Taming the Beast: How to Navigate Medical Misinformation Online?
Technology and its effect on patient engagement
A visit to the doctor’s office is not something many people look forward to. Whether it’s the long waiting times, a fear of needles or the reluctance to answer intrusive, personal questions, sometimes in front of family members, the doctor patient relationship was traditionally awkward and tense.
Physicians can appear intimidating and one in every five patients reported that they do suffer from “White coat Syndrome”, where their blood pressure increases during their doctor’s appointment, but is otherwise normal at home.
There’s no denying that the COVID 19 pandemic brought devastating effects to countries and economies worldwide. But, if one were to look at the silver lining, it also galvanized large scale reforms to the provision and delivery of healthcare services. While many countries may have already experimented with the idea of telehealth and teleconsultations, social distancing and stay at home mandates meant that almost all doctor- patient interactions, except emergencies, shifted online.
Telehealth services offered a convenient alternative to the traditional face to face, because patients felt more comfortable in their own surroundings, without having to worry about transportation or travel. Physicians were also able to give more focused attention to patients.
A survey of 1 million patients conducted by the Harvard Business Review found that even though most physicians and patients were new to the concept of telehealth visits, both sides have come to appreciate them. Patients found that physicians were more attentive on screen, ironically giving a personalised touch to the whole experience.
The Inevitable Next Step: Birth of the #MedInfluencer
Healthcare providers realized that in order to retain their patients they would have to meet them where they are most often found – on social media!
Physicians transitioned from their traditional, formal and often inaccessible personas, to a more relaxed and informal image, showing their human side, by revealing their own journeys, their struggles with the new normal sprinkled with sneak peeks into their personal lives, by showing up authentically online.
These doctors on social media seemed to have stumbled onto an untapped area online. Instagram stories and reels and short form video content platforms like TikTok, catapulted many physicians into instant internet fame, with their videos going viral.
Although the initial conversations revolved around Covid 19, it quickly transcended to other health conditions. While doctors on social media were careful to avoid giving direct medical advice or revealing patient information and violating patient confidentiality, online doctors did find themselves on a platform that positioned them as information providers to a large community.
There was room to question openly, to clarify doubts to explain conditions through imagery, infographics, short form video which is nearly impossible to do in a face-to-face consultation.
The success demonstrated by individual doctors on social media, with platforms like Instagram, Twitter, TikTok and Facebook prompted many major health organizations like the Mayo Clinic and the CDC to use their accounts to spread health awareness. Healthcare providers grabbed the marketing opportunity to showcase patient testimonials online for credibility and social proof.
The Jefferson University Hospital in Philadelphia even appointed their first Chief Medical Social Media Officer, Dr Austin Chiang, a prominent social media personality with a loyal following on Tik Tok, and founder of the #VerifyHealthcare transparency movement that advocates the use of social media for patient education and outreach.
A look at the flip side of the coin…
Unfortunately, as most physicians have acknowledged this year, there is never any training done in how to communicate on a public platform effectively, with both communities and patients, and they are realizing what a minefield social media can be. The skill required to keep yourself updated on trends, to acclimatize to an everchanging technological landscape all in a bid to stay relevant, is often underestimated.
In addition, while sharing interesting cases, anecdotes or experiences physicians must ensure that patient privacy is not violated. Doctors on social media struggle to maintain a balance, in an effort to come across as professional, but not too serious at the same time, as they cater to a largely millennial or Gen X audience.
While delivering complex medical information in bite sized, easy pieces for laymen to understand, they must also be careful to avoid falling prey to brands who may steal their content and use it to sell their product or services, as many physicians are generally not aware of influencer contracts or intellectual property agreements.
While the growth of doctors on social media are great for personal brand awareness and their hold over a captive audience can be used as a great outreach tool, its effects largely depend upon the credibility of the information spread or the dependability of the product being endorsed by them.
Take for example, international social media stars like the Kardashians. By buying a product with their names on it, one might end up with a lipstick that one really hates, but buying and taking supplements with no traceable or verified ingredients can be irreversibly damaging to one’s health. In the same way, fake medical news or misinformation can have catastrophic effects on the health and lives of the people who believe it to be true.
A game of Chinese Whispers gone rogue ? The Unchecked Spread of Medical Misinformation
Fake health information or medical misinformation is one of the largest, and by far the most dangerous forms of misinformation online. Touting phony cures, or ineffective and dangerous supplements along with pushing conspiracy theories to decrease the value of legitimate medical treatments and precautions like vaccines, added fuel to the fire, when combined with the confusion surrounding the COVID 19 pandemic in 2020.
- 1 in 10 of the news and information websites publish health care misinformation or hoaxes, according to an analysis of over 4,000 websites published by STAT News.
- 37% of misinformation sites identified by NewsGuard were sites that focussed on healthcare.
- 419 websites and over 320 domains have been identified as publishing COVID-19 myths in News Guard’s COVID-19 Misinformation Tracker, and the numbers are increasing daily.
With something as new as COVID-19, the theories surrounding its origin were outlandish, but rumors seemed to spread like wildfire.
One of the myths stated that “5G cell phone technology is linked to the coronavirus outbreak.” The first claim to this information was made by an anonymously run French conspiracy blog, Les Moutons Enragés. This news spread across Facebook Groups , YouTube and various other social media channels. The theory gained so much traction that some believers in the United Kingdom even attacked 5G telephone poles, which finally prompted government action on these fake news websites.
An article from the BBC, backed by renowned microbiologist, Dr Simon Clark eventually branded claim that 5G either transmits the virus, or suppresses the immune system, thus making people more vulnerable to it, as “complete rubbish.” This was followed by an Independent study from the International Commission on Non-Ionizing Radiation Protection, which also declared 5G technology as safe for human beings.
With the cases rising in 2020, it seemed that everyone was looking for a quick fix or a miracle cure, and it wasn’t long before existing sellers of colloidal silver began promoting it as an effective treatment for COVID-19 infection. This prompted the US FDA to issue warnings to companies for false advertising and misbranding, instructing them to “cease making claims that are not supported by competent and reliable scientific evidence”.
It seemed that the news of a vaccine made the rumor mills run even faster, with the aim to encourage vaccine hesitancy by stoking public fear of the unknown. Perhaps the most popular vaccine conspiracy is the one stating that Microsoft co-founder Bill Gates plans to use the vaccine to inject the population with embedded microchips that he would then use for surveillance.
This was sensationalized in various YouTube videos which further spread the propaganda. The truth was that Mr Gates referred to a digital certificate technology that would be used to transmit encrypted testing and vaccine information, rapidly and had made no reference to microchips.
As time went on it became clear that “We need a vaccine against misinformation.” as said by the Head of WHO’s emergencies program Dr Michael Ryan
Fighting the Good Fight : What are the platforms doing to Fight Misinformation Online?
Facebook and Instagram banned posts that dissuaded people from getting the vaccine and put disclaimers on all its vaccine or COVID-19 related posts to limit the spread of blatant misinformation or propaganda.
Individual doctors on social media are calling out medical misinformation through various online campaigns, and are making a concerted effort to explain the difference between anecdotal medicine and evidence based medicine.
These are Instagram hashtag campaigns that brought awareness to the issue of misinformation centered around health news, vaccine updates or the pandemic and garnered a large fan following in the online world.
- #citationplease : When sharing scientific information or studies online, people including doctors on social media are encouraged to give a credible source for the information
- #trashtagram : This is a segment on Dr Austin Chiang’s Instagram page that calls out bogus posts that fall under the category of medical misinformation, on the platform
- #hcw4science : Healthcare workers for science showcases the efforts of healthcare workers who are working to counteract the spread of misinformation by debunking vaccine
#thisisourshot : Started by a panel of doctors, it encourages vaccination awareness.
It helps to identify the transparency and reliability of websites that provide health information online. Credible websites are highlighted in green, while websites that have not passed their certification criteria are highlighted as red, indicating that it may be a source for misinformation.
In conclusion, social media is a great tool, and platforms like TikTok and Instagram reels are awesome short form videos that inspire and educate. But it is, in its own way, a double-edged sword and should be wielded with caution. While we can catch the next wave of #trends, we must stay grounded in science and fact.
- BBC Dr Simon Clark: https://www.bbc.com/news/52168096