Social media in traditional chinese medicine practice: Practitioners' perceptions, adoption barriers, and communication implications.

OBJECTIVE: Social media has become an increasingly important channel for public health information seeking and patient education. However, little is known about how Traditional Chinese Medicine (TCM) practitioners perceive and engage with social media in their professional practice. This study explores TCM practitioners' perceptions of social media in health communication, identifies key factors influencing its adoption and use, examines perceived barriers and challenges, and assesses its implications for doctor-patient communication. METHODS: Semi-structured, in-depth interviews were conducted with 31 TCM practitioners working in Shanghai. Interviews were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis involving iterative coding, theme development, and interpretation. RESULTS: TCM practitioners expressed mixed and context-dependent attitudes toward social media, ranging from active engagement to deliberate avoidance. Beyond commercial considerations, participants viewed social media as a means of disseminating TCM knowledge and sustaining cultural traditions. Social media was perceived as facilitating initial trust-building with patients, although long-term trust was seen to depend on clinical competence and treatment outcomes. Practitioners also reported greater willingness to present diverse personal identities online and to engage in more relational forms of interaction with patients. Institutional differences were evident between public and private healthcare settings. Public hospital practitioners faced stricter organizational constraints on social media use. CONCLUSION: Social media plays a multifaceted role in TCM practice, supporting patient education, cultural transmission, and evolving forms of doctor-patient communication. Adoption is shaped by professional values, institutional contexts, and tensions between visibility, trust, and regulation. PRACTICE IMPLICATIONS: Context-sensitive guidance should distinguish general health education from individualized advice, establish tiered institutional review, and help practitioners communicate limitations, manage expectations, and maintain professional boundaries.