Just before the pandemic began, a group from Northwestern University and the University of Chicago wrapped up one of the first major studies to describe physician experiences with online harassment. In the offline world, health care jobs are among the most dangerous, and hospital workers face four times the risk of violence as people in other industries (“When Healers Get Hurt,” Winter 2019). The study, published in JAMA Internal Medicine early in 2021, found that this danger exists online as well, with one in four physicians reporting a personal attack on social media. Top reasons for attacks included the doctors’ advocacy of vaccinations, gun control and access to abortion. But there were also personal attacks based on the poster’s religion and race, and one in six female physicians faced online sexual harassment.

The problem has almost certainly escalated since the onset of COVID-19. The pandemic triggered a tide of medical misinformation, which health care workers have been on the front lines of correcting. In return, they have received threats of assault and death. The research team from the JAMA study expects to find that online violence against physicians has increased in a new, larger study it has launched. “These issues aren’t going away,” says Vineet Arora, a co-author of the study who is the assistant dean for scholarship and discovery at the University of Chicago Pritzker School of Medicine.

What are the solutions? Ali Raja, a physician and executive vice chairman of the Department of Emergency Medicine at Massachusetts General Hospital, says he and many other health care workers have chosen a reduced social media presence. Raja says he only posts content on his Twitter account that is impersonal and professional and he uses a pseudonym on Facebook to limit the chances of becoming a target. “All it takes is one threat to be real,” he says. “We deal with violent patients every day, and I’m definitely worried that people might find me or my family outside the emergency department.”

Others are experimenting with ways to fight back. Todd Wolynn, a Pittsburgh-based pediatrician, was bullied online for his pro-vaccination views and saw his practice rating go down to one star online. In response, Wolynn co-founded Shots Heard Round the World, which now has 1,000 vetted volunteers who mobilize to combat anti-vaccine attacks. Participants are alerted by email to post supportive and factual content to drown out the misinformation. “We’re the rapid response digital cavalry,” Wolynn says. The network has been successful in countering more than 150 attacks against advocates so far.

Arora is a founding member of a similar effort, the Illinois Medical Professionals Action Collaborative Team, launched in 2020. Participants provide support to those on the receiving end of online attacks. “It’s easier to advocate on social media as part of a group,” Arora says. “We can be part of a louder voice that supports them.”