Transcript
I first met Dr Kevin Fernando in person at a European medical congress where thousands of doctors were meeting to learn about the latest science in diabetes care.
But I felt like I knew him already, because I’d been listening to his social media posts and seeing the impact he was making online among healthcare professionals all over the world, through the work I do at CREATION.co.
But what I really loved about recording this episode with Dr Fernando was how much he talks about how social media is what allows him to learn – to keep on top of new science – and then to share that knowledge.
He’s a GP with a special interest in diabetes and cardiometabolic disease, and he practises in a small town on the East Coast of Scotland, but from there he reaches healthcare professionals all over the UK, and in fact all over the world.
I loved learning from his predictions about the future of primary care in the UK, and about the future or social media for doctors and patients, and the role of industry in the online medical conversation.
Here we go.
Daniel Ghinn (00:01)
Well, I’m so glad to be joined here by Dr. Kevin Fernando. According to the latest CREATION research, one of the world’s most impactful doctors online in type two diabetes. Kevin, welcome. Could you start by describing your current location? Where are you? What’s the view from your chair?
Kevin (00:14)
Thank you. Thanks, Daniel. Cheers.
I’m in Haddington, which is a little town east of Edinburgh in Scotland. So I’ve lived here for a long time. My practice is just down the road North Berwick, which actually was just voted nicest place, nicest town to live in the UK in a Times survey just last week, actually. I think it’s the first time a Scottish town has topped that survey. So but for many years, all the talks have been doing, no one’s known where North Berwick is, but now it’s on the map.
Daniel Ghinn (00:36)
Oh, fantastic.
Oh,
that’s lovely. That’s fantastic. So can you tell us a bit about the background to you? What do you do? How long have you done it and how did you get into it?
Kevin (00:59)
First and foremost, I’m very much a jobbing GP partner in North Berwick, North Berwick Health Center. I work two days a week there as a partner, Mondays and Thursdays usually, and the rest of my time basically is keeping up to date, but I don’t need to tell you the rapid evolution in research and evidence and guidelines. So it’s almost a full-time job in itself, keeping up to date.
I was chatting actually to our GP trainee recently telling her about a really interesting paper I’d read from a number of years ago actually about the doubling of medical knowledge. So in the 1950s, the estimated time of doubling of all medical knowledge, not just diabetes, it was about 50 years. 1980s estimated time of doubling of medical knowledge, seven and a half years. 2010 estimated time of doubling of medical knowledge about three years. Guess what it’s now, Daniel.
Daniel Ghinn (01:31)
Wow.
Well, it must
be less than that.
Kevin (01:52)
Yes,
estimated time for doubling of all medical knowledge is 77 days.
Daniel Ghinn (01:59)
Oh my goodness, that’s ridiculous. So how do you handle that? What for you as a GP? I mean, does that mean that the knowledge increases or that just much more information to go out and discover? What does that look like for you practically?
Kevin (02:09)
Yeah,
a bit of everything, but another statistic, this I don’t have a paper to back up with, but I remember someone telling me in primary care, we get about 250 guidelines a year to follow across all clinical specialisms. So you can see what we’re dealing with in primary care. I mean, what I love and hate about GP is you don’t know what’s coming in the door next, but you’ve got to deal with it. And, you know, I suppose that comes back to the reason for this interview.
You know, social media has been phenomenally helpful over the last, well, it’s been, I should say, it’s been both a blessing and a curse for me. Come back onto that. But it’s been hugely helpful in trying to keep up to date. If I can’t get to some of the latest, you know, diabetes conferences, cardiovascular, I could, someone’s going to be tweeting from it. That’s where I often hear about breaking news from the MHRA or other drug safety alerts. So certainly.
Daniel Ghinn (02:44)
Yeah.
Kevin (03:04)
That’s been hugely helpful in helping me keep up to date. I suppose I’m fortunate in that I work two days as a GP. So I’ve got set aside protected time to keep up to date, but my colleagues in North Berwick who work more full time than me , they routinely tell me, they struggle to keep up to date and rely on people like myself to help keep them up to date.
Daniel Ghinn (03:24)
Right, so that’s really interesting because I’ve seen that, you know, you’re actively involved not only online, but also in real life, face to face meetings and gatherings and so on. So how do how does social media kind of add to that, that real life experience and then back online? What does that look like for you?
Kevin (03:38)
Yeah,
absolutely. Relaying those key take home messages from whichever educational meeting or other activity I’ve been doing or either giving or as a delegate, I think is a key part of being an HCP these days. Again, because of those figures I gave you about the rapidly evolving nature of medicine. So I see that as a key responsibility of all healthcare professionals.
I mean, I can’t get to all meetings. My main focus, as you said, is type two diabetes, cardiovascular, renal, metabolic. So respiratory medicine, for example, women’s health, dermatology, I rely on many other key opinion leaders to help keep me up to date. And many of them, you know, I find online or find, you know, meet face to face at other meetings. So, you know, relaying medical knowledge is a key responsibility. I mean, in fact, that’s where the term…
doctor comes from, isn’t it? It’s to teach the Latin from to teach. So I’ve always seen that as a key role. It’s not easy. It’s not easy, of course, keeping up to date and maintaining that, you know, contemporaneous flow of information online or in person, but you know, it can be hugely, hugely satisfying.
Daniel Ghinn (04:53)
And I’ve seen that one of the things that you do online is you not only engage with other healthcare professionals, like you say, helping other doctors to learn, but you also deliberately engage with patients, right?
Kevin (05:03)
Yeah, so that’s something I’ve sort of dipped my toes into just really over the last six to 12 months, but it’s really important. We even just over the last couple of years, we’ve seen some of the biggest therapeutic advances in my career to date since I graduated from Edinburgh in 2000. And so, yes, we are perhaps feeling a wee bit overwhelmed as healthcare professionals. But what do you think our patients feel like, you know, when the HCPs are
Daniel Ghinn (05:27)
Exactly.
Kevin (05:29)
are bombarding them with all these new therapeutic or pharmacological or non-pharmacological options. So that’s why I think, you know, we also have a key role to help educate our patients. The challenge in primary care is time. In North Berwick, we still have 10-minute appointments. So there’s only so much you can pack into a 10-minute appointment. So that’s why I started a YouTube and TikTok channel. To be honest, I’ve only done a few videos so far focused on a particular therapeutic class of diabetes drug, which is…
the new standard of care, but they seem to have landed very well. And, you know, as you alluded to, my mantra has always been to put out information, education that’s going to make our lives a little bit easier in primary care, but ultimately to help improve the lives of our patients. So certainly that’s always been my mantra for educating HCPs, but of course, but for educating people living with diabetes and other long-term conditions.
Daniel Ghinn (06:23)
That’s amazing. And what is the most effective way that social media is helping you right now? Can you think of a great example of something that you think this is, this is happening now or recently, that’s a really useful way that social media is helping in, I suppose, particularly in that challenge that you talked about the massive advances in medical knowledge.
Kevin (06:40)
Absolutely. Well, just this morning, actually, I was fortunate. I was invited to speak at the Royal College of Physicians in Edinburgh on managing the kidney patient with diabetes in the community. So I’d actually put together a presentation a number of weeks ago, but I had to rewrite it three times this month because of breaking advances in managing. And all those breaking advances, I came across online on Twitter, LinkedIn, or other channels.
Daniel Ghinn (07:00)
Wow.
Kevin (07:08)
So there was a recent study looking at one of the GLP-1 drugs and its impact in diabetic kidney disease. So I was able to add in a slide on that. Literally a few days ago, KDIGO, one of the big global kidney disease organizations published new guidelines. So I just saw that on LinkedIn. So I was able to integrate that into my presentation. So yes, it was quite a bit more work for me. But you know, this morning I was very proud to deliver a cutting edge talk in
Daniel Ghinn (07:36)
Fantastic.
Kevin (07:37)
diabetes and kidney disease because I was able to include stuff right up to the date I was alerted to on social media.
Daniel Ghinn (07:44)
So I love that you’re actually sharing some of that knowledge on social media, you’re learning from social media. That social media content is feeding into what you’ve just described as cutting edge knowledge that you can feed into a live meeting, and then you put it back online.
Kevin (07:51)
Yes. And absolutely,
so the live meeting this morning, there was a face-to-face contingent, but it was being streamed out across the world. The Royal [College], so I think there was over 400 people, we were told, across the world. So there, I suppose that nicely impacts the, sorry, nicely illustrates the impact of my learning.
Daniel Ghinn (08:14)
Mm.
Kevin (08:15)
But then of course, you know, the pitfalls there, I need to make sure that the information I’m giving out is accurate, isn’t it? And, uh, and reliable. So that’s another key responsibility. And when I can’t just copy and paste, of course, I need to read, digest, assess myself and then, and then really. So yeah. Yeah. So with to quote, I think it wasn’t it’s much Spider-Man with great power comes great responsibility. So
Daniel Ghinn (08:21)
Absolutely.
Yeah.
Absolutely.
Kevin (08:42)
So, I suppose I’m fortunate to have this quite large following on social media and this quite large impact that you’ve kindly outlined, but with that comes a lot of responsibility. If I put misinformation out there, that ultimately could potentially have a negative impact on patient care, couldn’t it? So, yeah. Yeah.
Daniel Ghinn (08:49)
Mm-hmm.
Absolutely. Let’s talk about that a little bit, because we’ve seen in recent years that the World Health Organization has talked about a kind of infodemic. And there’s been a lot of raised awareness about misinformation online. So how do you as a doctor know what to trust? And how do you help to guide people in knowing to signpost into where’s the truth and where’s the misinformation?
Kevin (09:05)
Yeah.
No, no, excellent question. You know, a big part of that is my own appraisal of the data, my own appraisal of the studies. But then I have a trusted inner circle, if you like, as well, that I know who know the data well, who I trust implicitly, their clinical judgment, their statistical knowledge, who I’m happy to take a steer from them as well. Because it’s just impossible for me to assess every single…
piece of information I come across online. So you’ll know a lot of these other people are people in your top 50 lists as well, aren’t they?
Daniel Ghinn (09:49)
Mmm.
Absolutely.
But I love to see how this works out. So you’re saying, is it reasonable to say that when you look at a piece of information, who it is that actually shares it will help to determine at a first glance how credible that is.
Kevin (10:04)
100% you’ll know one of my good buddies, Patrick Holmes, another GP with a long-standing interest in diabetes. So he’s one of the cleverest people I know. So if he tags me in or retweets something, I know it’s something that’s relevant to my own personal development, professional development and of course then relevant to my patients. So absolutely. So having those core followers.
Daniel Ghinn (10:07)
Mm.
Kevin (10:32)
or call colleagues online that you can trust, that you know are not going to put any misinformation out there. It’s hugely helpful to hear.
Daniel Ghinn (10:41)
That’s
really powerful. And we see that in the data. There’s this, when we talk about using a digital opinion leader, because of, you know, actually seeing who else online seems to trust what you say, you know, and we kind of measure that. Yeah.
Kevin (10:46)
Yes.
Exactly. Yeah.
I mean, I would like to think by, you know, my, the size of my following that people do trust me online, you know, and, but again, you know, that carries a, carries a heavy responsibility at times, doesn’t it? Yeah. So I, I’m very, you know, I, I have to be very careful about what I post up there because ultimately, you know, going back to my mantra, what I tweet, I want to help improve the lives of our patients.
Daniel Ghinn (11:01)
does. Absolutely.
That’s fantastic. Can I ask you about your specific disease area interests and diabetes and related chronic diseases? What what is most exciting to you at the moment in terms of advances in treatment in that kind of space?
Kevin (11:22)
Yeah.
Well, everything, you know, every day is a school day these days. But the last, I reckon the last four or five years, almost every day has been a school day. You know, clearly we were contending with a pandemic as well in the middle of all of that. But even before the pandemic, there’d been huge strides in how we manage diabetes, not just pharmacologically, non-pharmacologically as well, the concept of diabetes remission, reversing type 2 diabetes. And then certainly the last couple of years.
Daniel Ghinn (11:40)
Mm.
Kevin (11:56)
very much aware of treating diabetes holistically. We’ve always done that, but very much being aware of associated chronic conditions. Kidney disease, like I was speaking about today, fatty liver disease or the new terminology is MASLD which I also speak a lot about. So certainly these changes, these advances have really pushed me to talk about a huge variety of different topics, not just type 2 diabetes, which has kept things interesting for me as well.
Daniel Ghinn (12:02)
Mm-hmm.
Mm.
That’s fascinating how that’s kind of developing. And we’ve really been seeing that in the online conversation. We did the study on, you know, types of diabetes conversation, but now there are suddenly cardiologists in there and other kinds of specialists really interested in the diabetes conversation.
Kevin (12:30)
Oh no, absolutely, yeah.
I mean,
even just a couple of years ago, if you told me, oh, Kevin, you’ll be, you’ll be speaking on diabetes and chronic kidney disease at the Royal College of Physicians, I would have laughed. I said, don’t be silly, you know. But it just shows how the narrative has changed, how guidelines have changed to encourage us to focus on these comorbidities.
Daniel Ghinn (12:46)
Right? Wow.
Well, let me ask you about this. As a GP, you’ve got some special interests, but what would you say are the biggest challenges or opportunities that are facing GPs, let’s say UK GPs, kind of maybe locally for you in Scotland, but also nationally and perhaps, you know, internationally as well. You talked a bit already about the massive, you know, rapid growth in medical information. What else do you see as kind of key challenges and opportunities?
Kevin (13:20)
Well,
I mean, we can see every day in the news, unfortunately, workload is a significant challenge at the moment. You know, meeting patient demand, patient expectation is next to impossible these days. You know, we’re still seeing a legacy, of course, of the pandemic.
people who weren’t able to give them the same sort of care for their chronic conditions during the pandemic. So we’re seeing a legacy of that workforce. We’ve had a lot of people retire early in primary care. So there’s been a real brain drain of some of my very senior, very experienced, knowledgeable colleagues. So we are, yes, I’ve been waxing lyrical lumbar, it’s great to have all these exciting advances, but ultimately, you know, we have to see our patients.
Daniel Ghinn (13:51)
Hmm.
Kevin (14:06)
We have to meet their care needs and we’re struggling at the moment because of workload and workforce issues. So it’s a tough time. To be honest, it’s the toughest time I’ve worked in general practice in the last 15 years. So yes, a lot of exciting advances, but we have to face what the reality is now. We’re in everything unfortunately in general practice for many reasons.
Daniel Ghinn (14:14)
Wow. So what do you think needs to happen?
And what do you think needs to happen then?
Kevin (14:36)
Yeah, good question. That’s the $64,000 question. Well, I think certainly I don’t know all of our younger trainees coming in. No one wants to be a full-time GP anymore. I think it’s just not sustainable. I completely agree. But I was one of the very early pioneering portfolio GP. So I’ve been a GP partner for 15 years, but very early on I dropped days to allow me to do diabetes, medical education, et cetera.
And I think that variety in the week has kept things manageable for me, helped my resilience and ultimately helped my enjoyment of the job too. So I’ve spoken a couple of medical schools recently. They’ve been invited to talk about the benefits of being a portfolio GP, having a specialist interest or an extended role in another area. And I think that’s the future for all of us because working full time, five days, four or five days in a.
Daniel Ghinn (15:10)
Wow.
Kevin (15:30)
primary care is pretty exhausting these days in terms of the workload. So portfolio GP, so I think in many ways, that’s what’s helped sustain me as a GP partner all these years.
Daniel Ghinn (15:42)
So it’s actually kind of brought that variety to the role. So it’s not just like hard slog all the way through. It’s actually changing.
Kevin (15:45)
Yeah. And I know that might sound a
wee bit, might sound a wee bit selfish, but it’s not ultimately that variety, that upskilling in diabetes, cardiovascular has helped my patients, hasn’t it? You know, they, so they, my patients trust me. They know they’re getting the latest diabetes, cardiovascular, kidney metabolic care. Um, so, uh, yes, you know, I mentioned that the personal benefits, but there’s no doubt it’s benefits, uh, my, uh, my patients and my colleagues, because
Daniel Ghinn (15:55)
Absolutely.
Kevin (16:14)
a lot of them feel de-skilled in diabetes because it is such a complex area. So I’m, you know, unexpectedly, sorry, as expected, I’m the diabetes lead for the practice. And even neighbouring practices just drop me messages asking for help. So I see it as a win-win.
Daniel Ghinn (16:29)
Amazing.
That’s great. But actually, by looking after your own well-being, you’ve been able to thrive more. And actually, clearly, the data shows make a great, huge impact.
Kevin (16:40)
I’m looking at perhaps Instagram and ways to perhaps use that. Whereas other colleagues I know who do use Instagram a lot. So I think the key thing is finding a platform you’re comfortable with, finding an area you’re comfortable with. You don’t even need to have a specialist interest like I do. Just working in general practice every day highlights many PUNS and DENs. I don’t know if you’re familiar with this terminology, puns and dens, patient unmet needs, doctors, educational needs.
Daniel Ghinn (16:42)
yes.
Kevin (17:01)
Yeah. Um, just do it. I suppose to, to quote Nike, uh, just do it because I would, yes, I’m on a social media a lot. I do, but I’m still learning. There’s a lot I still need to learn, particularly YouTube, TikTok. It’s been quite a journey so far. It’s an interesting journey. Um, but there’s a platform to match everyone’s interests, background. You know, I tend to mainly focus on Twitter and LinkedIn.
Daniel Ghinn (17:04)
Hahaha
Mm.
Kevin (17:27)
I’m looking at perhaps Instagram and ways to perhaps use that. Whereas other colleagues I know who do use Instagram a lot. So I think the key thing is finding a platform you’re comfortable with, finding an area you’re comfortable in. You don’t even need to have a specialist interest like I do. Just working in general practice every day highlights many puns and dens. I don’t know if you’re familiar with this terminology, puns and dens, patient unmet needs, doctors, educational needs.
Daniel Ghinn (17:53)
Ah,
right, yes.
Kevin (17:56)
So that’s key part of our appraisal. You know, if I, you know, as I said, I don’t know what’s coming in the door next, you know, when I’m doing a clinic. So if someone comes in with something I’m not clear about, you know, I jot that down as a puns and dens, you know, a patient unmet need, because I wasn’t quite sure what to do. So what do I do? I’ll go and I’ll use social media. I’ll use other resources to find out about that condition or the complaint, how I can manage it. So I think that’s a good start. That’s what I tell my GP trainees. Talk about your puns and dens. Of course, we’ve got to be mindful of.
uh, not, not giving outpatient identifying data, but talking about the puns and then the clinical presentation. And then you’re using your puns and then to help educate others who might be in that position in the future. So I think that’s a, you know, in many ways, a lot of the education content I’ve put together rights itself, just from the days I’m in surgery, you know, if I’m stuck on something, a patient comes in, I’m just no, no Scooby, what to do. I said, Oh, I think I’ll do a presentation on that. And it makes me, you know, the
Daniel Ghinn (18:29)
Mm-hmm.
Yeah.
Kevin (18:54)
The best way to learn about something is to teach on it, isn’t it?
Daniel Ghinn (18:57)
Absolutely.
Figure it out. And yeah, so you talked about LinkedIn and Twitter, some of the key channels, I know you’re using other channels for patient facing work as well. But what does it look like practically day to day? I mean, how much I’m sort of thinking to myself, how much time does Dr. Fernando spend on Twitter, you know, every day? What does it look like?
Kevin (19:06)
Yeah. Yeah, yeah, so YouTube.
Yeah,
Well, I mean, that’s the other thing, you know, again, talking about resilience, you know, you could spend your whole day on this, all your spare you know, in between patients even, couldn’t you, or after clinic. So I think we have to be mindful of the time because the time just gets swallowed up on Twitter. So that’s why I try and focus, you know, you see the sort of things I do. I’m certainly not a daily poster, you know, on these very, I try and post two or three times a week.
Daniel Ghinn (19:25)
Mm.
Kevin (19:44)
content I feel will have a tangible impact again, on my either my patients or my colleagues. Certainly people like Patrick Holmes and others in your top list. In fact, some people in those top five are quite frequent posters, aren’t they? And I think the same, Daniel, I think how do you have the time to do all of that? I mean, it’s great content, but how do you find the time? So I think again, you have to look at your own work life balance, your own time in.
Daniel Ghinn (19:55)
Mm-mm.
Prolific.
Hahaha
Mmm.
Kevin (20:13)
which platforms you use and how often you tweet or post. But it’s no doubt, time management is a real challenge.
Daniel Ghinn (20:18)
What do you think about?
Yes, absolutely. Now that makes sense. Okay, great. So I like that. It doesn’t seem to kind of take over your life, but you’ve kind of got a balance there a few times a week and then, um, what do you think about, I mean, Twitter itself, or we should call it X, but nobody that didn’t seem to really catch, you know, it calls itself X, but no one talks about it as X anymore. Right. Has this sort of happened for a while? And obviously it went through quite a bit of disruption over the last year or so as a Donald Trump took over the company. And we all wondered maybe for a moment, is it going to keep running? Is he going to shut it down and so on?
Kevin (20:35)
And nobody causes X.
Yeah, yeah, absolutely.
Daniel Ghinn (20:50)
We did see some doctors leave X and go onto Mastodon or Threads or, you know, some other platform, but eventually kind of say, well, Threads, sorry, Twitter gives us the, um, the kind of community. What, what do you think? How, how was that process for you? Did, did you get concerned about that? Did you think you might go somewhere else or?
Kevin (20:55)
Yeah.
Yeah,
well, Twitter or X, it’s a curious place in many ways, isn’t it? I mean, I’d stay out of all the politics. I stay out of it. I purely use it as an educational arm. I learn a lot from it and I hope people learn a lot from what I post. So I think when I just stuck to that, it was fine for me.
Daniel Ghinn (21:13)
Yeah, yeah. Aha, good.
Kevin (21:29)
But, you know, unfortunately, not just X, but a lot of these other channels are increasingly vitriolic places, you know, and that worried me actually, you know, that, that very much did worry me, but, you know, my aim, I think that’s another thing that might be a key advice for everyone considering going on to social media, what, what is, what is your aim of going on that social media channel? So mine, you know, I told you my mantra several times already, that was my mantra. So that’s why I’m using these social media channels.
I mean, I occasionally use Facebook for education, but mostly for personal reasons. But my main use of social media is that mantra. So I think it’s very important to know your why, isn’t it? When you use it. And because I knew my why, even with this turmoil that was happening on Twitter stroke eggs, I was able to weather it. Cause ultimately I still think it’s a great platform for getting out.
Daniel Ghinn (22:09)
Yes, absolutely.
Kevin (22:22)
Cause you’re forced to be concise, aren’t you? And, and, and that’s what I love about Twitter. And in fact, uh, tutorials I do for my, my GP trainees, I asked them to answer a clinical question in the style of Twitter. So, you know, it can’t waffle on, you know, they have to give me a nice concise answer. Maybe I’m not quite as harsh as 250 characters or whatever it is, but, and I love the fact that you have to be concise.
Daniel Ghinn (22:24)
Exactly.
Uh huh, brilliant.
Hahaha
Kevin (22:47)
And, you know, you can, you know, imagine an abuse of emoticons or emojis, you know, can really add to those postings. So again, my good buddy and colleague, Patrick Holmes is excellent at that. So, so, so that’s why I stuck with Twitter stroke X, because I still think it’s a great platform to get those key messages from Congress highlights or breaking research, et cetera.
Daniel Ghinn (22:51)
Yes.
Exactly. No, that’s fantastic. That’s brilliant. What would you do differently if you were kind of starting over in if you were if you were just going online now and you’re thinking, Oh, actually, and because you really have, it may not have been your original goal to go and become one of the world’s most influential doctors in diabetes, but that’s, that’s kind of that’s where you are. Right? No, no.
Kevin (23:17)
Cool.
Yeah.
I promise you that was never my goal.
Daniel Ghinn (23:34)
But it but it’s happened through how you work and maybe what you’ve expressed about how you learn from it, learn from social media, and then you share that knowledge and kind of we think about amplify that knowledge to others. And it’s led people to listen and follow. And what would you do? Yeah, what would you differently if you were starting out?
Kevin (23:43)
Yeah.
Yeah, that’s good. I don’t think everyone’s ever asked me that before. I mean, inevitably I’ve made mistakes. I’m sure you have as well, Danny. We all make, you know, Twitter, social media has been a learning curve, but then I suppose making those mistakes has made me a better user of social media as well. So, you know, it’s like, it’d be quite easy to say I’d go back and not do that, but actually in many ways, making those mistakes, you know, has focused it. So I’ve got to be honest, I probably wouldn’t do anything particularly differently, you know, I’m
Daniel Ghinn (23:57)
Yeah
Kevin (24:18)
quite enjoyed the journey in many ways. There’s been a few wobbles along the way, but as I said, I’ve learned about them. So I think to be honest, I probably wouldn’t do anything differently. Others would argue, I’ve definitely had conversations, people would maybe have a more targeted strategy or have a more organized strategy. I suppose I never had a documented strategy on what I was gonna do. It was very much ad hoc, driven by these puns and dens I told you or other clinical dilemmas I’ve come across. But…
Daniel Ghinn (24:27)
Trillin’.
Mm-hmm.
Kevin (24:47)
It’s worked for me, as you said, doesn’t it? And, and I suppose it just reflects because one thing that, you know, I have been accused of the past, oh, you, you just go to all these conferences, speaking all the meetings, you never see any patients and that hurts actually. Because, you know, I’m very much a jobbing GP and I like to see that. I hope people would see that reflected in what, what I’ve put. For example, I’ve just launched a podcast for global podcasts from Medscape. And every episode is just about puns and dead. So the.
Daniel Ghinn (25:03)
Mm-hmm.
Mmm.
Wow.
Kevin (25:15)
You know, the first one is about penicillin allergy in primary care. Half of our patients seem allergic to penicillin or have been erroneously because I’m talking about that. I just recorded one on restless legs syndrome. Patient came to see me was really debilitating restless legs. Uh, already tried a few treatments and I was a bit stuck what to do next. So I thought I’m going to make a podcast out of this and I’m so I’m recorded it and I’ve now been able to go back to the patient and actually say, I’ve got a couple more options for us to try to do. So, you know, it’s a win-win.
Daniel Ghinn (25:18)
Oh, wow.
Brilliant.
Oh, that’s fantastic. So you talked a bit there about the kind of conferences and events that you get involved with, and I guess some of the organizations that you get involved with. And I’m conscious also from what you’ve described that there’s a lot of kind of that peer trust that happens between yourself and other healthcare professionals, and you get to know them online. Some that you may know in person, but perhaps some that you get to know online and develop trust and so on.
Kevin (25:57)
Yes.
Daniel Ghinn (26:05)
What should the role of industry, I mean, when it comes to medicine, especially the pharmaceutical industry, what role can the industry play to support? I mean, we talked about the challenge of, you know, the massive growth in medical knowledge, and the need to keep learning and sharing what role legitimately can industry play to support you?
Kevin (26:10)
Yeah.
Industry has a key role in providing that education. I mean, we, you know, unlike my colleagues, I’ve known for decades from uni who work in finance, all the industry, they all get very generous stipends to attend courses, to progress, you know, additional qualifications. We in NHS, we have to pay everything for ourselves. All my postgraduate qualifications, all the courses I go to, I mean, there’s a lot of free courses.
I pay for myself, you know, which, which adds up over, you know, over 20 plus years. So that’s why, you know, I, over the years, I’ve had no problem attending, you know, industry sponsored education again, by people I trust to, I know it’s going to give me objective information. So I think industry do have a key role there. The challenge though is, you know, many of my colleagues still do feel there’s no such thing as a free lunch. You know,
Daniel Ghinn (27:14)
Mm-hmm.
Kevin (27:16)
You know, Ben Goldacre has written that book, hasn’t he? And I suppose we could talk about this another day, but that subliminal influence in these meetings. But again, when you go back to those figures, I tell you the doubling of medical knowledge, you know, we need to keep up to date. You know, it’s, yes, I organize various courses, but you know, I rely on industry and other partners to keep me up to date as well. So, but I suppose.
industry still suffering from the legacy of the eighties and nineties, when it was a lot less regular. I can talk from this from experience. Well, I was in that transition period. I graduated about 2000, but my dad is a doctor or retired now, very much a doctor in the eighties and nineties, when things were completely unregulated. So I know the sort of nonsense that went on. So unfortunately, the legacy of that is still having an impact on the trust between many HCPs. But things have, arguably things have gone…
Daniel Ghinn (27:49)
Mm.
Mmm.
Kevin (28:13)
very much the other way now. I think probably regulations are too tight now. So I suppose it’s finding that happy medium, rebuilding that trust, industry rebuilding that trust with HCPs. And of course, I’m not naive, industry have their commercial agendas, but there can be, of course, there’s a happy medium there where we can help, maybe help.
Daniel Ghinn (28:23)
Mmm.
Yeah.
Kevin (28:38)
achieve that commercial agenda but also provide high quality education to help improve the lives of our patients.
Daniel Ghinn (28:45)
So do you think, and you talked about trust there, do you think that there’s, is there caution towards industry when it comes to being on social media, industry’s presence on social media, do you think, among health professionals?
Kevin (28:56)
Yeah, well,
I think it’s a, you know, many companies just don’t go anywhere near social media, you know, because of the inherent pitfalls and, you know, a lot of companies, diabetes companies do have quite helpful information, patient facing videos on their company websites, but HCPs are reluctant to click through to, you know, to the big industry name, you know, the big names in diabetes. They won’t go through the websites for the, you know, for the reasons I’ve mentioned.
Daniel Ghinn (29:01)
Mm-hmm.
Kevin (29:24)
There’s definitely some reticence there. So I suppose that’s why social media is helpful. Other key opinion leaders. I mean, I speak on the behalf of many of these companies and, you know, I declare my conflicts or disclosures, but I still get, you know, no, no company will ever pay me to say anything. You know, I will give I will give my objective opinion. And companies know not to approach me if they don’t expect a straightforward and honest, objective presentation from me. So.
Again, I hope people, even though I speak on behalf of various companies, I hope people trust what I have to say. And then ultimately, I suppose that has a beneficial knock on effect on the company in question too.
Daniel Ghinn (30:08)
Yeah, of course. And how important is that to you in terms of your own professional development and reputation that sense of being trusted to be objective when it comes to that engagement with industry?
Kevin (30:19)
Oh,
very important. I mean, sadly, as I alluded to, you know, I’ve had my property challenged, you know, a few times over the years. And I do find that incredibly helpful. You know, as I said, no one will ever pay me to do anything. I’d say anything, you know, specifically, I will always give an objective, but there’s no doubt, you know, guilty by association. People assume because I’m speaking on behalf of a particular industry partner.
that I’m going to tour the party line. Certainly, well, that’s what I’ve been told in the past, but I think that’s unfair personally.
Daniel Ghinn (30:51)
Yeah, it’s a tough, tough dilemma, isn’t it? I can see. Yeah. Okay, let’s talk about the future. Let’s finish by talking about the future. Where is it going next for you in terms of social media engagement? How’s it going to help you to achieve, you know, better, better outcomes, better health?
Kevin (31:04)
I definitely want to expand my patient offerings, patient facing offerings. So YouTube, as I said, I’ve got those four videos at the moment, all about particular costs of drugs, but I’ve just recorded another set of videos on lifestyle intervention and type two diabetes, you know, cornerstone of the management of type two diabetes. Um, so they’re not released yet, but the ones I’ve done have landed extremely well. So, and my pay, you know, my
compliments from HCPs, but particularly I send them out to my own patients living with type 2. We just text out a link to the YouTube channel. So patients find it quite amusing that their GP has a YouTube channel. But actually the feedback from them is very positive. So that’s really what I’d like to expand my patient-facing offerings. Because again, with all these new therapeutic options and other management options, we need to keep patients well informed.
Daniel Ghinn (31:34)
Brilliant
Kevin (31:53)
I suppose if we specifically talk about medications, and I’m not trying to medicalize diabetes or any other long-term condition, these drugs only work if patients take them regularly. So that’s why I did those SGLT-2 videos, to talk about the benefits, why you’d be prescribed it, but also to be honest and balance that out with potential adverse effects and side effects. So I think if we can present information in a patient-friendly manner, an honest…
Daniel Ghinn (32:03)
Yes.
Kevin (32:23)
I think hopefully there’s more chance my patients will take that tablet regularly and in the longer term.
Daniel Ghinn (32:29)
That’s fantastic. And you talked there about how, as a GP, those videos have been helpful for your patients and also helpful for you because you’ve been able to direct patients to those videos. Have you found that other GPs have also been able to use your videos as a resource to help their patients?
Kevin (32:37)
Yes.
Yeah,
absolutely. I’ve had some, you know, if I say so myself, I’ve been delighted with the response. I’ve had physicians or GPs from across the UK and some abroad as well who’ve asked permission to signpost. I said, you know, they’re really available online. Do what you want with them. So they’ve been signposting. There’s a lovely GP from Somerset who actually emailed me and said, she’s been sending that out for all patients newly prescribed on SGLT, whose links to my YouTube channel. So I’ve just even in the last few months, I’ve definitely noticed
Daniel Ghinn (33:08)
Fantastic.
Kevin (33:13)
a big increase in viewers and subscribers. You know, it’s a while till I’m the next Mr. Beast, but I’ve got now, I think I’ve got nearly over 300 subscribers now and certainly the views per video have jumped up quite a bit. So it’s nice to see that there. People are, some people anyway are finding them helpful.
Daniel Ghinn (33:19)
Hahaha.
Fantastic. Well, thank you so much for taking the time to talk today, Dr. Fernando, really appreciate that. It’s been great, been really insightful, great to learn from you.
Kevin (33:36)
Okay.
No problem. Thanks for inviting me to speak Daniel. Cheers.
