Gen Z followers in a 26-person VCU study trust TikTok doctors over their own physicians

The study's design limits what the finding can show. The VCU team analyzed 330 TikTok videos from 11 licensed U.S. physicians with large followings, about 30 videos per doctor ^[4][17], and they interviewed 26 Gen Z people who actively follow physician-influencers ^[5]. Those 26 were chosen because they already follow these doctors. The published account does not describe a comparison group of non-followers or a scale on which credibility was scored. So the study shows how committed followers explain their trust. It cannot say how common that trust is among people born between 1997 and 2012 ^[14].

Makarem, an associate professor of marketing in VCU's School of Business, ran the study with two colleagues ^[6]. She has named the pattern. "We call it the mere social media presence effect," she said. "What a physician-influencer recommends may carry more weight than what their own doctor tells them. That should give us pause." ^[7]

The interviews show clearly where the credibility comes from, and a lot of it is clothing and props. Asked whether they had checked that the doctors were real, a follower answered, "No, but I'm sure. They're wearing a stethoscope; there's a diploma hanging on the wall; they have scrubs on. I don't think they'd be lying about this." ^[10] The videos supply those cues even when the topic isn't medicine. Makarem described doctors "making a peanut butter and jelly sandwich in their kitchen, but they have a lab coat on." ^[9] Other viewers' comments add to it. "If you're reading things like, 'Thank you, this changed my life,' then you see the positive impact of the influencer on other people," she said ^[16].

All 11 doctors in the sample were licensed ^[4]. The study did not test how the same followers would treat someone in the same lab coat without a license. I'd expect the cues to work just as well, since none of them requires a medical degree to buy.

In Makarem's account, the physician label also changes how young people handle commercial intent. "Young consumers are usually very literate when it comes to social media influencers and commercial intent. But when you have a physician on TikTok, that becomes something different," she said ^[8]. When followers do notice the selling, she said, "they say, 'Well, they have to. If they could do it for free, they would.'" ^[11]

The behavioral claim is strong. "We found that the followers have very high adherence," Makarem said. "They buy the products; they follow the advice." ^[1] That is self-report from 26 people. An interview study is not built to show whether the products or the advice helped anyone.

The comparison with their own doctors is the part clinicians can act on. The complaints are about motive, cost and explanations patients cannot follow. Makarem recalled followers saying things like, "My physician isn't interested in preventive medicine. He wants me to keep coming to see him because that's how he makes money. I have to make a copay to see him, and then I get information I can't understand." ^[12]

Makarem's recommendations address both sides. She said the study points to teaching consumers to verify credentials and to recognize commercial intent no matter who is selling ^[15]. She also suggested that physicians who have stayed off social media reconsider. In the VCU account, only about 17% of health and wellness influencers are conventional medical professionals such as doctors ^[13].