Nurses and doctors are flocking to TikTok to crack jokes and lip sync. But are they eroding patients' trust?

Updated 1006 GMT (1806 HKT) January 18, 2020

(CNN)Scroll past the teens who film themselves flossing (that's the dance, not the act of dental hygiene) and the young activists satirizing the issues of the day, and you might find a board-certified physician thrusting furiously to a Ciara song, extolling the virtues of complex carbohydrates.

That may sound like a sentence straight out of Mad Libs. It's not.
Medical professionals are navigating the testy waters of TikTok, one of the most popular social media platforms in the world, en masse.
The hope is, if TikTok's primarily teen demographic doesn't get adequate health education in school, maybe they can pick up a tip or two in between all the lip syncing. Just make it funny, self-aware enough and, if possible, frame it like a meme.
They don't always get it right.
Healthcare-themed TikToks that have gone viral as of late have been widely derided. A now-deleted clip from a user named Nurse Holly was widely criticized this month for stating that abstinence is the best form of STI prevention. Before that, a nurse who goes by D Rose on TikTok who mocked patients for faking their symptoms accidentally kicked off a hashtag movement that led thousands of users to share moments when their medical providers didn't believe them.
And when a few people get it wrong, experts worry that their slip-ups, shared far and wide, could sow growing distrust in the medical profession.
"Social media is absolutely an important space for medical professionals to be having conversations around things like public education, trying to combat some of the misinformation and pseudoscience that's just running rampant on all these different platforms," said Sarah Mojarad, a lecturer at the University of Southern California and science communications expert.
"But people are just posting content. They're not really thinking about their role as a medical professional and how that's going to impact the public's perception of medical professionals," she told CNN.

There's no precedent for viral physicians

TikTok is taking over the world, gradually in older spheres, all at once among young people. The short-form video platform is mostly populated by teens, who become its stars.
But not exclusively. The Washington Post, Reese Witherspoon and Julian Castro are among the decidedly hip platform's recent additions. Now healthcare providers are getting in on the fun. All of them package their messages in bite-sized clips that almost always feature lipsyncing.
If the statistics are any indication, users with a message are doing something right by joining the platform: ByteDance, the Chinese company that owns TikTok, has more than one billion active users across its apps. TikTok, already at 1 billion downloads since its 2017 rebranding, is wildly popular.
But there's never really been a precedent for what doctors can -- or should -- say in humorous videos that lampoon their profession.
Dr. Matthew Burke, a neurologist who teaches at the University of Toronto and has written about the dissolution of patient-physician trust, said flippant clips about healthcare, made and shared by healthcare professionals, are emblematic of a broader issue within medicine.
"This is just really symptomatic of this bigger problem: The fact that patients with complex, medically unexplained symptoms ... they're often dismissed, and a lot of mainstream physicians think that patients are faking it," he told CNN. "And that has gradually eroded some of the patient-physician relationships."
The public's trust in physicians has continuously waned. A 2014 Harvard School of Public Health study found that Americans are less trusting of medical professionals than residents of other countries, even if they like and trust their own provider.
And yet for the 18th year in a row, a recent Gallup poll named nursing the most honest and ethical profession. It's a badge the American Nurses Association wears with pride -- and likely why it's encouraging nurses to think twice, and maybe three times, before posting something personal.
"There's a difference between talking about what one does in their role as a nurse and mocking someone or what someone was experiencing," said Kendra McMillan, the American Nurses Association's senior policy advisor and a registered nurse. "It's our responsibility to respect and value patients who are trusting us."

The Christian nurse accused of shaming patients

Holly Grace, who declined to provide her full name but performs on TikTok as Nurse Holly, downloaded the app a bit over a year ago after undergoing unexpected brain surgery. She "cosplays" about her daily experiences at work, usually filming in her room wearing scrubs. Much of her content relates to her Christian faith.
"Using humor, I performed skits highlighting some of the chaotic things nurses do throughout the day, while showing people it's OK to laugh at oneself and to make mistakes," she told CNN.
Her videos are wholesome, for the most part. Though she's made clips about her brain injury, sexual abuse, depression and eating disorders. In one wordless clip, she references them all. A text bubble appears above her downtrodden face and says God helped her heal from all of them -- she brightens, then a new bubble appears -- "He can heal you too."
But in her most widely criticized TikTok, Holly suggests the best way to prevent sexually transmitted infections is to stay celibate until marriage.
Abstinence is one of the Centers for Disease Control and Prevention's recommendations to avoid STIs, along with vaccines, condoms and mutual monogamy. But users took issue with the nurse seemingly shaming her patients, overlooking cases of STIs transmitted through rape and infidelity and relying on her moral beliefs in a clinical setting.
Mojarad, the USC lecturer, said to hear calls for abstinence from a registered nurse is "incredibly harmful."
"Studies have confirmed that abstinence education in high school is just something that's not working," she said.
Holly said she's made mistakes online but asserted that she doesn't insert her moral beliefs into her work.