It was a medical mystery. Or was it?
I was seeing a young man in my Miami clinic. He looked healthy but felt awful. His condition was baffling, he told me, considering his daily intake of vitamins, herbal supplements, and energy drinks. When I suggested this cocktail could be to blame, he was skeptical.
After all, he had developed the regimen under the expert eye of the internet.
Lifestyle choices weren’t the root cause of my patient’s condition. They were the symptoms of a more dangerous and widespread contagion: misinformation.
Researchers have found that falsehoods traveled six times faster than the truth on Twitter, which has since rebranded to X. Misinformation is so pervasive that it reminds me of the subtle, sterile smell that permeates all hospitals. Just as every doctor and nurse knows the smell exists but rarely mentions it, most physicians and health care leaders feel misinformation’s presence but accept it, like onlookers to a highway crash.
But if not us, then who? At the onset of COVID-19, social media falsehoods killed at least 800 people and hospitalized 5,800 globally. Health misinformation erodes trust, delays care, diminishes treatment adherence, exacerbates burnout, runs up costs, and risks lives. This is health care’s problem to solve.
While writing my recent book, “Dead Wrong: Diagnosing and Treating Healthcare’s Misinformation Illness,” I identified ways to combat the crisis. It became clear that this pervasive challenge required systemic solutions beyond any single doctor’s control. But the more I researched, the more I came to understand the levers physicians can pull to quash health misinformation. Here’s how.
Address health misinformation early on
As with any illness, early intervention must be the goal. Because research suggests misinformation leads to long-term disruptions in reasoning, doctors need to influence patients before disinformation producers do. Our work to keep patients informed must start before the first encounter and continue throughout the care journey.
Conversations about misinformation should begin when clinicians screen for tobacco use and other risk factors. Over time, questions and fears invariably emerge as patients research their diagnoses and treatments at home. Virtual visits and quick check-ins can help keep patients from misinformation’s grip.
Doctors must acknowledge that patients want more information than we can provide. To help patients avoid bogus content, I direct patients to credible sources of information. As a practicing rheumatologist, I’ve found people are most receptive to my resource recommendations when they receive their initial diagnoses. I share plain-language guides and let them know where I find papers written in doctor-speak. I often encourage my patients to join support groups, which expand the networks of people to push back against falsehoods. More recently, I’ve identified trained experts on social media for patients to follow — because that’s where our patients live.
Misinformation offers comfort and a sense of control to people who believe they lack agency. Doctors can fill that void in a few ways. I structure my patient relationships so that they have the decision-making power. That means I try to listen more than I speak and practice cultural sensitivity. The trust clinicians build with patients is a defense against deception.
Design patient relationships that pay off
What can doctors do for a patient who’s already deep down the misinformation rabbit hole? Instead of arguing about the facts, lean in to their values. Consider a patient who fears exposing their body to a new vaccine. Instead of picking apart efficacy rates or antigens, acknowledge the patient’s root concern.
“I understand you care about your health, and it can be frightening to receive a vaccine that just entered the market,” I might say. “But the truth is, researchers have tested it in thousands of people and found that it’s great at protecting the body. That’s why I got the shot, too.”
When a patient has already suffered health effects related to misinformation, I remind them of those consequences. That’s easier for them to feel than an intellectual argument against the dubious information itself.
It’s OK to give patients time to go home, think, and return with more questions. Quality care is an ongoing conversation. But we fail patients and ourselves when we allow patients to dictate treatment.
That’s why I’m happy to discuss a range of lupus treatments with my patients, but I never prescribe vitamin E. It’s not the standard of care. Similarly, a pediatrician friend accommodates parents with only one change to their child’s vaccine schedule. If they don’t accept that, they can find another doctor.
Addressing misinformation is hard work that requires compensation. Right now, our best bet is to bill for general counseling and chronic care management using evaluation and management codes. In the long run, we need a dedicated CPT code covering misinformation-related services.
How health care can combat misinformation at scale
Doctors, already stretched thin and with limited reach, won’t solve the misinformation crisis alone.
Imagine if administrators succeeded in reducing long waits, byzantine bureaucracy, and bills that lead to bankruptcy. That could expand access to care and increase trust, pulling patients away from misinformation.
Artificial intelligence, data and analytics, and other emerging technologies have the potential to improve the patient experience and patient engagement. Value-based care, meanwhile, promises to align incentives, cut costs, and recenter patient health.
More than ever, health care organizations and tech companies need to place clinicians in leadership positions, where we can use our expertise to advance the battle against misinformation. Every health system has patient experience, brand loyalty, and value-based care teams. Misinformation hurts all of those priorities, but clinical leadership can clear a path to success.
At the same time, we need to crack down on clinicians who promote misinformation. During the pandemic, a small group of social media personalities promoted anti-science messaging in a big way. The “Disinformation Dozen” included some doctors, whose falsehoods harmed patients. Medical associations and licensing boards have the power to police their ranks, as Washington recently showed when it barred a misinformation-spreading physician from practicing primary care in the state for five years.
But patchwork policies aren’t enough. As doctors, we can shape how federal lawmakers view health misinformation and its solutions. We must take our concerns and ideas to Capitol Hill, where our most powerful weapon is honest storytelling. Change won’t occur quickly, but staying quiet makes change less likely to happen at all.
Do no harm
It’s tempting to wait for someone else to solve the misinformation crisis. While writing “Dead Wrong,” I sometimes wondered whether health care was up to the task. Some of my colleagues questioned whether it was even our responsibility.
Each time we blame-shift, point fingers, or throw up our hands, we’re lying to ourselves. In denying our duty to address misinformation, health care leaders of all ranks and roles support the spread of misinformation, becoming its vectors and victims.
Misinformation and disinformation threaten patient health, clinician health, and the health of the U.S. health care system. To abdicate responsibility is to do harm — to admit failure, an unworthiness to serve, and a fatal disconnect from reality. Doing nothing means losing everything. But doing no harm means doing everything we can — and that starts with us doctors.
Geeta Nayyar, MD, MBA, is a globally recognized chief medical officer, technologist, and bestselling author who helps leaders leverage a human approach to innovation, including rapid advances in AI, to achieve better health and business outcomes. A widely sought-after speaker and author of the Wall Street Journal and USA Today bestseller “Dead Wrong: Diagnosing and Treating Healthcare’s Misinformation Illness,” Dr. G has appeared on CNBC, CNN, CBS, and other prominent media outlets. She previously served as chief medical officer for Salesforce and AT&T.
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