Your account is set up. But trolls, malware and spam may lead to missteps that damage your reputation. Most of your experience online can be positive, but chance favors the prepared tweeter. Here are some tips that may help.

1. Twitter 103
Trolls, Malware & Spam
A Tutorial for Oncologists
Matthew Katz, MD
May 2014

2. Overview
 Trolls
 Definition
 Types
 How to respond
 Malware & Spam
 Definitions
 Magnitude
 How to minimize it

3. Troll
 Wikipedia: “Creation of any content that
targets anther person.”
 Mostly intentional, but in healthcare there
are new variants that may be unintentional

4. Who is a troll?
Troublemaking
Ridicules
Objectionable content
Lying
Lead astray

5. Reality Check
 Trolls are not people who disagree with you
 Expect debate on Twitter
 Be open to being wrong
 When conversations get heated and emotional,
show respect so you aren’t considered the troll

6. Troll Types in Social Media
 “Calling Out” Troll*
 Taunts you about your achievements, position
 Mainly affects self-promoters
 “Public Shaming” Troll*
 Keeps pestering you, repeated tweets
 May alternate between email, tweet, FB post
 May try to make you look unresponsive
 “Freeloader” Troll*
 People following others to obtain free materials
* Mitch Joel, TwistImage.com, http://bit.ly/1iNVm3C

7. The 5 R’s of Responding to Trolls
 Read, then walk around the block
 Trolls love emotional reactions
 Respectfully ask for them to clarify
 Give benefit of the doubt since it’s only 140 characters
 Reserve and humility are key
 Neutralize, de-escalate the hostile tone
 Redirect topic after making your point
 Indicate you have moved on
 Reject baiting if troll persists
 Don’t give trolls the attention they crave

8. “Help Me Doctor”
 Patient/caregiver
 Request for medical advice
 May share symptoms, problems
 May want treatment recommendations
 Complain about actual real-life providers
 Request for medical assistance
 Money for tests, medical procedures or medication
 Public support for raising awareness without full
disclosure, information

9. “Help Me Doctor”
 Different types
 Honest (unintentional)
 Fake (intentional)
 Don’t believe you can tell the difference!
 Contacting you
 Public tweet or DM
 Email or LinkedIn, Facebook message

10. Troll or not?
 Reasonable to consider trying to get medical
advice “objectionable”
 Not good medical practice
 Patient/caregiver may not know that, though
 Assume it’s someone truly in need
 Even if it ends up being someone who’s baiting you,
you’ll be judged by how you treat that person
 Empathy and professional

11. Handling “Help Me Doctor”
 Expressing sympathy is fine
 Identify the boundary
 “Sorry, I can’t address that for you”
 “That sounds like something to discuss with
your doctor”
 If the issue is pertinent to your field:
 “Twitter isn’t the place for direct medical care. Call
my office to make an appointment.”
 Direct to Cancer.net to find doctor near him/her
http://www.cancer.net/find-cancer-doctor

12. For Persistent Trolls

13. Block or Report?
 Block is more appropriate for trolls
 Caveat: You won’t see what they say about you
anymore
 Generally recommend ignoring, unfollowing if
applicable
 If it’s on a topic you care about, consider
checking in on them instead
 Don’t follow; lends credence to true trolls
 Report is more for spam

14. Malware and Spam
 Malware = “malicious software”
 Access private information
 Disrupt computer/website
 Mostly for financial gain
 Spam = unsolicited messages for advertising,
other messages
Source: Wikipedia Malware: http://bit.ly/Sqjlva
Spam: http://bit.ly/1kD6uxe

15. Malware in 2014
 Breaches and malware may cost $491B from
malware in pirated software alone
 1.2 B hours spent dealing with malware
from pirated software
 On Twitter and other platforms, fraudulent
accounts can be sold to be used for malware
or spam
Source: IDC/NUS, http://bit.ly/RfAXJj
UC Berkeley, http://bit.ly/1mtodNa

16. Mobile = computers
Source: Cisco Systems, http://bit.ly/1ig9xZp
Forbes.com, http://onforb.es/1msRrY0
Android = 70-97% of malware

17. Social Spam
 0.5% of all social content is spam
 355% increase in 1st
half of 2013
 Facebook+YouTube for 99% of content
 15% provide link/URL to spam, porn or
malware
Source: Nexgate, http://bit.ly/1msQcbs

18. Twitter Spam
 May use bit.ly or tinyurl.com shortlinks to
mask the URL
 Twitter banned such links in Direct Messages
(DM) in October 2013
 Social [ro]bots can autoreply to certain tweet
content to share spam with you

19. A Hint: Account Activity
Source: Nexgate, http://bit.ly/1msQcbs

20. Beware of friends, too
 Your account, or those of your
friends/followers may be taken over
 Spam may also come from legitimate
accounts
 If you notice it happen, notify the person
with a DM
 If no response, open message in case spammer
has disabled notifications or deleted the DM

21. Ways to Avoid Malware & Spam
 Strong password
 Follow with care
 No autofollow (using 3rd
party apps)
 Minimize 3rd
party software linked to Twitter
 Don’t share your email on Twitter openly (DM
only)
 Don’t click on links from folks you don’t know
Source: Social Media Examiner, http://bit.ly/1g1E9xU
eHow.com, http://bit.ly/Q4NKgv

22. For Spammers: Block & Report

23. Summary
 Trolls will test you
 Medical professionalism = take the high road
 Protect your brand from malware and spam
 Strong password
 Value = quality not number of followers
 Limit 3rd
party apps to essentials
 Look before you click

24. Questions?
 Contact me
 Twitter @subatomicdoc
 Website http://www.subatomicdoc.com/social-media.html