During the day, Wang Tihua works as a doctor of traditional Chinese medicine at a public hospital in Zhejiang province. After hours, he moonlights as a health-care influencer, setting up a smartphone at his desk to film himself delivering lectures on a range of medical issues — from flu prevention to high blood pressure.
In a recent lecture, posted in April, Wang explains the difference between a stent and a pacemaker in treating heart disease. “Inserting a stent is like making sure fuel can flow well inside a car,” the 54-year-old says to the camera in Chinese. “Inserting a pacemaker is the equivalent of repairing a car’s ignition system.”
Wang shares the video lectures, typically one to three minutes long, on WeChat and Douyin, TikTok’s Chinese sister app. With more than 8,700 followers across both platforms, his new role as a doctor-influencer has allowed him to share his medical knowledge with a much wider audience. Around 20% of his new patients had booked consultations with him after watching his lectures, Wang told Rest of World.
“If [a doctor] speaks at conferences or lectures, there are only a limited number of people listening,” he said. “But on online platforms, the audience is huge.”
Wang is one of the tens of thousands of Chinese doctors who became influencers during the Covid-19 pandemic, as locked-down patients increasingly turned to short-video apps to seek health advice. In March 2023, there were more than 35,000 verified doctor accounts on Douyin alone. One of the platform’s most popular doctors is a Beijing surgeon with over 24 million followers. He shares everything from how to identify the early signs of a heart attack to the best method for removing fish bones stuck in the throat.
Doctor-influencer accounts not only make medical information more accessible to the public but also provide China’s notoriously underpaid medical professionals with a lucrative side hustle. Through social media, many doctor-influencers are able to make money by selling books, health-care tutorials, and nutritional supplements, and by soliciting potential patients to visit their clinics. One spine specialist said Douyin fans accounted for more than 90% of his offline clients, according to health news outlet HealthInsight. Some hospitals have organized training sessions in video filming and editing for medical workers.
The business model has become so successful that it has spawned an entire industry of doctor-influencer agencies. In return for a cut of the profits, these companies edit videos, reply to patients’ enquiries, negotiate advertising deals, and help doctors build and market their online personas. Shi, a Shanghai-based employee at an influencer agency, told Rest of World he coached plastic surgeons on how to appear more accessible and trustworthy in online videos. “When doctors speak in a heartfelt way, you find them more professional,” he said, requesting to use only his last name for fear of being identified by his employer.
Ale is a Beijing-based social media manager who handles 14 doctor-influencer accounts. He told Rest of World his company sometimes uses ChatGPT to write video scripts, which are then given to the doctors for approval. The goal of these videos — which typically depict doctors explaining how to treat various diseases, answering fan queries, and comforting patients — is to get followers to book video consultations, said Ale, using a pseudonym as he was not authorized to speak to the media.
The head of a doctor-influencer agency in Beijing, who requested anonymity due to concerns over violating platform rules, told Rest of World agencies like his had become crucial during the pandemic, helping deliver much-needed medical information to the public. Doctors didn’t have time to manage their own side hustles as internet celebrities, he said.
But without clear regulations, the doctor-influencer business model has also given rise to scams and misinformation. Consumers could be misled by product placements and content bulk-produced by influencer agencies, said Yixuan Liu, a PhD candidate at the University of Texas at Austin, who studies how women access health information on social media. Some patients told state media they ended up paying for expensive traditional Chinese medicine without drug labels after they messaged doctor-influencers about their reproductive, urological, or skin conditions. One consumer told Chinese media he bought a shampoo recommended by a doctor-influencer, but the product didn’t actually prevent hair loss like the doctor had claimed it would.
In recent months, the industry has fallen under government scrutiny due to concerns over false advertising. In May 2022, the government banned medical professionals from selling products on livestreaming platforms; this April, Douyin banned all verified doctor accounts from direct messaging and opening fan groups, to prevent them from soliciting patients. The platform has also asked doctors not to work with influencer agencies, citing concerns over misleading and exaggerated content — though how this would be enforced remains unclear. Other platforms such as Kuaishou and Xiaohongshu have also pledged to clamp down on doctors’ online marketing.
Employees at influencer agencies told Rest of World the industry has taken a hit because of the tightening restrictions. Ale, the Beijing-based social media manager, said his team had been operating at a loss under the new rules. The Shanghai-based employee, Shi, said his company tried to get around the ban by using non-medical accounts to reply to followers’ messages, but Douyin shut those down, too. Users can now only contact doctor-influencers on Douyin by booking an online consultation or by making a public hospital appointment through parent company ByteDance’s Xiaohe Health portal. Moving forward, agencies would have to be much more subtle about their advertising, such as by having doctors recommend generic drugs instead of explicitly mentioning brand names, said the head of the Beijing-based agency.
Wang, the doctor in Zhejiang, said he had no intention of working with influencer agencies. But he still hoped his video lectures would boost his reputation in nearby cities. His promotional strategy has remained more intimate and low-key: He encourages patients at his clinic to follow his account and share his lectures with friends and family through word of mouth. Recently, patients told Wang they had made appointments with him after family members shared his videos on anxiety and insomnia in WeChat groups.
Wang said he also advised younger colleagues to take up filming. “If you want to grow your career faster, you need to make videos,” he said. “Once people know you [through videos], they will come to you for treatment.”