Countering Misinformation in Medicine

Medical misinformation is a growing challenge throughout health care, exacerbated by the ubiquitous use of social media that reinforces people’s tendencies to perceive and believe in things supported by other people. Countering medical misinformation is critical to advance health care and provide the best possible care to patients.

Health literacy plays a critical role in improving health outcomes. Educating the public on behaviors that create and maintain health is critical to advance public health and population-based care. For patients diagnosed with a medical condition, optimal treatment depends on an understanding by the patient about the diagnosis and treatment options so that, among other considerations, they adhere to treatment recommendations.

Improving health literacy is difficult. Making this more difficult is the prevalence of medical misinformation that exacerbates the challenge to educate people on medical information that can be complex and ever-changing. Perhaps one of the key lessons learned through COVID-19 is the widespread lack of understanding about how science works as an evolving not static field. Medical science, unlike sciences like physics and mathematics, is more fluid as its practice requires providers to talk to patients about prognoses in statistical terms while mindful of the individuality of the patient.

While the challenges of medical misinformation have long existed, social media has driven its spread into high gear. Data published in Pharmacy & Therapeutics show 8 of 10 internet users search online for health information and 74% of these users use social media.

A systematic review published in the Journal of Medical Internet Research observed the prevalence of health misinformation on social media found misinformation reached 87% in some studies, with the highest prevalence in studies related to smoking products and drugs. Whether or not such exposure results in the consequences of receiving inaccurate information—which can prompt more issues like vaccine hesitancy during a pandemic—depends on the reasons people may believe misinformation.

For providers trying their best to care for their patients, understanding the way misinformation works can help them to counter it to better serve their patients. Much of this can be done in the clinical setting. Other resources to help patients find accurate information are also important given the broad use of the internet by patients to look for answers to their medical questions.

Through his research on the psychology of conspiracy theories, Daniel Jolley, assistant professor in social psychology at University of Nottingham, found when faced with complex and confusing events and issues people tend to want to seek meaning.

“Sometimes events/issues, such as vaccination decisions, can make us feel anxious, worried, or uncertain,” said Mr Jolley. “In these moments, with the desire for meaning also playing a role, we might find information that provides a simple solution to the event/issue appealing.”

While misinformation may propel people toward a simple solution, believing misinformation is often shaped by what social psychologists refer to as misperceived norms. Explaining this in a 2021 article entitled, “How to dissuade parents from believing in anti-vaxxer conspiracy theories,” Mr Jolley and colleagues cite research showing that people are influenced by social norms—or the perceived beliefs and behaviors of other people. When these perceptions are inaccurate, which often occurs, people’s behavior can be shaped to fit the misperceived norm. The researchers also found that people’s beliefs in misinformation grow stronger based on the number of other people they believe share their beliefs.

What Mr Jolley and colleagues found is that people tend to overestimate the number of people who hold an inaccurate perception or belief in something. One key way to help a person move away from inaccurate toward accurate information is to underscore that the inaccurate beliefs are less commonplace than the person might think.

For health professionals in particular, Mr Jolley emphasized the importance of building a rapport with patients by taking an empathetic and understanding approach, and above all, listening to them. “If the patient is feeling uncertain or worried, take some time to try and make the patient feel more in control,” he said. “Acknowledge the concerns and listen carefully.”

What he advises against is for health professionals to defend their own beliefs.

In 2021, the US Surgeon General issued a report and community toolkit for addressing health information. It is among several efforts to help health care providers understand and counter misinformation.

Other efforts are coming from sources with expertise in communication. As an associate professor of communications at Elon University, Amanda Sturgill, PhD, examines the effectiveness of online communication technologies. She believes providers have a lot of power to influence patients because of the trust patients place in them on routine matters of health.
Highlighting the misinformation on COVID-19 providers heard from patients, she said that handling patient questions about other aspects of health care they read online is similar. “It is useful to remember that people tend to disregard information they don’t already agree with,” said Dr Sturgill. “It is easier for patients to believe what they want to believe, and combative attitudes do not work as well as rapport does.”

She emphasized other than for behavior that may imminently endanger others, like a patient’s abusive treatment of staff for which strict boundaries are necessary, providers may do better to counter misinformation expressed by patients through listening and following up with a willingness to discuss further. “That way, what [patients] don’t do today, they may do tomorrow,” she said, suggesting, like Mr Jolley, the essential need to listen and build trust with patients as the best way to move them away from misinformation toward accepting accurate information.

She also cited several potential strategies for providers to help them educate patients about health information (see Table). A more in-depth discussion of these strategies in the context of the pandemic can be found in an invited commentary published in North Carolina Medical Journal on how health care providers can help combat harmful misinformation about the pandemic.

Dr Sturgill highlighted that medical information is often quite nuanced and the changes in guidance, such as protection measures recommended during the pandemic, can be frustrating to patients and lead them not to trust credible sources. She again encouraged providers to be honest and empathetic in their approach to patients and communicate this through phrases such as “I know it is irritating, but I will use my expertise to find the best information and we will work together to keep you healthy.”

Given the ubiquitous use of the internet by patients and the public to look for medical information, helping patients find trusted sources is another way to steer them toward accurate information. Government agencies, academic health centers, and medical associations are all trusted sources of information. The National Institute of Health provides a checklist of questions consumers can ask to help identify trusted sources which include the following: (1) Is the website a federal agency, medical school, large professional or nonprofit organization, or related to one of these? For example, does the URL contain any of the following that indicate these types of websites: .gov, .edu, .org, or .com; (2) Is the website written by a health care professional or reference a healthcare professional?; (3)Why was the site created? Is the mission of the website sponsor clear?; (4) Is there a way to contact the sponsor of the website, or is it clear who authored the information?; (5) When was the information written or last updated?; (6) Is your privacy protected?; and (7) Does the website offer unbelievable solutions to a health problem(s), such as offering a quick, miracle cure?

Another resource, recently launched is GoodRx Health, which is taking a slightly different approach by creating health content that provides patients with authoritative and actionable information. Chief Research and Communications Officer of GoodRx, Thomas Goetz, who oversees GoodRx Health, said the site was created to answer the need by consumers for a reliable source of health care information. “There is a lot of angst about what information people are getting on the internet outside of their clinical care,” said Mr Goetz.

Built around the way people use the internet for seeking medical information—by googling a question about a given disease, treatment, etc—the content of GoodRx Health is created to answer questions about what people want to know but also provides additional information on what people may not be aware of (and should know). Written by an experienced team of medical experts and professional journalists, the content is both authoritative and offers consumers actionable information. Development of the content mirrors the way that guidelines for physicians are created, that is, via literature reviews and the most up-to-date evidence.
“We took that same approach for physicians and created a tool for lay people that provides information built around answering a question,” he said, adding that patients can then use that information to make decisions for themselves or to provide to their physicians to discuss.

Launched in September 2021, the site also offers “Health Debunked,” a series that Goetz described as cutting through some of the health information claims consumers find on the internet that are unsupported by the evidence.

Medical misinformation is a growing challenge throughout health care, exacerbated by the ubiquitous use of social media that reinforces people’s tendencies to perceive and believe in things supported by other people. Countering medical misinformation is critical to advance health care and provide the best possible care to patients. Providers can use a variety of strategies to do this.