How Can We Combat Medical Social Media Rumors That Harm Millions of Lives?

The spread of misleading medical claims is at least as old as healthcare itself.

There was a particularly large increase in misinformation during the Covid-19 Pandemic. Incorrect and misleading information intended to misdirect people is spread through social media. This brings new and complex challenges. Worse still, a substantial proportion of those spreading misinformation do so deliberately/for profit and even come to believe it themselves over time (see How to Become a Charlatan?).

According to a recent survey, 95% of people in the US view misinformation as a problem, and 45% are extremely concerned when personally exposed to it; nevertheless, many people fall into the misinformation trap without even realizing it.

Training Healthcare Workers Is Important in Combating Misinformation

In response to these challenges, a US general surgeon recently published a striking report on misinformation as a public health threat. The report calls on healthcare organizations to proactively train their staff to fight misinformation. Healthcare workers need to combat misinformation by using both technology (such as social media) and traditional media platforms to disseminate accurate information.

However, doctors using social media to respond to misinformation face significant barriers: users who spread misinformation (including healthcare workers) and the companies that provide their platforms (Twitter, Facebook, etc.). Further barriers include online attacks and threats that frequently target doctors trying to correct information, and inadequate medical training in strategies for responding to misinformation. It is crucial to overcome these barriers and enable doctors to respond to online misinformation, which is vital to strengthening trust in the medical profession.

The Source of Misinformation Should Be the Target

It is important to target the source of misinformation.

Doctors say social media companies are responsible because misinformation spreads through their platforms. In the US, the Center for Countering Digital Hate identified 12 accounts (individual or joint accounts) responsible for most (65%) of the misleading anti-vaccine information on Facebook and Twitter as a “disinformation dozen.”

Since December 2020, the 425 most-followed anti-vaccine social media accounts are estimated to have been followed by a total of 59.2 million users. Some of these accounts have a “verified” badge suggesting credibility despite the misinformation they spread. Although company executives promised to act against this dozen misinformation-spreading accounts, little has been done. At the very least, we believe their verified status should be revoked; they should face sanctions for spreading misinformation.

The Greatest Danger

Some of the users who allow misinformation to spread and persist are doctors, which damages trust in medicine. The US Federation of State Medical Boards and various medical treatment organizations have supported us by announcing plans to act against doctors who produce and spread misinformation, including suspending their medical licenses. There are also nonpartisan groups of doctors and members of the public formed to advocate for medical boards and governing bodies to take steps to protect the public from the harm caused by misleading information.

Healthcare Workers Are Under Threat

Healthcare workers who want to dispel harmful myths cannot be expected to openly combat misinformation without protection from attacks and harassment.

According to a study conducted before the Covid-19 Pandemic, 1 in 4 physicians is attacked on social media. The study found that people posting content particularly in defense of vaccines are the most frequently targeted.

1 in 6 female physicians reports sexual harassment on social media – and this rate is likely much higher among women who also belong to minority racial or ethnic groups or other marginalized groups.

A survey conducted during the pandemic reported that approximately 1 in 3 physicians and scientists interviewed by news organizations about Covid-19 had been attacked because of their social media posts or views expressed in the media. Attacks generally take place online, but physical attacks also occur. Alarmingly, 22% of victims reported threats of physical and sexual violence, while 15% reported death threats.

Physicians and scientists often do not tell their employers when they are harassed because they do not believe their employers will act. Experts say that people who have been attacked are also less likely to participate in future media interviews – a finding that highlights the attacks' effectiveness.

All of this leads to an even more serious consequence: pseudoscientists or charlatans begin to appear more prominent on social media. Naturally, people who are not healthcare professionals may not recognize that the information forming the majority is wrong.

Pseudoscience or false science (in English, pseudoscience) is the name given to a body of claims, beliefs, information and practices presented using scientific arguments but lacking the standards required by scientific studies, such as materials, methods and testability, or not supported by sufficient scientific research. In this sense, all traditional or alternative medicine practices can be considered pseudoscience.

Combating Threats Against Healthcare Workers

Strategies are needed to help healthcare workers who are attacked and to prevent attacks. Working together as a group is one approach. We believe people who misuse social media platforms to harm or threaten doctors fighting misinformation should face sanctions such as the removal of verified status and restrictions on their ability to post.

Combating Medical Misinformation

Misinformation interferes with the doctor-patient relationship, often harming patients. Healthcare workers urgently need training in using science communication to combat misinformation. However, strategies for providing this training have not yet been well defined.

Encouraging healthcare workers to combat misinformation without formal educational support can intensify its spread online and in clinical interactions. For example, a popular messaging tactic presents a myth first, followed by the relevant facts. However, research suggests this approach can backfire by making misinformation more memorable, since cognitive biases favor recall of the information presented first. Instead, doctors can debunk misinformation using the three-step process used by climate scientists. This involves

• first presenting the fact,
• then explaining the relevant myth/pseudoscientific claim, and
• finally explaining why the misinformation is wrong.

Emphasizing why misinformation is wrong can help people change their minds. It is equally important to explain why belief in misinformation needs to be challenged. It is clear that simply presenting scientific evidence against rumors or deceptive claims will increase many people's denial; this issue therefore needs to be addressed systematically. On the other hand, “anticipating” myths before they emerge or providing general science education can be particularly effective.

Medical schools and universities should invest in teaching students strategies for communicating scientific information effectively, approaches to identifying and debunking misinformation, and how cognitive biases predispose people to believe it. Students in the biological sciences departments at the University of Chicago are encouraged to attend classes taught by science and communication specialists on explaining their work to the public. Students at the Pritzker School of Medicine also take courses on medical misinformation. Methods developed by librarians, such as SIFT (stop, investigate the source, find trusted coverage and trace the original coverage), can be used in doctors' training to identify reliable information sources, and healthcare workers can then share these strategies with patients. Given the mistrust of healthcare systems, it is particularly important to empower future doctors to address misinformation and share accurate information empathetically with patients. Despite this general mistrust, patients often say they trust their own doctors. Nurses are among the most trusted professionals in the US. Doctors are not far behind in this survey.

In conclusion, helping healthcare workers successfully combat online medical misinformation means more than instilling an awareness of the importance of science communication in future doctors and training them to dispel medical misinformation. It also requires holding the people who spread misinformation and various social media organizations accountable for the harm they cause.

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• Related topic: Scientific knowledge and evidence-based medicine! Science begins with wanting to know