Misinformation: A public health crisis DOs can address

The United States is currently facing the largest measles outbreak in three decades, with more than 1,200 cases reported to the Centers for Disease Control. The spread of that disease is a mere symptom of one of the most dangerous pandemics of our time: misinformation.

Social media transformed the information age, kicking it into overdrive. Now everyone has a platform to push natural remedy products or cast doubt on pharmaceuticals and medical science.

Our culture shifted in step with the technology. Science is now politicized and often claimed as a domain of the left; though, both sides found rationales for becoming anti-vaxxers.

Medical expertise is democratized through sites like WebMD. While it’s great when patients are informed and involved in managing their own health, it can be a problem when they think they know better than their physician, armed only with incomplete online information.

The medical profession also suffers from some self-inflicted wounds. Physicians represent dubious “natural” treatments in their private practices and on daytime talk shows. Some doctors still placate patients with antibiotics for the common cold. And the opioid crisis constitutes a nationwide sentinel event.

We can’t exactly blame people for being wary.

We also cannot resign ourselves to a world of compounding population health crises brought on by preventable disease. There are three routes we can use to win back the public’s trust in medicine: individual patient care, social media and political advocacy.

Ask the right questions

At least once a month, I see a patient in the ED with serious liver or kidney damage caused by an unregulated supplement they thought would make them stronger or healthier.

Why did they take it? Because a trusted friend or celebrity endorsed the product, assuring them it’s “all natural”. I usually take the opportunity to ask some questions about why they’re taking the supplement and explain the healthier means to get what they want.

Primary care physicians are in the best position to get ahead of this. What if, while taking histories and asking about nonprescription medications and herbal supplements, it became standard clinical practice to also ask if patients if they read anything health related online that they weren’t sure about? That might allow us to clear up misconceptions before the damage is done.

Meet patients where they are

In harm reduction, we often talk about meeting patients where they are. Literally everyone is online. By creating an online presence that is personable, approachable and educational, you can help bridge the physician/patient divide and counter misinformation in real time.

On Twitter, I have an audience of nearly 30,000 people who I can educate on everything from benign yet misleading conventional wisdom, like “an apple a day…” to very serious risks of unregulated supplements. And in turn, they can ask follow up questions and share what they’ve learned.

This platform lets me plug into political conversations and advocate for policies that help reduce harm and improve health. I’ve also found a phenomenal professional community. We help each other, commiserate on hard days, learn from one another and provide a united front that can help when the public assumes all opinions are equal.

Demand accountability

We can educate people about vaccine safety and efficacy and the fallacy of natural remedies. However, as long as there are people with influence and authority spreading false information, some portion of the public will fall victim to it.

A celebrity or physician telling their audience that vaccines cause autism or essential oils and vitamins can cure cancer is tantamount to yelling fire in a crowded public space. There must be consequences for causing so much harm on a mass scale.

As physicians we wield a degree of influence and should use it to appeal to our lawmakers in the interest of protecting patients. Most of us also belong to multiple associations that advocate in D.C. on our behalf. We must urge them to speak up in unison.

Together we can call for an unequivocal return to evidence based medicine and a ban on snake oil. We can petition our state governments and fellow physicians in private practices to insist on vaccination. No more religious or philosophical exemptions.

Back in the 19^th century, Rudolf Virchow, a pathologist well ahead of his time in understanding public health, opined that “if medicine is really to accomplish its great task, it must intervene in political and social life.”

That’s as true now as it was then.