There seems to be a trend on social media that starts the same way every single time.

“I’m a physical therapist with a doctorate in my field…”

Or…

“I’m a physician…”

“I’m a psychologist…”

“I’m a nurse practitioner…”

The credential is presented first because it’s meant to establish authority before anything else is said.

That’s perfectly fine. If you’ve earned an advanced degree, you should be proud of it. I certainly respect the work physical therapists do. Some of my closest friends are physical therapists, and I’ve worked alongside them for decades. They provide an invaluable service to patients every day.

But credentials carry responsibility.

The particular videos filling my feed usually follow the same formula. After introducing themselves, the creator plays a clip of a public figure—often the President—and proceeds to offer what amounts to a diagnosis and, in some cases, even a prognosis based entirely on video footage.

Not observations.

Not possibilities.

A diagnosis.

As a healthcare professional, that makes me uncomfortable.

Years ago, psychiatry addressed this very issue with what became known as the Goldwater Rule. Following the 1964 presidential campaign, psychiatrists publicly speculated about Senator Barry Goldwater’s mental health without ever examining him. In response, the American Psychiatric Association established an ethical guideline stating that psychiatrists should not offer professional opinions about public figures they have not personally evaluated and who have not authorized such an opinion.

Technically, that rule applies only to psychiatrists.

The underlying principle, however, is one that should resonate throughout healthcare.

There is a tremendous difference between making an observation and making a diagnosis.

It is entirely reasonable to say that someone appears to have a tremor, appears unsteady while walking, appears forgetful, or demonstrates behaviors that can sometimes be associated with a particular disease process.

Those are observations.

Saying someone has Parkinson’s disease, Alzheimer’s disease, frontotemporal dementia, or another neurological disorder—and then predicting how it will progress—is something entirely different.

That’s practicing medicine without the medicine.

A proper diagnosis requires far more than a thirty-second video clip.

It requires a medical history.

A physical examination.

A neurological examination.

Laboratory studies.

Imaging when appropriate.

Consideration of differential diagnoses.

Sometimes repeated evaluations over months or even years.

Anyone who has worked in medicine knows how many different conditions can mimic one another.

Take dementia, for example.

People often assume confusion automatically means Alzheimer’s disease. In reality, confusion in an older adult can result from medication side effects, dehydration, infections, metabolic abnormalities, depression, strokes, sleep disorders, vitamin deficiencies, thyroid disease, or something as surprisingly common as a urinary tract infection.

One symptom does not equal one diagnosis.

That’s why medicine isn’t practiced through TikTok.

I understand the counterargument.

People say healthcare professionals have a duty to point out concerning behaviors because the public deserves expert insight.

I actually agree—with one important caveat.

Experts should educate.

They should explain what certain symptoms can mean.

They should discuss diseases, warning signs, risk factors, and why something might warrant further evaluation.

What they shouldn’t do is diagnose someone they’ve never met.

There’s another issue that bothers me.

Stay in your lane.

Again, I have enormous respect for physical therapists. Their knowledge of movement, gait, rehabilitation, musculoskeletal conditions, and functional assessments is exceptional. Many cognitive assessments also fall within their practice, particularly in neurological rehabilitation.

That doesn’t automatically make someone an expert in diagnosing complex neurodegenerative diseases from internet videos.

Healthcare has specialties for a reason.

I certainly wouldn’t expect an emergency nurse practitioner to suddenly become an authority on advanced orthopedic reconstruction simply because I watched a few surgeries.

Likewise, I wouldn’t expect an orthopedic surgeon to manage my psychiatric medications.

We all have limits.

Recognizing those limits isn’t weakness.

It’s professionalism.

When I read the comments under these videos, I see thousands of people applauding.

“Thank you for confirming what we’ve all been thinking.”

“Finally, an expert tells the truth.”

I rarely see other healthcare professionals joining in.

I suspect many are having the same reaction I am.

Not because we necessarily disagree with the observations.

Because we’re concerned about the process.

Public trust in medicine depends on the belief that diagnoses are based on evidence—not popularity, politics, or thirty-second clips designed to generate views.

Whether the public figure is a president, a celebrity, a billionaire, or your next-door neighbor shouldn’t matter.

The standard should be the same.

I’ve said before that I don’t particularly like this president.

That’s my opinion as a citizen.

If I want to criticize his policies or his behavior, I’ll happily do that.

But I’m not going to manufacture a medical diagnosis to make the criticism sound more authoritative.

Those are two very different conversations.

At the end of the day, I wouldn’t trust someone on TikTok to diagnose my dog—or my mom—without taking a proper history, performing a thorough examination, and ordering the appropriate testing.

Why would I lower that standard simply because the patient happens to be famous?

Be the kind of person your dog and your mom hope you are.