The findings arrive at a moment when TikTok has become one of the most consequential platforms for health communication. Makarem, whose broader research program examines consumer experiences with healthcare services, notes that members of Generation Z — the cohort born between 1997 and 2012 — turn to social media for health information at significantly higher rates than previous generations. Among the platforms competing for their attention, TikTok has emerged as especially influential as a source of health and wellness content. That shift makes the platform a natural laboratory for studying how digital persuasion operates when the persuader wears a white coat.

To investigate, Makarem and two colleagues assembled a two-part research design. First, the team analyzed 330 TikTok videos produced by 11 U.S.-based, licensed medical doctors with substantial reach and impact on the platform — what Makarem describes as the mega influencers. Second, the researchers conducted in-depth interviews with 26 Gen Z participants who actively follow physician-influencers. This combination of content analysis and consumer interviews allowed the team to examine both what these creators actually post and how their young audiences interpret, evaluate, and act on that content.

One of the study’s central theoretical contributions is what the researchers call the mere social media presence effect. According to Makarem, a recommendation from a physician-influencer may carry more weight with a young follower than advice from that follower’s own doctor. The mechanism is subtle but powerful. Consumers are generally trained to respond positively to credentialed experts, and social media adds an additional layer of perceived authenticity. As Makarem explains, followers see these physicians as busy professionals who already earn comfortable incomes and have no obligation to post online — so the very act of taking time to educate the public reads as an act of generosity rather than marketing.

This perception persists despite abundant evidence of commercial activity. The physician-influencers studied behave much like other social media creators, though with a more professional orientation. They are not singing and dancing like many influencers, but they do share personal information, and they frequently wear medical attire even when their content has nothing to do with medicine — Makarem observed creators making a peanut butter and jelly sandwich in their kitchens while wearing a lab coat. They also demonstrate that they practice what they preach, showing themselves at the gym, using their own products and supplements, and displaying the books they have written. The influencers are, in other words, visibly making money from their platforms.

Yet the young followers largely discount that commercial intent. When Makarem asked interview participants whether they had checked whether these creators were actual physicians, the answer was no — but the participants expressed confidence anyway, reasoning that the stethoscopes, the scrubs, and the diplomas hanging on the wall made deception unlikely. When followers did recognize a financial motive, they rationalized it: the influencers have to monetize, the reasoning goes, and if they could do it for free, they would. This pattern is precisely what the study’s published title, When Doctors Become Influencers: How Social Media Presence Disarms Persuasion Knowledge and Shapes Consumer Behaviors, describes. Persuasion knowledge — the consumer’s ability to recognize when someone is trying to sell them something — appears to be suspended when the seller is a credentialed doctor in a medical setting, even a digital one.

The research also identifies social proof as a reinforcing force. Comments from other followers amplify the perceived value of a physician-influencer’s content. When a young user scrolls through replies saying thank you, this changed my life, the visible positive impact of the influencer on other people strengthens their own trust and engagement. The cumulative effect is a feedback loop in which credibility, altruism, and community endorsement continually validate one another. The behavioral consequences are substantial: Makarem reports that followers exhibit very high adherence, both buying the products the influencers recommend and following the health advice they dispense.

The contrast with followers’ experiences of their own physicians is stark. In the interviews, participants described personal doctors as inaccessible and commercially motivated in a way the influencers are not. Some said their physicians seemed uninterested in preventive medicine, with one participant suggesting the doctor preferred recurring visits because that is how he makes money. Others pointed to the friction of co-pays followed by information they could not understand. Where the TikTok physician is free, fluent in the platform’s vernacular, and apparently selfless, the office-based physician is costly, formal, and transactional. That asymmetry, Makarem argues, should give the medical community pause, because it suggests that a creator’s recommendation may outweigh a treating physician’s clinical guidance in the decisions young patients actually make.

The study carries practical implications on both sides of the screen. For consumers, Makarem emphasizes the importance of education: young users should verify credentials rather than infer them from lab coats and wall décor, and they should recognize commercial intent no matter who is doing the selling. The same skepticism Gen Z applies fluently to fashion and beauty influencers, in other words, needs to be reactivated when the influencer claims medical authority. For the medical profession, the findings suggest an uncomfortable strategic question. According to a study by the Pew Research Center, only about 17 percent of health and wellness influencers on these platforms are conventional medical professionals such as doctors, dentists, and nurses. Makarem attributes that underrepresentation partly to concerns about legal liability, but she argues there is room for credentialed professionals on social media. She understands why physicians are reluctant, she says, but the platform is a very effective way to reach patients, and physicians who have shied away from it may want to reconsider.

More broadly, the research documents a generational realignment of medical authority. Trust, once anchored in institutions, licensure, and the physical clinic, is migrating toward parasocial relationships built one short video at a time. The mere presence of a credentialed figure in a social feed is enough to disarm the defensive skepticism that young consumers otherwise deploy with sophistication. As physician-influencers continue to accumulate audiences that dwarf many clinical practices, the study suggests that the future of health communication will be contested not in waiting rooms but on feeds — and that both regulators and medical educators will need to catch up with a world in which the most trusted doctor in a young person’s life may be one they have never met, whose credentials they have never checked, and who may be selling them something in the very next post.

Subject of Research: The influence of physician-influencers on TikTok on Gen Z health behaviors and consumer trust

Article Title: Popular TikTok docs have big influence on Gen Z followers, new VCU research finds

Article References: Popular TikTok docs have big influence on Gen Z followers, new VCU research finds. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: TikTok, physician-influencers, Gen Z, health communication, social media, consumer behavior, persuasion knowledge, medical credibility, Virginia Commonwealth University, Journal of Consumer Affairs, health misinformation, influencer marketing