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Public Health March 15, 2023

What Every Doctor Should Know About Medical Misinformation

How should physicians contend with the proliferation of medical misinformation? Anti-science and anti-vaccine rhetoric are not new, but as noted in this JAMA Viewpoint, factors such as distrust in institutions, a polarized political climate, fractured media ecosystem and worsening economic inequality have given rise to new, highly transmissible “variants” of a longstanding problem. Fueled by social media, false or misleading information has spread farther and faster than accurate information during the COVID-19 pandemic, posing an ongoing threat to public health. Following are some key considerations for doctors when confronting medical misinformation.

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  1. False information has a novelty factor.

    Understanding how false news spreads is key to mitigating it. In 2018, researchers at MIT Sloan conducted the largest-ever longitudinal study of the spread of false news online. The study found that falsehoods are 70 percent more likely to be retweeted on Twitter than the truth. Why is this? Researchers hypothesize that “the degree of novelty” plays a significant role. Recipients of false news may have a greater emotional reaction to novel information, and thus are more likely to share it, whether it's true or not. Knowing this, clinicians may consider new ways of communicating facts, including a narrative approach. “Instead of dealing in principles, lecturing patients on the data and the numbers, perhaps we should concentrate on stories instead,” suggests this physician-authored essay in JAMA. “After all, that's how we ourselves learn: medical students may be trained in theory, but practicing physicians are educated by anecdote.”

  2. Communication skills must be honed.

    As discussed in this Stanford Medcast: COVID-19 Mini-Series, better communication training is needed in general to combat the rising tides of misinformation, false information and disinformation. “When we think about the way that we design medical education, communications is a soft science…[considered] not as important as, for example, teaching a resident how to do a lumbar puncture,” says Dr. Seema Yasmin, a journalist, physician and author of Viral BS: Medical Myths and Why We Fall for Them. But knowing how to communicate effectively with patients during clinical encounters—listening with empathy, using accessible language, and directing patients to evidence-based sources of information—helps engender trust.

  3. Understand health care’s breaches of trust.

    Speaking of trust, any efforts to counteract misinformation and support evidence-based medicine must acknowledge the ways in which patient trust has been compromised. This includes unethical medical experimentation—from the Tuskegee Syphilis Study to the more recent Baltimore Lead Paint Study, to cite a few U.S.-based examples—and substandard care for people from racial and ethnic minority groups. This module from the AMA Center for Health Equity, developed in collaboration with COVID Black, explores how institutional racism fosters medical mistrust and distrust, as well as questions to consider when striving for trustworthiness. Bear in mind that addressing misinformation—whether related to vaccination, reproductive health, causes of cancer or other topics—requires sensitivity to patients’ diverse concerns, backgrounds and experiences.

  4. Combatting misinformation takes a village.

    Pointing patients toward credible information “isn’t the job of any one clinician to do alone,” notes communication science expert Brian Southwell, PhD‚ in this interview with JAMA. Efforts must be made within health care organizations to ensure patients are getting reliable information, whether that’s routinely updating a Frequently Asked Questions section on the organization’s website, improving their social media presence, or partnering with community groups to develop effective public health messaging. For its part, the American Medical Association recently adopted a new policy to combat health-related disinformation specifically disseminated by health care professionals—a small number of individuals who undermine public health efforts by making unscientific claims and pushing untested treatments.

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The rampant spread of medical misinformation is an escalating issue. Time-pressed physicians can’t entirely fix the problem at the clinical level, but by understanding how falsehoods spread, acknowledging the causes of medical mistrust, and communicating clearly and with compassion, they can be an essential part of the solution.

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