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Physician leaders’ cross-boundary use of social media: what are the implications in the current COVID-19 environment?

Scott Comber (Rowe School of Business, Dalhousie University, Halifax, Canada)
Lisette Wilson (Marine Affairs Program, Dalhousie University, Halifax, Canada)
Scarlett Kelly (Treasury Board of Canada Secretariat, Ottawa, Canada)
Lori McCay-Peet (School of Information Management, Dalhousie University Faculty of Management, Halifax, Canada)

Leadership in Health Services

ISSN: 1751-1879

Article publication date: 28 July 2021

Issue publication date: 21 September 2021




The purpose of this study is to better understand social media (SM) factors that physician leaders need to consider, as they adapt their cross-boundary practices to engage with colleagues and patients. Firstly, this study explores why SM is being used by physicians to cross horizontal (physician to physician) and stakeholder (physician to patient) boundaries prior to COVID-19. Secondly, based on the studies reviewed, this study provides insights on the practical SM implications for physician leaders working in the COVID-19 environment to actively enhance their practices, reduce public confusion and improve patient care, thus informing health-care practices.


A systematic literature review was used to conduct a structured transparent overview of peer reviewed articles that describe physicians’ use of cross-boundary SM across several disciplines (e.g. health, information science). As a baseline assessment prior to COVID-19, the review synthesized 47 articles, identified and selected from six databases and Novanet. This study used NVivo 12 to thematical code the articles, leading to the emergence of four broad factors that influence SM use.


A key reason noted in the literature for physicians use of SM to cross horizontal boundaries is to share knowledge. Regarding stakeholder boundaries, the most cited reasons are to improve patient’s health and encourage behavioural changes. Insights garnered on the practical SM implications include the need for physicians to be stronger leaders in presenting trustworthy and consistent facts about health information to the public and fellow peers. As role models for the effective use of SM tools, physician leaders can mentor and coach their colleagues and counterparts.

Research limitations/implications

As this was a literature review, the authors did not collect primary data to further explore this rapidly changing and dynamic SM world. Next steps could include a survey to determine firstly, how physicians currently use SM in this COVID-19 environment, and secondly, how they could leverage it for their work. Findings from this survey will help us better understand the role of physician leaders as health-care influencers and how they could better create trust and inform the Canadian public in the health information that is being conveyed.

Practical implications

Physician leaders can play a key role in positively influencing institutional support for ethical and safe SM use and engagement practices. Physicians need to participate in developing regulations and guidelines that are fundamentally to physician leader’s SM use. Central to this research would be the need to understand how physicians cross-boundary practices have changed during and potentially post COVID-19. Physician leaders also need to monitor information sources for credibility and ensure that these sources are protected. As role models for the effective use of SM tools, physician leaders can mentor and coach their colleagues and counterparts in this area.


Although there have been studies of how physicians use SM, fewer studies explore why physician leaders’ cross boundaries (horizontal and stakeholder) using SM. Important insights are gained in physician leaders practical use of SM. Key themes that emerged included: organizational and individual, information, professional and regulations and guideline factors. These factors strengthen physician leaders understanding of areas of foci to enhance their cross-boundary interactions. There is an urgency to study the complexity of SM and the effectiveness of regulations and guidelines for physicians, who are being required, at an accelerated rate, to strengthen and increase their cross-boundary practices.



The authors appreciate the very helpful comments of the anonymous reviewer of this paper. We are also grateful for the patience and support of Dr Jennifer Bowerman, editor, Leadership in Health Services journal. This study was funded by the Social Sciences and Humanities Research Council (SSHRC) Research Development Fund. The purpose of this fund is to support activities that develop, increase, or strengthen research excellence in the social sciences and humanities at Dalhousie University. The authors declare that there is no conflict of interest regarding the publication of this paper.


Comber, S., Wilson, L., Kelly, S. and McCay-Peet, L. (2021), "Physician leaders’ cross-boundary use of social media: what are the implications in the current COVID-19 environment?", Leadership in Health Services, Vol. 34 No. 4, pp. 462-484.



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