One pervasive question we’ve gotten throughout 2023 was, are healthcare professionals still using X, formerly known as Twitter? In case you’ve been under a digital rock, you probably know that X has been in various states of flux ever since its acquisition by Elon Musk. That’s kept us busy at Syneos Health®, as we’ve been inundated with questions from our clients about using or not using the platform. We’ve also developed countless POVs for our clients on how to handle situations like fake handles, Twitter Blue, staff layoffs, corporate ad boycotts, the proposed “hardcore culture,” name change to “X,” and so on.

Early on, our position had been that X continued to function as it always had – users were still posting to it, and we saw healthcare professionals continue to Tweet and connect with each other. Following reports of increased hate speech, we began advising clients to carefully consider the pros and cons of using the platform.

In particular, we’ve been curious about HCPs’ continued use of X. Anecdotally, we’ve heard that HCPs continued to use the platform, because it still worked for them and because of a lack of viable alternatives. However, with the platform’s mounting troubles, we were starting to see some drop-off of usage and genuine attempts by HCPs to find alternatives.

We now have a more quantitative answer to that question from our digital/social teams. We examined the Tweet activity of 27 prominent doctors and health voices online to analyze how their Tweet activity changed throughout the year. Some findings:

  • There was a 31% decline in the number of posts these HCPs were publishing on Twitter/X from the first half of 2023 to the second half.
  • Some of those HCPs dropped off the platform entirely with zero Tweets in some months, as the year went on.
  • September, October, and November 2023 marked the biggest decline in total Tweet activity among them.
  • Even the most prolific Tweeters, posting several hundred Tweets a month, trailed off in their Twitter/X activity throughout the year.


Here’s a look at the total and individual volume of Tweets from January to November of 2023 (NOTE: December is often a lighter month for social media activity).

But the question may remain regarding your use of the platform, since it is still an effective, quick-news-generating platform that HCPs and media continue to use. And while many journalists and some of the most social-savvy HCPs are also experimenting with upstarts like Mastodon, Threads, Discord, or BlueSky, those pale in comparison to X’s active users.

Last year, we examined the Twitter usage of the top 20 pharma companies, in the wake of the Elon Musk’s acquisition and the fake Eli Lilly Tweet debacle. Soon, we’ll be unveiling updated research in looking at those same companies’ use of Twitter/X throughout 2023.

With this and other social media topics, we’re here to help with things like X strategy, response protocols, and follower guidelines, so please do reach out to us to guide you through these rough social media waters.

About the Author:

Matthew Snodgrass is a lead in Digital & Social Strategy at Syneos Health in New York. He has more than twenty years of experience in digital marketing with a concentration in health and pharmaceuticals. Matt helps bring digital marketing campaigns to life while shepherding them through MLR review teams with numerous pharmaceutical companies. He has also helped to develop policy and training for employees and brand communicators in the area of social media.