But not everyone agrees they should
Health misinformation plagues the internet, and it isn’t only anti-vaxxers who buy into it. From influencers peddling useless supplements to fashion publications extolling the virtues of CBD oil face masks, misinformation — while often not malicious — touches most of us. At best, it can waste time and money. At worst, it puts people’s lives at risk.
The question of how best to battle this misinformation, if at all, is a vexing one within the medical community. What responsibility do doctors and other medical professionals have in fighting pseudoscience, particularly online? Some believe doctors should essentially be seen and not heard. A growing contingent of the medical community, however, is choosing to voice their frustration and correct the record on social media. But this comes with some risk, as confronting conspiracy theorists and alternative health moguls can be exhausting and even dangerous.
These medical professionals — doctors, nurses, even health policy lawyers — often differ in their methods, but for the most part they share one goal: to battle the health misinformation that infiltrates every corner of the internet. And while anti-vaxxers, who cluster in private Facebook groups and other closed communities like fervent supporters of some new church, may be beyond the reach of even the savviest doctor online, the rest of us — from those who may have questions about new dermatological treatments to those who aren’t entirely convinced one way or another about vaccines — could stand to benefit from the wisdom of the medical professionals who dare wade into social media’s treacherous waters.
Austin Chiang, a gastroenterologist based in Philadelphia, is the president of the Association for Healthcare Social Media (AHSM), a new nonprofit organization whose mission is to educate doctors on proper social media use and advocate for it as a crucial tool in the public health toolbox.
Patients are getting their medical information from social media and Google — everywhere “except for the clinic visit that they have with us for 30 minutes at a time,” Chiang says. “With every single field out there, there’s something that is misinterpreted or misconstrued by the general public… We want to meet the patient where they are.” Chiang points to the existence and belief in colonic cleanses and detox teas as two issues that plague his own specialty, along with the most commonly known medical misinformation issue, anti-vaxxers.
Doctors need to consider their digital bedside manner as they approach all of this, but there’s a problem. Medical professionals, says Chiang, aren’t taught how to communicate online in an engaging and accessible manner, while the communications teams employed by hospitals and doctor’s offices don’t possess the same medical expertise as the doctors and nurses themselves. “If we aren’t engaged with online discussion, then the conversation is dominated by other people, and who knows where they’re getting their information from,” he says. “There are plenty of docs and nurses online these days, but relatively speaking, compared to the number of health professionals we have out there it’s still a very small minority.”
Harassment is rampant, and some doctors have even been sued by proponents of alternative medicine.
And when doctors engage, there’s a debate around the best approach. David Gorski, a surgical oncologist at the Barbara Ann Karmanos Cancer Institute and managing editor of the popular medical blog Science-Based Medicine, took to Twitter to point out that countering misinformation is more complicated than merely “drowning it out,” as a recent CNBC story said Chiang was aiming to do.
“We frequently assume the answer to bad information is good information, in greater quantity than the bad information, but we’ve known for some time that this is not how human minds work,” wrote Gorski in a tweet thread. “There just aren’t enough doctors and scientists who are interested enough in and good enough at social media to execute this strategy, at least not compared to the armies of cranks, trolls, and bots spreading the misinformation.”
An April post on Science-Based Medicine written by its founder Steven Novella, a neurologist and host of the science podcast The Skeptics’ Guide to the Universe, lays out a framework for the medical community as it participates in the grand war against misinformation. Much of its advice is internal, focusing on issues like the acceptance of alternative medicine within the greater medical community, as well as the publishing of inflammatory, preliminary studies that aren’t being held to high enough standards. But it also mentions that the “knowledge deficit” model — the idea held by many doctors that the public lacks the health information it needs — is flawed. Lack of information is a problem, but it’s less important than a lack of critical thinking skills more generally. “Facts don’t matter if you are stuck in a conspiracy mindset, or do not trust science, or are overwhelmed with motivated reasoning and confirmation bias,” writes Novella in the post.
But doctors are nevertheless working to combat misinformation on social media. Some of them host opinionated and passionate discussions on Twitter, as in the case of Gorski or the popular gynecologist Jen Gunter, who has written about how doctors can use social media to fight misinformation. Others create irreverent and informative videos for YouTube and Facebook, like the physician Zubin Damania aka ZDoggMD, and still others engage with followers on Instagram, like the British dermatologist Anjali Mahto.
“[Doctors] that do join, join with all the best interests of wanting to stamp out misinformation, [of] being that louder, more credible voice. The problem is you realize very, very quickly that it’s such a difficult battle,” says Mahto. “If I do a post about food and acne, and acne and diet, the amount of backlash I will get being like, ‘No you’re just wrong,’ and I’m like, I’m just telling you the evidence.” Mahto says some of her most successful posts result when she talks about her own struggles with acne.
Bogus corrections are just the start. Harassment is also rampant, and some doctors have even been sued by proponents of alternative medicine. There’s also the chance that the doctor’s institution may not take kindly to their employees’ posts, as happened to a nurse at New York-Presbyterian Hospital after she reposted an image of a messy trauma room on her Instagram.
Still, Damania thinks doctors have a responsibility to fight misinformation, which he elects to do on his various popular social media channels. “If we motivate [people] with stories and emotional hooks, then we can guide them simply with instructions that don’t overwhelm and cause folks to shut down,” Damania says. He adds that former vaccine-hesitant parents have messaged him to say that he changed their minds about vaccines or educated them about the dangers of “raw water.”
Timothy Caulfield, a professor of health law and science policy at the University of Alberta and host of the Netflix show A User’s Guide to Cheating Death, thinks that Chiang’s initiative could prove helpful. “It’s true that ‘more science’ on its own rarely changes minds,” Caulfield says. But “there has been too much tolerance of pseudoscience from many in the health care community. An initiative like this can help to build momentum that may nudge more in the direction of a science-informed approach.”
Of course, doctors alone can’t fight this battle. It demands collaboration from lawmakers, educators, the people behind social media platforms like Facebook, and the general medical community. But when Americans’ faith in doctors is falling, vaccine hesitancy is a global health crisis, and other conspiracy theories run rampant online, we need all hands on deck.