Given the demand for authentic personal interactions over social media, it is unclear how much firms should actively manage their social media presence. We study this question empirically in a health care setting. We show that active social media management drives more user-generated content. However, we find that this is due to an incremental increase in user postings from an organization's employees rather than from its clients. This result holds when we explore exogenous variation in social media policies, employees, and clients that are explained by medical marketing laws, medical malpractice laws, and distortions in Medicare incentives. Further examination suggests that content being generated mainly by employees can be avoided if a firm's postings are entirely client focused. However, most firm postings seem not to be specifically targeted to clients' interests, instead highlighting more general observations or achievements of the firm itself. We show that untargeted postings like these provoke activity by employees rather than clients. This may not be a bad thing because employee-generated content may help with employee motivation, recruitment, or retention, but it does suggest that social media should not be funded or managed exclusively as a marketing function of the firm.