I am pleased to see Harrison et al ^{Reference Harrison, Hayes, Woollard and Tracy1} discussing the interface between social media and academic publishing and ask where the BJPsych should ‘strategically place itself’. Many clinicians – including myself – use social media as their main source of access to new publications and its use allows a wider audience to be reached.

The authors give sensible advice for clinicians in public debate on emotive topics. Unfortunately, avoiding argument and accepting differences in opinion do not tend to have a powerful impact on social media.

If BJPsych or other academic institutions hope to guide public opinion on scientific and health topics, an understanding of the failings of traditional communication strategies in social media is essential. In their book #newpower, Henry Timms and Jeremy Heiman^{Reference Timms and Heimans2} outline the shifting rules on how public opinion can be formed and shaped in the age of social media. They draw on examples such as recruitment to ISIS and the emergence of the antivaccine (or antivaxxers) movement to show how traditional institutions are failing in their messaging.

Social media is used extensively in quality improvement networks to connect and share knowledge, and help spread innovation. For example the 1 h TweetChat on 20 May 2019 with Hugh McCauchey (@HughMcCauchey), National Director for Improvement in England, reached an estimated 1.25 million people (according to Twitter analytics).

The #EndPJparalysis campaign has become a global social movement activating a range of healthcare professionals, patients and carers, reducing long hospital stays and has led to new avenues of research being explored.^{Reference Oliver3}

Social media can have a positive impact on health care and health. Understanding how it can be used effectively to spread learning, combat misinformation and change minds is essential and we can all be involved in this work.