Physicians and scientists who use social media to communicate evidence-based health information are increasingly becoming targets of online harassment, raising concerns that abuse and intimidation could discourage experts from participating in public health discussions. Research suggests the problem intensified during the COVID pandemic and continues to affect health communicators, particularly those addressing controversial topics.

A study published in JAMA Network Open in 2023 surveyed more than 350 physicians and biomedical scientists recruited primarily through X and found that approximately two thirds had experienced online harassment. Most respondents cited multiple reasons for the abuse, and nearly 90% said it was related to their public advocacy.

Speaking with the American Medical Association, Regina Royan, MD, MPH, emergency physician in the Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, and lead author of the study, said, “This is a problem that’s getting worse at a time when physicians and scientists should be able to be using social media even more to promote accurate public health information.”

Similar concerns have been raised elsewhere. Researchers and experts from the Universitat Oberta de Catalunya (UOC), Barcelona, Spain, previously warned about increasing intimidation directed at scientists on social media, while emphasizing that the growing spread of misinformation makes public engagement by physicians and scientists more important than ever.

Salvador Macip i Maresma, MD, PhD, professor and director of the Faculty of Health Sciences at the UOC, discussed the issue with El Médico Interactivo, part of the Medscape Professional Network.

“Today, attacks on social media are well coordinated. They are no longer isolated individuals acting at random. They are communities united by common beliefs that mobilize when a leader identifies something that can advance their cause,” he said, drawing on his own experience as a science communicator.

Topics and Communicators Most Frequently Targeted

According to Macip, although any topic can attract criticism, certain subjects are more likely to provoke coordinated attacks.

“Any topic can trigger attacks, but anything related to vaccines or children is particularly sensitive,” he said.

He also noted that some groups experience disproportionately high levels of abuse.

“Without question, women receive more hate by default. But no one is immune to these attacks; it depends more on the topic than on the person.”

A commentary published in June 2025 in The BMJ echoed these concerns, warning that online harassment is discouraging women physicians from participating in public discourse. The commentary cited a survey of US physicians in which 1 in 4 reported experiencing personal attacks on social media. Women were disproportionately targeted and reported higher levels of anxiety and burnout, raising concerns that such harassment could further widen existing gender disparities in leadership and mentorship.

Managing Online Harassment

Reflecting on his own experience, Macip said that most online abuse consists of relatively unimaginative insults. More concerning are threats that attempt to extend into everyday life.

“The messages that become truly frightening are those that try to cross into the real world by saying things like, ‘I know where you live,’ or by revealing personal information. Very few of these threats probably lead to actual violence, but when you’re the one receiving them, you have no way of knowing whether this will be the case.”

Based on his experience, he recommends remaining calm while reporting behavior that crosses the line.

“I’ve been fortunate that most of the attacks I’ve received have been relatively mild. The people who threatened to come after me overlooked the fact that I was living in another country and that we were under COVID lockdown, making it extremely difficult for them to carry out their threats. But there are genuinely serious cases, and they should never be taken lightly.”

Communication Training and Institutional Support

Macip believes institutions have an important role in supporting physicians and scientists who experience online harassment.

“Research centers, universities, and hospitals should have professionals trained to support people experiencing this type of harassment. Institutions also need clear protocols, as well as legal and psychological support. This behavior is dangerous and must be addressed immediately.”

He also believes physicians and scientists need more formal training in public communication.

“You end up learning through experience because no one really prepares you for it, even if you know beforehand that these things happen.”

Despite the challenges, Macip remains optimistic about the value of science communication.

“We should recognize and commend everyone who continues communicating despite the constant hate they receive on social media. Their work is genuinely worthwhile.”

This article was translated from El Médico Interactivo on Univadis.