By Serena Marshall 

Medfluencers: Medical professionals by day, influencers by night, these clinicians and researchers use their social media clout to educate, enlighten, and entertain their large following about today's most pressing medical topics.

When it comes to social media, the word "influencer" has experienced a reformation during the COVID-19 pandemic. Once, a title that was given to mommy-bloggers or home DIYers, it was a way to monetize through endorsements and product placement.

Now, as the pandemic has continued past the 1-year mark, it has become a place for medical professionals to share information, insight, and knowledge, especially as confidence in the medical system has surged, up 15 percentage points in a single year (36% to 51%) -- the highest on record since Gallup began tracking it in 1993, while overall trust in institutions like the media and congress remains on the decline.

As more than 50% of Americans get their news from social media, the role medical professionals play in the space has also changed.

Emily Scott, RN, found her way into "medfluencing" by accident. Along with her husband, their Instagram account was set up to share sustainable travel tips.

With a modest following of 8,000 followers, the Seattle nurse found an unexpected audience as she quickly pivoted her profile to all things COVID-19.

She recently spoke with Serena Marshall to explain what happened and offer tips for those interested in exploring the space.

Let's start at the beginning. When you got your Instagram handle -- Two Dusty Travelers -- not exactly what you would think of to be a "medfluencer."

Scott: Not at all.

I'm a registered nurse. And that's a big part of my life. But it wasn't a big part of our Instagram page. My husband and I started it because we have a travel blog. And when we do a lot of off-the-beaten-path travel, and that was what it was kind of supposed to be about and has been about (for) ... probably 2, 3 years, something like that.

And then COVID.

I happened to get the first COVID patient in the U.S. in my hospital. I'm on our bio-containment team. So from the get-go, I was kind of in it and posting about it.

Did you make a cognizant effort to say, "I'm going to now post about COVID?" Or was it just expected to be a one-off?

Scott: The first post I posted about COVID was probably back at the end of February 2020, when we had had that first COVID patient. I thought we did a pretty good job.

To my knowledge, it wasn't spreading wildly in the U.S. So I posted, basically telling everyone to just calm down. There was just so much hysteria and so much panic. And I had seen a lot of that from working in the Ebola outbreak that it was really unnecessary, honestly, kind of racist. And so my original post was the first one that kind of blew up. And I was just like, everybody chill out, wash your hands.

And then it was, a couple of days later that the post blew up, and when we first started getting deaths. And I started realizing: "Oh, this has been spreading the whole time. And the CDC didn't have any control." I didn't have any way of knowing that. So then I had to reverse course.

Was there a point though, when you thought, "OK, I'm going to make this an official transition and start posting about COVID," where you saw the numbers go up, and you knew that that was now what your platform is going to be used for?

Scott: It feels like it hasn't really been any other option, because I certainly don't feel right about posting about travel right now. I'm certainly not traveling, short of just taking the whole page down and not saying anything until we all can travel again.

I'm like, I have something to say. And I'm getting flooded with messages. And there was this just absolute absence of health education coming from our government. So, I just thought this is what I'm going to do until it's over.

Do you go in every week with an idea of what you want to share? Or is it just whatever comes to you, what you experienced that week at your hospital?

Scott: I don't plan it at all, I've not planned any of this.

I kind of go based on -- I kind of scan through my DMs (direct messages) and see what questions I'm getting; I've often gotten a lot of similar stuff.

I've had a lot of experiences where I feel, almost like, I have a time machine or that I can see the future (because of Ebola). And then I'm like: I know, based on science, what's coming. I'm telling you all, this is what's happening 3 weeks from now, so I'm trying to get ahead of it.

Why was Instagram the right platform for you outside of already having that initial following or initial base?

Scott: Well, to be honest, when I first did my first COVID post, I just posted automatically to Instagram and to Facebook.

Facebook was so horrifying. I will never know how many of those people are bots and how many are people, or trolls trying to be awful -- for some reason, it was just so much worse on Facebook.

I can't handle both of these. I mean, (on Facebook) I have thousands of comments and people just being so awful ... but I got more of a response on Instagram with genuine questions, and I'm happy to answer any of those.

What would you recommend to medical or scientific professionals if they're just jumping into this space?

Scott: Just do it. And just because we need as many voices doing this right now as humanly possible. And I have accounts that I follow now, they've only recently started.

There's still plenty of room.

People need to hear this information in different ways. Because everybody learns differently. So, we need a lot of people out there, saying all this stuff in different ways.

I honestly have had no method for this. It's just kind of happened. And I think I have felt that that's the best way to go about it. Because I'm just following what I feel people want to know.

Is it weird to you that people are coming to you on a social media platform? Asking you for health and medical information?

Scott: It is a little. I have some empathy for it because, especially in the U.S., our healthcare system sucks. And especially during a pandemic, it's not like you can just call your doctor up any time of day and ask them a random question you're having about COVID. It takes time and it's expensive.

But it is a little wild to me that 50-some-odd-thousand people have decided that I'm trustworthy. There's so much sense that people just choose someone that they like and connect with and then believe them. And that can be really dangerous because some of us are coming at it from a science perspective, other people are not.

How do you balance your day job? And then the social media influencer role, which to many people is a full-time job?

Scott: It's hard. I have to remind myself that my day job is what pays the bills. And I'm just doing Instagram for free; so as much as I feel a responsibility to try to answer every DM (and I could do this all day, every day) I have to rest on my days off because my work is really physical and emotionally draining.

I'm no good as a nurse, I'm no good on Instagram -- helping anyone -- if I'm exhausted, and I have no patience to answer a question kindly.

Did you make a decision to not try and get any sponsorship or payment from the start?

Scott: It's really important to me to do it for free. Finally, months and months in, I put my Venmo up because I was literally like taking days off and going unpaid to do this instead (and people were asking).

I think there's a lot of a misperception that "Big Pharma" is out there hiring influencers and that has not been my experience. No one has offered me money to say any word from "Big Pharma." I get called a shill so much.

I'm making less than normal because I'm home doing Instagram instead of picking up an extra shift. None of us are getting paid for doing this; it's just because we literally want fewer people to die. And it is super important to me to not take sponsorships or do anything that would seem like making my information untrustworthy or questionable because that's the most important thing.

Are there certain tools that you utilize to help with your engagement and your sharing of information?

Scott: I try to make my stories as interactive as possible.

I'm learning as I'm going, I don't want it to be a lecture. I don't want it to be overwhelming to people. ... I don't want to give people a wall of text. I try to do polls and leave question boxes up and really engage with people.

I want to keep my finger on the pulse of what people really are wondering about.