Like a life raft in a sea of misinformation, healthcare providers have appeared on social media platforms, correcting misguided health information and pointing out credible research.
But as they joined the influencer sphere, a subset of professionals, including several registered dietitians in Canada, adopted the influencer business model: creating sponsored content or “paid partnerships” with brands and industry groups.
Until now, dietitian colleges that act as regulators have largely allowed their members to receive money from the industry, as long as they follow advertising guidelines.
But some experts say the current level of oversight is insufficient or argue that it is not possible for a licensed health professional to receive money from the industry without having a conflict of interest.
A recent joint research by the Washington Post and health journalism outlet The Examination found that several American dietitians had posted videos on Instagram criticizing headlines questioning the safety of aspartame. It was revealed that the beverage industry had paid dietitians to make the publications and that in some cases the payment was not disclosed.
The same article highlighted paid publications that some Canadian dietitians had done for the Canadian Sugar Institute, a non-profit industry group funded by private companies.
However, the institute says on its website that it operates on an arm’s length basis with its funders and does not participate in the marketing efforts of those companies.
Breaking: contacted 11 Canadian registered dietitians who post sponsored content on their Instagram accounts, including two who were interviewed by the Washington Post, but none agreed to an interview.
Jessica Penner and Nita Sharda, registered dietitians and business partners based in Winnipeg, declined an interview but said in an email that they are open to brand partnerships that align with their goal of supporting nutrition and a positive relationship with food. .
“Our audience always knows if something is gifted or sponsored and we are proud of our transparency.”
Professionals used as a ‘marketing tool’
But transparency is not enough to avoid conflicts of interest, says Alison Thompson, a bioethicist who teaches ethics to pharmacy and public health students at the University of Toronto.
“It’s not a question of whether you were actually influenced by that conflict. It’s the perception of a conflict of interest that can undermine public confidence in the profession itself,” Thompson said, adding that studies have shown that research funded by the industry ends up having a positive bias. .
“We know the industry pays health professionals to share their opinions because it works. It’s a marketing tool.”
Thompson says that financial connections to industry are increasingly frowned upon (such as doctors’ relationships with pharmaceutical companies), but that there is less public awareness about how this happens on social media.
Thompson said clearer disclosure is a good first step and he would like to see a public registry where Canadian professionals are required to openly share all relationships with the industry.
Regulations and standards
In Canada, dietitians are supervised by regulators at the provincial level.
Regulatory bodies in British Columbia, Alberta, Saskatchewan, Manitoba and Ontario shared copies of their policies and other resources provided to members related to social media and advertising, which shared similar principles in varying degrees of detail.
The College of Dietitians of Ontario warns dietitians that they should “carefully consider” endorsing any specific brand or product.
“Principles of transparency, honesty, evidence-based practice, professional judgment and ethics should be considered,” Ontario’s social media standards and guidelines state.
The College of Dietitians of BC cites Ad Standards Canada’s recommendations on disclosure of brand associations, recommending that disclosure be “direct, conspicuous and unambiguous”: disclosure should be made at the beginning of the video and in the first few lines of the post .
The university recommends using widely accepted hashtags such as #ad and #sponsored and avoiding hashtags that do not clarify whether monetary connections exist. “It is not enough to label the brand,” BC guidelines advise.
While regulators have the ability to discipline members who violate their standards, Ontario, BC and Prairies universities said they have not received any public complaints about dietitians making paid posts on social media.
Preserving trust is a concern
Some complaints have reached the doors of Quebec’s regulator, the Ordre des dietites nutritionalnistes du Québec.
So far, none of the complaints have led to sanctions, President Joelle Emond said in an interview, adding that only a minority of Quebec dietitians are on social media, and an even smaller number make sponsored posts.
The code of ethics for Quebec dietitians is currently under review and Emond says they are trying to find the best way forward.
“Our primary concern is trust and preserving the public’s trust in our health care professionals and registered dietitians,” he said. “If we lose the bond of trust, we lose everything.”
Emond said that while the public likes that dietitians are on social media providing credible information, there is much less public approval of paid partnerships.
Meanwhile, he says dietitians who create paid content argue that it allows them to spend time sharing trustworthy information on platforms like Instagram and TikTok, and that their professional codes of conduct ensure the information is evidence-based and free of influence.
“But the question we ask ourselves is: is that enough?” Emond said.
Dietitians aren’t the only ones taking advantage of their credibility from private companies: Doctors and physiotherapists do it too, says Timothy Caulfield, Canada research chair in health law and policy at the University of Alberta, who studies misinformation. online.
On platforms packed with health and wellness influencers eager to work with companies of all types, he says licensed healthcare providers are particularly attractive to advertisers.
According to Caulfield, there has been a “huge erosion of trust” with institutions and professionals. “But health care providers are still among the most trusted voices out there.”
Like Thompson, Caulfield wants regulators to do more to require clear and obvious disclosures from their members. He doesn’t think simply adding “#ad” to an Instagram caption is enough.
Until there are better standards, Caulfield said people should assume that if a product is promoted, there may be a commercial connection.
“Pause and look at those revelations, and if you see that it’s an advertisement, be skeptical,” he said.