true, but I think that’s on writers and on editors and you know, the lawyers have these sites to make sure that what they’re putting out there is backed up somehow. You know, giving people enough cover. Because what we’re reading every day, and because health writing is just so pervasive now is every day we’re told there’s something wrong with our body that needs to be fixed. You know, we’re sleeping on our side instead of our back or back instead of our side. And so even really smart people think they’re broken and that they have to do something. And our bodies are capable of pretty amazing things when you actually dig pretty deep. But yeah, I think we’re duping a lot of people. You know, you have to look at the credibility of the writer who’s doing the story, whether it’s sponsored content or not. You know, there’s, it’s just an explainer on something that a person’s not going too deep on. You need to really click those links, make sure it’s actually sourced. You know websites like the Federalist for instance. Totally different topics, but they don’t source anything. They don’t put a link to the things that they’re saying. And so when I’m reading something about my health, I want it linked to a doctor who agreed with the opinion or a study that has been done that supports the statement that’s being made. But it’s the wild West out there and you know, God bless the first amendment, but where it hurts us in a lot of ways too because people can say anything they want on the internet. I think going back to just like playing on people’s vulnerabilities and where they’re getting their information. I don’t begrudge the person that believes if somebody is being paid to say something is good, then it’s good. You know, that it works. And I keep going back to this surgical technique that is being advertised to women who’ve had mastectomies and it’s being advertised as something that is going to regenerate sensation in their breasts after mastectomy. Your nerves are cut. You don’t often have very great sensation in your chest afterwards. And that’s something that’s playing into the psyche of a woman who wants to feel sexual, who wants to feel great in their body. But all of the advertisements I was seeing for this done by influencers, never once said, what kind of breast reconstruction you had to have for this to use. It never said how many successful times the surgery had been done. And when I started digging in it, and this is what started the influencer story that I wrote for Vox, is the surgery was barely being done. They were paying doctors to do the surgery and decades ago other doctors had tried to reconnect women’s nerves in their chests and have very little and mixed success. And it really had to do with the patient and nothing to do with the technique. And so we’re just like repackaging something that didn’t work previously. Telling women it’s going to work and getting their hopes up when they realize they’re not even a candidate for this. And so then I go to people not wanting to speak up because they’re afraid. And you maybe don’t want to get your hopes up too that things are going to get better. Right?

Emily: No setting realistic expectations is like such a key to happiness.

Suzanne Zupello: Yeah. And I think social media is failing us in so many ways in that regard. And you know, all the posts of social media is not real life. Well then why do we keep having a post that and tell people it’s not.

Emily: I think Suzanne’s point this week and certainly these two episodes on influencers highlight the larger theme, which is really the theme of the podcast in some ways, which is that we’re facing sort of a crisis of credibility. Like there’s a lot in medicine and in wellness and in this health space that is just not known. And there’s more and more people who are coming to the table and claiming to be experts or making claims about products or services or things you need or things you don’t need or what not. And it’s sort of becoming a real buyer beware environment. And you as the buyer of healthcare, whether that be a new skin cream or a surgery or a doctor need to be informed and that requires some work and that’s tiring and it’s not always fun. And I think what makes social media so tricky is that it’s like the easiest format by which to be enticed in. And I think we’re really just at the beginning stages of trying to understand all of this. So I’m on the one hand excited that people are looking at this critically and starting to figure out what its impact is on us as consumers. But it does make me feel nervous because I think it probably is more influential than we even realize. You know, anecdotally, I know so many people who do this kind of stuff where they’re recommending products. And I think Jill and I get sent stuff all the time. And mostly we just accept books because otherwise it becomes kind of a conflict. And we’re strict about it, but most people aren’t. And I don’t blame them for not being strict. I think it’s hard to say no to free stuff, but it does create sort of a slippery slope. And so I just think we all have to sort of, I don’t know, be critical while also still remaining optimistic. And I don’t think that’s always easy to do. But we’re here to help and we’re here to try and give you all as much information as we can to allow you to make the best decisions. So our goal is not to make decisions for you, it’s to give you information for you to be able to decide for yourself. So I hope these episodes have helped you look at your social media feeds in a way that allow you to make informed choices. I’m Emily Kumler and that was Empowered Health. Thanks for joining us. Don’t forget to check out our website at empoweredhealthshow.com for all the show notes, links to everything that was mentioned in the episode, as well as a chance to sign up for our newsletter and get some extra fun tidbits. See you next week.

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