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After Elon Musk Acquisition, Will #ScienceTwitter #MedTwitter Move To Mastodon, Other Platforms?

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What happens when the world’s richest man gets control of Twitter, one of the largest social media platforms out there? Well, a lot of people out there seem to be getting shall we say quite “twittery” about what may happen to Twitter next. That’s because the Twitter platform has already been infested with mounds of misinformation, disinformation, racism, sexism, and every other -ism that you can imagine. The question is whether it will stay the same, improve, or get even worse with mega-billionaire Elon Musk in charge. And will that mean an mass exodus to some other social media platform like Mastodon or Discord of many real scientists and health professionals, including those frequently using the hashtags #ScienceTwitter and #MedTwitter?

By the way, if you are wondering who Elon Musk is, he’s the guy who recently closed a $44 billion deal to acquire Twitter. Now, if you happened to have had a spare $44 billion and one cent lying around, you missed your opportunity to take over the company and thus shape how Twitter works as Musk has already been doing. Musk has already fired the previous leadership of Twitter, including now ex-CEO Parag Agrawal, ordered changes in Twitter’s homepage, and anointed himself “Chief Twit.” He’s already laid off half the Twitter workforce, so this is probably not the best time to make Holiday Party plans if you are still working there. Additionally, as reported by Brian Bushard for Forbes, Musk has initiated charging $8 per month for people and organizations who want a blue check mark by their account, you know the check mark that’s supposed to separate out verified legitimate accounts rather than simply determine who can afford paying a monthly fee.

Musk is also the guy who in April 2020 tweeted the following prediction about the Covid-19 pandemic, essentially going against what experts were warning about at the time:

Yeah, Musk’s prediction was kind of a bit off as there’s been over 97 million Covid-19 cases and over a million Covid-19-related deaths in the U.S. since then. Plus, two-and-half years later the Covid-19 pandemic is still going on, despite what people may be saying before the mid-term elections.

That was far from Musk’s only questionable tweet about the pandemic. For example, in 2020, he repeatedly downplayed the threat of the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) and called for the lifting of Covid-19 precautions, as described by Russell Brandom for The Verge. Then there were the times Musk shared things that real scientists and medical experts quickly deemed misinformation and dangerous such as:

Will such tweets be a sign of what’s to come on Twitter? Will Twitter become a share-whatever-is-on-your-mind-or-whatever-you-want-to-be-on-others’-minds-free-for-all? Or will there be legitimate transparent scientific moderation by legitimate real scientists who follow the real science? It’s hard to tell with the current Musk-y future.

There have also been concerns that racist remarks, other hate speech, and bullying will surge since Musk has been tweeting about “free speech” on Twitter without saying nearly as much about combatting racism, other -isms, and hate. For example, NBA star LeBron James tweet-forwarded the following tweet from Philip Lewis, Senior Front Page Editor for the HuffPost:

So right now the future of Twitter is about as clear as a Nutella milkshake. That’s led a number of real scientists and health professional to tweet about moving to other social media platforms such as Mastodon and Discord. For example, here’s what Arghavan Salles, MD, PhD, a surgeon and Senior Research Scholar at the Clayman Institute at Stanford University, tweeted:

And Naftali Kaminski, MD, the Boehringer Ingelheim Pharmaceuticals, Inc. Professor of Medicine at the Yale School of Medicine, asked for a plan:

This is sort of reminiscent of that Beatles song “Eleanor Rigby” and the lyrics, “All the lonely people Where do they all belong?” It’s also reminiscent of that Clash song “Should I Stay or Should I Go?” Many scientists and health professionals seem unclear of what to do now, since it seems like the “end of an era,” especially with Twitter now charging for Blue Check Marks, as Angela Christine Weyand, MD, a Clinical Associate Professor of Pediatrics at the University of Michigan, tweeted:

Some have questioned whether any of the existing social media platforms will serve as a reasonable alternative to #ScienceTwitter and #MedTwitter. Of course, the landscape may change as other social networks emerge such as the Bluesky initiative that Twitter founder Jack Dorsey and other former Twitter execs have been building that will purportedly be a decentralized social network protocol.

Mastodon certainly has gotten a lot of attention since the Musk move with the word trending on Twitter over the past week. Presumably, most people weren’t talking about the creature that existed about 10,000 years ago and resembled a giant elephant with huge tusks. Instead, they were talking about the free and open-source software that’s named after the prehistoric creature and that Eugen Rochko launched back in 2016. Mastodon does have microblogging features similar to Twitter, allowing you to post and share “toots” as opposed to “tweets.” So you may want to be careful when telling people that you just “tooted.”

There are key differences, though, between Mastodon and Twitter. Unlike Twitter, Mastodon is decentralized so that one individual can’t control the whole kit and caboodle. Rather than a single platform, Mastodon is a collection of a variety of servers, not the kind that you see at a restaurant but rather the computery kind of server. When you first sign up for Mastodon, you have to choose a server amongst a mish mosh of ones representing different locations and interests. This doesn’t mean that your communication will be restricted to that server. Say you choose a server that seems to specialize in something, say hot dogs. You won’t have to toot hot dogs exclusively and will be able to follow users on all the other servers. You can search for other people by searching for their Mastodon handles, which consists of their names and servers such as: @bruceylee@mas.to with mas.to, being a generic server. Unlike Twitter, though, Mastodon won't suggest that you follow Elon Musk or Jared Leto over and over again or offer other follow suggestions.

The server that that you join is important in that whoever is running the server is in charge of moderating the content on that server. Many of the servers remain unmoderated so may still be susceptible to misinformation, disinformation, and hate garbage. Some of the servers are free to join. Others are asking for donations because in theory someone’s gotta pay for all this. Also, if the person running the server decides to close up shop, you may have to say bye-bye to the user name associated with that server and find another user name and server. So it is currently unclear how all of this will play out in the near future.

If you want to join Mastodon, David Brückner, PhD, a postdoctoral researcher at the Institute of Science and Technology Austria (ISTA), provided a tweet thread of instructions:

In his thread, Brückner, emphasized that “Twitter is a profit-oriented company whose attention-economy algorithm maximizes time spent on the site - to run ads.” He asked. “Should this be how we run our science/academia digital townsquare,” as you can see here:

It remains to be seen how many real scientists and health professionals will flee Twitter. When Donald Trump was elected President of the U.S. in 2017, many people seemed to be talking about moving to Canada. But it’s not clear how many people actually subsequently migrated to what’s been called the Great White North but may not be the best moniker these days. Of course, changing social media platforms is not the same as moving all your belongings and your life to another country. As the recent emergence of TikTok has shown, people are willing to move their social media activities to another platform when there’s a more attractive alternative.

Eric Topol, MD, founder and director of the Scripps Research Translational Institute, did urge #ScienceTwitter and #MedTwitter to stay on Twitter to keep spreading “truth/facts/good info” in order to counter the misinformation and disinformation:

It will be interesting to see what Musk ends up doing about science and medical disinformation and misinformation as well as hate on Twitter. Ultimately, what will matter is whom Musk assigns to run Twitter and handle its day-to-day operations. After all, while Musk has gotten most of the attention for companies like Tesla and SpaceX, it’s the nameless and faceless people doing the actual groundwork who have been responsible for the successes and failures of those companies. Of course, Musk will have tremendous influence over what Twitter becomes based on the people whom he selects to run Twitter and the general directives that he gives. A given tweet may have a character limit. But it’s the characters who will work at Twitter and their character that in the end will matter.

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