‘Provide the science’: Communication with patients vital to fight medical misinformation
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Medical misinformation threatens public health, but physicians can combat it by improving communication with their patients, according to a speaker at the American College of Allergy, Asthma & Immunology Annual Scientific Meeting.
“We have to take advantage of the very special role that we all play in the lives of our patients,” David R. Stukus, MD, FACAAI, professor of clinical pediatrics in the division of allergy and immunology and director of the Food Allergy Treatment Center at Nationwide Children’s Hospital, said during his presentation.
“We are the trusted resource, and we have to embrace that,” he said. “Take advantage of the long-term relationships. We want to be the resource for our patients. We want to spend time with them. We want to use that trust that we have developed with them to combat misinformation and have conversations with them.”
Many patients may have questions and concerns about how their allergies may interact with the COVID-19 vaccines, for example. Stukus encouraged physicians to listen to those questions, pay attention to their patients’ body language as they ask them and provide thoughtful responses.
“We need to listen. We need to give them our time,” he said. “We need to be empathetic, nonjudgmental and then available for follow-up discussion.”
Impact of 24-hour news cycle, social media
Stukus acknowledged the large volume of misinformation now circulating. He noted how the 24-hour news cycle has changed the way medical stories are covered, bombarding patients without giving them time to reflect on and digest this content. The internet, he continued, has compounded these issues.
“Social media has fundamentally changed the way in which humans interact with one another,” he said. “It’s changing how people understand what is good information.”
Unfortunately, that means many patients come into physicians’ offices with inaccurate ideas about vaccine safety and other issues, he said, and it is up to physicians to present the correct information.
“We do have the expertise. We need to own that,” he said.
Stukus urged physicians to spend time entering the most common questions they get from their patients into different search engines to see what is being reported online in order to prepare their own responses.
“We really need to anticipate these concerns and ask permission to discuss them. You could ask, ‘Would it be OK with you if I discuss some common misconceptions I hear about food allergies during today’s visit?’” he said. “Make it a normal part of the encounter.
“We also need to help our patients understand what evidence is,” he said, adding that just because somebody posts a video about something on YouTube, that doesn’t make it true.
Patients also can be alarmed by anecdotes and dramatic examples of negative outcomes.
“Negative stories circulate like crazy, despite the fact that fewer than 20 children a year have fatal food reactions,” Stukus said. “Every time one of these tragedies occurs, it circulates like wildfire in the food allergy community. When patients and families read these stories, it drives anxiety, decreases quality of life and may lead people to take unnecessary restrictions.”
Of course, social media can also be used as a forum where physicians can reach a large audience looking for information.
“What’s in your portfolio? What are you doing right now to engage beyond the patient encounters that you have?” Stukus said.
Cognitive biases, politics
Physicians and patients should be aware of cognitive biases as well, Stukus said.
Stukus routinely asks his patients if they have changed anything since their allergy diagnoses. Typically, patients report some adjustments, but one family said they stopped going out to eat after watching a documentary about the food industry that included a story about a man with a tree nut allergy who died after a restaurant visit.
“That’s recency bias. That’s the type of impact that these cognitive biases can have on our patients, and we can recognize that,” he said.
Patients bring their politics into physicians’ offices too, Stukus said, noting how the 2020 map of the Electoral College results mirrors maps of COVID-19 vaccination rates.
“Political affiliations and ideologies absolutely have impacted the medical decision-making of our patients. I’m not saying it’s right or it’s wrong, but we need to be aware of that,” he said, adding that physicians should bring these influences into their conversations with patients.
Stukus suggested clinicians ask their patients:
- “Can we separate these in some way?”
- “What information can we talk about?”
- “What are your sources of information?”
- “Who do you trust?”
'We can’t reach everyone’
Despite these efforts, physicians should realize that they are not going to persuade everybody who may be against particular medical treatments to change their minds.
“We also have to be comfortable with the fact that we can’t reach everyone,” he said. “And that’s okay. There’s a group in the middle who do want to hear from us, and it’s a silent majority.”
Physicians can reach audiences beyond their patients too, Stukus said. He advised physicians to use their practices’ websites to provide trusted information to their communities. Plus, physicians can post blogs on their own websites or contribute articles to other sites that are popular.
Stukus has appeared in informative videos, and he encouraged others to do the same.
He additionally recommended using the Surgeon General’s July 2021 “Confronting Health Misinformation” report.
“This is a wonderful guide that’s free for anybody to access. It walks through a lot of the evidence behind this as well as practical tools,” he said. “We want to proactively engage with patients and the public using technology and media platforms.”
Despite the variety of options, physicians should settle on a strategy that fits their niche and is most comfortable for them. Regardless of the methodology, all of these messages should keep facts at their core.
“Just provide the science. We don’t have to dumb it down, but we can explain things in a way that makes it easier for people to understand,” he said.
Treating patients with respect is as essential as the message itself in these efforts.
“Be yourself. Be nice. We don’t need to be judgmental. We don’t need to be argumentative. That’s what the other side does. They’re very good at it. We don’t need to take that route,” he said. “We are caring health care professionals, and we can let that show.”
Reference:
Murthy, VH. Confronting Health Misinformation: The U.S. Surgeon General’s Advisory on Building a Healthy Information Environment. https://www.hhs.gov/sites/default/files/surgeon-general-misinformation-advisory.pdf. Published July 15, 2021. Accessed: Nov. 9, 2021.