Beginning on July 23, physicians all over the world took to social media to post pictures of themselves in bikinis, using the hashtag #MedBikini. Against the backdrop of the ongoing COVID-19 pandemic and our broad social awakening to a second pandemic of systemic racism, why would thousands of doctors post pictures of something so seemingly frivolous as themselves in swimwear? We are both surgeons, and watched this play out in real time.
It initially started with a study published in the Journal of Vascular surgery that purported to analyze the behavior of physicians on social media. The study, conducted by a team of researchers based at the Boston Medical Center and Boston University School of Mecicine, was an attempt to classify the posts of trainees in vascular surgery as either professional or unprofessional.
Of course, we can point to any number of costly mistakes people have made on social media. Just in the last two months, Nick Cannon lost a contract with ViacomCBS for his longtime improv comedy show Wild ‘N Out because he made anti-Semitic remarks on his podcast. Similarly, Dee Nguyen, a cast member on MTV’s The Challenge, was fired after she made racist comments about the Black Lives Matter movement on Twitter and Instagram. So, one could understand why the authors were interested in ascertaining whether the posts of trainees in their own field might be professionally risky.
When the article was widely disseminated on Twitter, however, the authors faced a backlash for what was seen as their own lack of professionalism. For one thing, people raised concerns about the methodology used the study, in which three members of the research team created fake social media accounts to spy on the accounts of these young trainees.
The bigger problem, which led to the #MedBikini hashtag, were the authors’ definitions of “unprofessional,” including “controversial political or religious comments,” “controversial social topics” and ““inappropriate attire.” In that last category, they included “pictures in underwear, provocative Halloween costumes, and provocative posing in bikinis/swimwear.” And whether something was provocative or not was judged by the nearly all-male research team
The researchers also concluded that physicians should not post about “controversial” topics such as gun violence or abortion. But physicians have long been advocates for social causes. In recent years, physicians have risen up to fight gun violence with the #ThisIsOurLane movement, and with the current administration there have been many challenges related to abortion rights. Many physicians have rightfully spoken out about racial disparities in healthcare outcomes during the COVID pandemic, and when the murder of George Floyd sparked protests around the world, physician voices joined that battle cry as well. The Physician Charter on Professionalism, endorsed by over 108 organizations, says physicians should promote justice and advocate for the elimination of discrimination and advocating publicly.
In addition, it’s completely inappropriate for researchers to determine whether a woman’s Halloween costume or swimsuit is too “provocative” to be professional. It’s unclear how posts of this nature, outside of work, relate to a woman physician’s career. But what this study has shown, and why there has been so much outrage around it, is how people with privilege can use the label “professionalism” to target women, people of color, sexual and gender minorities, and anyone else they don’t approve of.
In the study’s defense, Erica Mitchell, the sole woman author of the manuscript, said on Twitter: “People get judged everyday by what is available on social media in all forms. It is the reality of today’s world in medicine or any other profession—like it or not. These impressions and the SM content stick and are hard to eliminate.” But in the face of withering criticism, some of the other authors and journal editors subsequently apologized for the paper and their approach to the study. The article has now been retracted.
We don’t believe anyone had malicious intent. But that is exactly the point. One need not have malicious intent to cause harm. In the same way, the gender pay gap affects women and implicit bias of physicians impairs the care of Black patients. In this case, researchers harmed the medical community by suggesting that speaking up about social causes, consuming alcohol when not working, and wearing a bikini were unprofessional. We may be doctors, but that doesn’t mean we’re not human.
The point is not who these researchers are or even what they did in this particular study. The authors, the institutional review board (which is supposed to watch out for ethical problems), the reviewers of the article and the journal’s editors all thought this was worth publishing. This is because in the culture of medicine, harassment and subjugation of those who don’t look like the dominant group is not only tolerated, it’s the norm.
At least one good thing has come out of this, though. That is the outpouring of support for women in medicine, with a number of our male colleagues posting pictures of themselves in their swimsuits. We are still fighting COVID-19, despite not having all the necessary tools to do so, but maybe this study and the #MedBikini hashtag have brought us all together.
Having a drink outside of work, wearing a bikini at the beach, and caring about social issues are just as appropriate for us as they are for anyone else. In our minds, advocating for social justice is more than appropriate: it’s our duty. The next time you see a doctor, remember that we’re human, too. And when you see your doctor post about wearing a bikini or going to a Black Lives Matter protest, we hope you won’t think it’s unprofessional.