“Just as water, gas, and electricity are brought into our houses from far off to satisfy our needs in response to a minimal effort, so we shall be supplied with visual or auditory images, which will appear and disappear at a simple movement of the hand, hardly more than a sign.”

Paul Valery, 1928

I have recently decided to kick off an Instagram account. It seems like a useful tool to keep afloat as an orthodontist in a private practice. However, I have several concerns. Would it compromise professional ethics? Would I be able not to create a distorted image of the specialty in the eyes of the patients? Wouldn’t the images eclipse the message?

I want to give it some thinking. I want to look at the issue of the visual stimuli of social media with some help from a famous 20th-century German philosopher, Walter Benjamin. I am particularly interested in his essay “The Work of Art in the Age of Mechanical Reproduction”. Given that most of the specialists agree that orthodontics is a mixture of both arts and science, I think this makes sense…

The Work of Art in the Age of Mechanical Reproduction (1935)

Here you can find the original text. It not only shows the evolution of the mass-produced visual images, but thoroughly explores the driving forces behind these metamorphoses.

The pivotal idea of the essay is that the modern mass-produced visual image is completely ripped out of its context. Benjamin writes: “Even the most perfect reproduction of a work of art is lacking in one element: its presence in time and space”. This feature of the mass-produced image gives its user a tempting opportunity to manipulate it in one’s own interests.

Benjamin points out that previously the production of visual images was mainly associated with ritual and religious purposes, however in the 20th century the image production industry was successfully leveraged by the politicians. He then describes how the 20th-century fascist and communist regimes were using visual propaganda to deliver their ugly messages to the gullible audience.

In Benjamin’s times, the most powerful media was cinema, a moving image. Today images are moved as predicted by a French poet Paul Valery “at a simple movement of the hand” on social media, probably the most persuasive media ever invented…

Orthodontic social media’s biases

Despite the fact that political propaganda and social media marketing are two drastically different worlds, I think some similarities are present. The visual content which both produce is often highly biased, out of context, and tend to appeal to the human’s instincts, not to logic or reason.

Unfortunately, many orthodontic social media accounts convey exaggeratedly photoshopped cherrypicked cases designed to cause a wow-effect or, in another words, to shut down logic and reason. The most adroit individuals are adding to such posts phrases as “revolutionary technology”, “we are fully booked till next year” or even “our doctors have God-given talents”. The latter is especially popular in Eastern Europe and the Middle East. I can’t help feeling that this is somehow connected to the fact that no legit certification mechanisms are present in many of the countries in these regions.

Everything mentioned above is, of course, an ubiquitous phenomenon seen in each and every industry today. The market has become the main exploiter of the image. Dr Lysle Johnston once ironically said: “In orthodontics everything works until it helps you to pay your bills”. The same situation is happening with social media: every image is fine as far as it brings you new guidable patients (now they are more often called clients).

We all are perfectly aware that a human being is a visual creature. As a result, even the most shrewd individuals can sometimes buy into the most obvious gimmicks…

Digital fatigue, professional ethics, and a responsible way to run a social media account

I am a big believer in professional ethics. I think patients should not be treated as Pavlov’s dogs, but should be given a chance to exercise their logic and reason prior to make any decision about the upcoming treatment.

Unfortunately, our patients often become the victims of digital overload when trying to explore the kaleidoscope of online claims about orthodontic treatment. Such claims are often designed to be appealing to the general public, but are in fact erroneous, and have hidden agendas. As a result, the patietns may acquire the wrong perception of what could and should be achieved by orthodontic treatment. We should not cater to such distorted vision of our patients. On the contrary, we should provide them with an explanation of sensible treatment options and potential side effects of extreme treatment modalities. 

We also should care about the overall image of our specialty. We should behave responsibly and collegially. We should not present our methods as unique and our skills as divine. Oppositely, we should provide some context behind our treatment modalities: some references to research data would help the patient to make a reasonable choice, meanwhile would also create a healthier image around our specialty.

Of course, I am a bit nervous to commence my Instagram account. I work and live in Russia, and orthodontic specialty has not yet been properly established here. Many people practising teeth-straightening techniques have very superficial knowledge of what they do, and mostly rely on local self-proclaimed gurus instead of orthodontic literature. As a result, I am fully prepared to receive disparaging and rude comments. Nevertheless, I will try to run my account in a responsible way. That’s what I mean by this:

1. I will try to deliver a meaning, not a wow effect.
2. I will respect the specialty of orthodontics and will indicate the context behind what I do.
3. I will promote the spirit of collegially and will promulgate the idea of board certification.

Now I have nothing more to tell you rather than… Hey, follow me on Instagram!