{"id":11353,"date":"2024-11-18T10:12:34","date_gmt":"2024-11-18T15:12:34","guid":{"rendered":"https:\/\/blogs.nejm.org\/hiv-id-observations\/?p=11353"},"modified":"2024-11-18T10:12:34","modified_gmt":"2024-11-18T15:12:34","slug":"marking-a-social-media-mass-migration-until-the-next-one","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/marking-a-social-media-mass-migration-until-the-next-one\/2024\/11\/18\/","title":{"rendered":"Marking a Social Media Mass Migration &#8212; Until the Next One"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-11355\" src=\"https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2024\/11\/download-1024x521.png\" alt=\"\" width=\"400\" height=\"204\" srcset=\"https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2024\/11\/download-1024x521.png 1024w, https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2024\/11\/download-300x153.png 300w, https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2024\/11\/download-768x391.png 768w, https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2024\/11\/download-1536x782.png 1536w, https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2024\/11\/download-2048x1043.png 2048w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/>Periodically my wife and I will have a bunch of trainees (medical students, or residents, or ID fellows, or a mix) over to dinner. Seated around a big table, with no time-crunch of rounds, pagers, or EPIC orders, we can all get to know one another in this more relaxed setting.<\/p>\n<p>Plus, they get free food, never a bad thing in the years before you start having a real salary.<\/p>\n<p>It helps at these events to have a few icebreaker questions ready in case the guests are nervous, or just because the answers to the questions are so darn interesting. One of our favorites is the classic, <em>What do you love to hate, and hate to love?<\/em><\/p>\n<p>To clarify the question, for the purposes of this post, <em>love to hate<\/em> means something you feel with such a passion that you&#8217;ll go on and on about how much you hate it. For years, my answer was readily at hand &#8212; football, the American version. I bore people at social events on this topic, despite being in the minority, and once even <a href=\"https:\/\/www.wbur.org\/news\/2017\/02\/03\/football-fan-kids-doctor\" target=\"_blank\" rel=\"noopener\">wrote an opinion piece making my argument.<\/a><\/p>\n<p>But for the past 2 years, my response has changed. The thing I now <em>love to hate<\/em> is what a certain billionaire has done with the site formerly known as Twitter.<\/p>\n<p>(Sorry, I can&#8217;t refer to it by the new name. That name is so unimaginative, so eye-rollingly juvenile that it hurts even to write it. Truly.)<\/p>\n<p>As I&#8217;ve noted before, the appeal of the original Twitter snuck up on me, with my participation essentially zero for years after I signed up. Then I discovered it was the easiest way to keep up on the latest advances in our field &#8212; infectious diseases specifically and medicine in general.<\/p>\n<p>During the pandemic, it became all but indispensable, as changes to the best treatment and prevention strategies came so quickly that I felt I had no way of staying current without it. Experts from around the world &#8212; people I otherwise never would have known about or met &#8212; enhanced its value, weighing in on strengths and weaknesses of new studies.<\/p>\n<p>I supplemented this informational use of Twitter with several other useful tasks. I could boost the accomplishments of others, promote my own work, and (no small thing) indulge in several miscellaneous hobbies (baseball, tennis, cute dog videos).<\/p>\n<p>The fact that I&#8217;d figured out a way to tweak the settings so that attackers couldn&#8217;t view or respond to my posts &#8212; and strictly followed <a href=\"https:\/\/images.app.goo.gl\/aQFcYqi9Rpzu6vt18\" target=\"_blank\" rel=\"noopener\">Peter Sagal&#8217;s rules<\/a> &#8212; made some of the more widely publicized limitations of Twitter something I was able to avoid. It was like having an effective social media vaccine.<\/p>\n<p>So what happened? Since October 2022 &#8212; <a href=\"https:\/\/www.nbcnews.com\/business\/business-news\/twitter-elon-musk-timeline-what-happened-so-far-rcna57532\" target=\"_blank\" rel=\"noopener\">note date<\/a> &#8212; my experience on the site has steadily deteriorated. The effectiveness of that vaccine has faded. So what happened?<\/p>\n<ul>\n<li><strong>Curation now fails.<\/strong> The algorithm either stinks, or most of the people in my field stopped posting interesting things, or both &#8212; hence I&#8217;m rarely seeing good ID content. Lots of what I get in my feed is irrelevant junk. Pointless ads. Spam.<\/li>\n<li><a href=\"https:\/\/boingboing.net\/2024\/09\/25\/twitter-limits-blocking-they-can-see-your-tweets-now.html\" target=\"_blank\" rel=\"noopener\"><strong>Limits on the blocking function.<\/strong><\/a> Why on earth would they remove this key safety feature?<\/li>\n<li><a href=\"https:\/\/www.socialmediatoday.com\/news\/x-limiting-the-reach-some-links-mentions-posts\/690980\/\" target=\"_blank\" rel=\"noopener\"><strong>Limits on displaying graphics generated from certain URLs, or limits on those URLs entirely.<\/strong><\/a> Surprise, surprise, they might be competitors, or sites that someone (guess who) doesn&#8217;t like.<\/li>\n<li><strong>A certain person&#8217;s posts pop up repeatedly, even though I don&#8217;t follow him.<\/strong> Hint: He owns the place.<\/li>\n<li><strong>Bots.<\/strong> Who&#8217;s real and who isn&#8217;t? Very hard to tell.<\/li>\n<li><strong><a href=\"https:\/\/x.com\/i\/premium_sign_up\" target=\"_blank\" rel=\"noopener\">Payment is regularly requested to boost influence.<\/a> <\/strong>Wasn&#8217;t &#8220;flattening hierarchies&#8221; one of the proposed benefits of Twitter, our &#8220;digital town hall&#8221;?<\/li>\n<li><strong>The stupid new name.<\/strong> See above.<\/li>\n<\/ul>\n<p>That&#8217;s plenty. Thanks to the prescient departure from Twitter of my colleague Dr. John Ross years ago, and the energetic assembly of ID &#8220;starter packs&#8221; by Dr. Ilan Schwartz, I&#8217;m joining hundreds of ID docs and millions of others who went over to Bluesky in the past couple of weeks &#8212; <a href=\"https:\/\/bsky.app\/profile\/paulsaxmd.bsky.social\" target=\"_blank\" rel=\"noopener\">here I am.<\/a> That&#8217;s a new background photo of Louie, featuring one of the silly plates my wife discovered in a remainder bin.<\/p>\n<p>And wow, this has been a fast switchover, nicely documented both by <a href=\"https:\/\/www.nytimes.com\/2024\/11\/17\/technology\/bluesky-growing-pains.html\" target=\"_blank\" rel=\"noopener\">the mainstream media<\/a> and more specifically for us ID docs, by <a href=\"https:\/\/bsky.app\/profile\/kenkoonwong.bsky.social\/post\/3lb4ni4idbk2s\" target=\"_blank\" rel=\"noopener\">Dr. Ken Koon Wong<\/a>. (That&#8217;s his figure on ID engagement at the top of this post, used with his permission.) If you&#8217;ve been active as a poster or just lurker on Twitter, I&#8217;d encourage you to give Bluesky a try. Here&#8217;s Ken&#8217;s <a href=\"https:\/\/www.kenkoonwong.com\/blog\/bluesky\/\" target=\"_blank\" rel=\"noopener\">excellent guide on how to get started.<\/a><\/p>\n<p>Let&#8217;s see what happens over time. I have no illusions about the permanence of this move, as nicely articulated in a <a href=\"https:\/\/www.theatlantic.com\/technology\/archive\/2024\/11\/bluesky-bubble-twitter-replacement\/680679\/\" target=\"_blank\" rel=\"noopener\">recent piece in <em>The Atlantic<\/em><\/a>. Ignored or abandoned social media sites (MySpace, Friendster, Mastodon, et al.) lay at the bottom of digital scrap heaps like unused USB drives in your desk drawer from a decade ago. Plus, I have no idea how the owners of Bluesky will find a way to support it financially.<\/p>\n<p>Note that the above list of reasons to leave Twitter left off its political associations. Honestly, that is the one thing that I&#8217;ll probably miss the most about leaving the site &#8212; the exposure to perspectives different from my own. Bluesky has already been accused of being an &#8220;echo chamber,&#8221; a notorious limitation of social media in general, most notoriously Facebook &#8212; of course your &#8220;friends&#8221; agree with most of your views!<\/p>\n<p>Other limitations of Bluesky are more technical than systemic. You can&#8217;t easily bookmark posts. There&#8217;s no app optimized for tablets. No polling function. Their servers sometimes struggle with the massive influx of new users. And I have no idea how they plan to make money on this thing, which ultimately I guess will determine its longevity.<\/p>\n<p>Importantly, I haven&#8217;t found most of the cute dog feeds yet. But I&#8217;m hopeful since WeRateDogs has made the move!<\/p>\n<blockquote class=\"bluesky-embed\" data-bluesky-uri=\"at:\/\/did:plc:rlr4e4zioxivpndzr4mqw4r2\/app.bsky.feed.post\/3lazcihyknc25\" data-bluesky-cid=\"bafyreiccborgs54l4iwoix6c23kltikpunblbubimcfkjxhe4zckev2x5e\">\n<p lang=\"en\">This is Lily. She&#39;s been accused of drinking her mom&#39;s slushie. Will not be taking any questions at this time. 14\/10<\/p>\n<p>&mdash; <a href=\"https:\/\/bsky.app\/profile\/did:plc:rlr4e4zioxivpndzr4mqw4r2?ref_src=embed\">WeRateDogs (@weratedogs.com)<\/a> <a href=\"https:\/\/bsky.app\/profile\/did:plc:rlr4e4zioxivpndzr4mqw4r2\/post\/3lazcihyknc25?ref_src=embed\">2024-11-15T21:18:48.329Z<\/a><\/p><\/blockquote>\n<p><script async src=\"https:\/\/embed.bsky.app\/static\/embed.js\" charset=\"utf-8\"><\/script><\/p>\n<p>I trust you, Lily.<\/p>\n<p>So this is where I&#8217;ll be in the social media universe, at least for the time being. Looking forward to more of that great learning I had from Twitter in the pre-2022 era &#8212; Bluesky can&#8217;t be far off if <a href=\"https:\/\/bsky.app\/profile\/tonybreu.bsky.social\/post\/3lb3tia65fp2e\" target=\"_blank\" rel=\"noopener\">Dr. Tony Breu has already posted.<\/a><\/p>\n<p>And if you&#8217;re wondering what I <em>hate to love<\/em> (the other part of the two-part question), it&#8217;s potato chips. Irresistible, but not salubrious.<\/p>\n<p>And it looks like I&#8217;m not the only one.<\/p>\n<blockquote class=\"bluesky-embed\" data-bluesky-uri=\"at:\/\/did:plc:bshaercmmku6gcw642dsjf7n\/app.bsky.feed.post\/3laz6wtmo4c2v\" data-bluesky-cid=\"bafyreib25xqmnmpwmn57kzjlfughzybmnfepxj6x5bvozowigr256lntxa\">\n<p lang=\"en\">Today in relatable science: Gulls making a mysterious daily trip that turned out to be to a potato chip factory<\/p>\n<p>&mdash; <a href=\"https:\/\/bsky.app\/profile\/did:plc:bshaercmmku6gcw642dsjf7n?ref_src=embed\">Brooke Jarvis (@brookejarvis.bsky.social)<\/a> <a href=\"https:\/\/bsky.app\/profile\/did:plc:bshaercmmku6gcw642dsjf7n\/post\/3laz6wtmo4c2v?ref_src=embed\">2024-11-15T20:15:15.323Z<\/a><\/p><\/blockquote>\n<p><script async src=\"https:\/\/embed.bsky.app\/static\/embed.js\" charset=\"utf-8\"><\/script><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Periodically my wife and I will have a bunch of trainees (medical students, or residents, or ID fellows, or a mix) over to dinner. Seated around a big table, with no time-crunch of rounds, pagers, or EPIC orders, we can all get to know one another in this more relaxed setting. Plus, they get free [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,5,6],"tags":[5850],"class_list":["post-11353","post","type-post","status-publish","format-standard","hentry","category-health-care","category-infectious-diseases","category-medical-education","tag-twitter"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/11353","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=11353"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/11353\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=11353"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=11353"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=11353"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}