When Raquelle Akavan, PA-C, started the PA Moms Facebook group in 2016, she was a new mother and the lead surgical physician associate at a hospital in the Bronx. When she failed to find a support group for women PAs juggling the demands of medicine and motherhood, she created her own. “There were lots of existing groups for physicians, but nothing for PAs,” says Akavan.
What began as a small peer network has grown into a powerhouse community of over 20,000 members, focusing on scholarships, advocacy efforts, conferences and even influencing national policy. Most of all, they provide working moms with much-needed support in a space exclusive to PAs.
“We’ve saved lives in this group. People have posted about their symptoms, and others encouraged them to see a provider. One woman discovered she had metastatic cancer because of advice she got in PA Moms,” says Akavan.
Still, the power of online communities can cut both ways. Clinicians have faced disciplinary action or job loss for posting unprofessional content, using discriminatory language or giving advice that crossed legal boundaries.
As the founder of PA Moms, which is now a Special Interest Group of the American Academy of PAs, and the author of a recent policy added to the AAPA policy manual on social media conduct, Akavan knows firsthand that the stakes of building an online presence are high.
Q: What are the biggest mistakes you see PAs making online?
Akavan: People say things out of emotion without thinking before they speak. It’s important not to be a keyboard warrior. Lead with kindness, respect and professionalism. You can still state your opinion while remaining professional.
Q: Have you seen real consequences for what people post online?
Akavan: There have been providers fired or removed from leadership roles because of discriminatory or unprofessional comments, especially in some recent anti-Semitic online posts. Even in private groups or on Reddit, nothing online is private. You have to be intentional with everything you post.
Medicine has become more politicized lately, but as providers, we have to be sure we aren’t divisive online in a way that makes people feel like they don’t belong.
Q: What boundaries do you recommend for PAs giving health information online?
Akavan: Obviously, don’t give personalized medical advice online. You can provide evidence-based public health tips or education, but include a disclaimer that advises people to consult their healthcare provider. In PA Moms, we’re all medical professionals, so it’s a bit different, but we still have a disclaimer because we can’t monitor every comment.
Q: What do you say to PAs who want to build a public platform on social media to share health content?
Akavan: If you’re representing yourself as a PA, you should maintain the same level of online professionalism that’s expected in the workplace.
Your employer, colleagues, patients and maybe even the licensing board are watching.
Q: What’s your strategy as a leader with a large audience?
Akavan: I have opinions like anyone else, but I lead a diverse group of women. So I think carefully about what I post. It’s a leadership skill more than anything. If you’re a PA online, you’re representing our entire profession, so think before you post.
Within our Facebook group, we have basic rules to ensure everyone feels welcome:
- People shouldn’t share posts from our group
- Be respectful, which means no discriminatory comments or bullying
- No politics or divisive posts or comments
Politics can divide people so quickly with one post. We want to create a cohesive group where people feel they belong.
Ethical online guidelines for PAs
Last year as part of the nonprofit that grew out of PA Moms, PAs for Women Empowerment, Akavan authored a new section in the AAPA policy manual, “Guidelines for Ethical Conduct for the PA Profession.” This formally states that PAs should maintain the same ethical standards online that are expected in the workplace.
This includes avoiding language that disparages any group and maintaining a respectful and professional online presence. “It wasn’t easy to get this passed. People were afraid the AAPA would get people in trouble, but I honestly think it’s important to have a guideline for behavior,” says Akavan.
The section is a good guideline for all clinicians and states:
PAs should maintain the same level of ethical conduct online as is expected in the workplace [when representing themselves as PAs]. It is important for PAs to remember their actions online may impact their reputation with patients and colleagues, as well as have consequences for their medical careers. In the digital world, where interactions can quickly reach a wide audience, PAs are responsible for maintaining behavior that reflects respect, empathy and ethical standards expected of healthcare professionals. By adhering to these guidelines, PAs ensure that their online presence aligns with the dignity of the profession and the trust placed in them by patients and their colleagues. All PAs shall refrain from engaging in or endorsing any communication that disparages any group based on characteristics such as race, ethnicity, gender, sexual orientation, nationality, religion, or other characteristics.
Final tips to protect yourself online as a healthcare professional
- Lead with professionalism. Assume everything online could be screenshot and shared with your employer, patients or even a licensing board.
- Avoid personal medical advice. Always include disclaimers and encourage followers to speak with their provider.
- Stay evidence-based. Avoid pseudoscience, unsupported claims and hot takes on controversial medical topics.
- Be mindful of tone. Emotional posts, sarcasm and heated arguments are easily misinterpreted.
- Know your group rules. If you run an online healthcare group, similar to the PA Moms Facebook group, state clear posting policies, set up post approvals and actively moderate comments.
- 6. Don’t let online attention inflate your ego. As Akavan says, “If you’re a PA online, you’re representing the profession.”
