Trust as an antidote to the viral spread of medical misinformation
The existence of medical misinformation is palpable for anyone scanning recent news headlines. Journalists and commentators often point to the spread of misinformation as a regular aspect of contemporary life, as we have seen in reporting on the novel coronavirus, which causes COVID-19. Faced with emerging and continued threats to public health and the simultaneous specter of patients being misled by misinformation, some health care professionals are frustrated and wonder what they can do to help.
At Duke University, I recently spent time talking with health care professionals in a workshop for the Duke AHEAD program that I organized with Dr. Jamie Wood, a medical education faculty member at Duke’s School of Medicine. Many participants had stories to tell about patient encounters with misinformation. Participants also were eager to talk about hypothetical scenarios we introduced as prompts to consider how we might optimally talk with patients about misleading information they reference, e.g., regarding an untested treatment for cancer.
In many instances, health care professionals’ first response is to generate a reasonable counterargument regarding misinformation, e.g., “my argument to them would be…” That well-intentioned response to patients, however, misses an important opportunity that could be central to our systemic response to the spread of medical misinformation.
What if our first response to patients who reference clearly problematic claims was to ask: “Why are those claims important to you, and what concerns or questions do you have about your health?” We do not need to validate false claims in order to acknowledge and validate our patients’ interest in well-being. If we can take a deep breath and focus on listening rather than counterarguing, we often can find opportunities to redirect patients to credible sources of information.
At a system level, we also could better monitor patient encounters with misinformation and develop easily accessible information sources that respond to the questions those encounters raise, rather than simply bemoan the falsehoods. We could be systematically tracking patient questions and learning from those questions to craft educational resources for communities. In this way, patient encounters with sensational misinformation could help crystalize their questions and concerns (even if at the same time also offering a frustrating distraction), which means that with the right monitoring and learning tools we could improve patient health education.
We do not have the time or resources to argue against every false claim to which patients are exposed, but we do have opportunities to build and reinforce trust by acknowledging and listening to patients. Such trust could inoculate against future acceptance of medical misinformation by encouraging conversations. From this perspective, patient references to misinformation in the clinic can be a victory of sorts if we consider that the alternative is patient refusal to show up at all or reluctance to mention their concerns in the first place.
Brian Southwell is Senior Director of the Science in the Public Sphere program at RTI International and Adjunct Professor and Duke-RTI Scholar at Duke University. He has written and edited numerous articles and books on misinformation and public understanding of health, including Misinformation and Mass Audiences (University of Texas Press). He also hosts a public radio program called The Measure of Everyday Life for WNCU.