Face Medical Misinformation Head on, Nephrologists Are Told

On the same day that Elon Musk reportedly laid off half of Twitter’s staff, including teams that moderate inflammatory or fake political and health content, a session at Kidney Week 2022 delved into how nephrologists and the medical profession in general can use social media as well as visual abstracts and podcasting to educate.

One of the speakers was Jen Gunter, MD, an obstetrician and gynecologist (OB/GYN) who practices at Kaiser Permanente in San Francisco, an author, and a podcaster. She also is known for swatting myths on Twitter.

Gunter noted that she is no stranger to medical crisisis, and in fact, they all relate to why she does what she does. At 11 years old, she ruptured her spleen and, in the course of having it removed, doctors discovered she also had kidney disease and removed one of the organs. That experience led her to studying medicine, she said.

When she discussed that experience on the first episode of her podcast, BodyStuff, 2 listeners contacted her to say they had decided to become a living kidney donor, “because they heard me talk about how it’s totally fine to have a life with 1 kidney.”

But being an OB/GYN did not protect her when she had a medically complicated pregnancy with triplets; only 2 of the children survived and were born at 26 weeks with many medical issues.

"Like many people with questions, where did I turn? I turned to the internet and I found, obviously, bad information," she said.

That experience is what spurred her to, as she put it, “fix the medical internet” when her children were older.

However, medical lies and misinformation are persisting and even growing. Part of this stems from the illusory truth effect, where people are more inclined to believe something, even if it is false, if they have been exposed to it before, and repitition increases the effect.

When it comes to medical misinformation, Gunter said, “I think the first step is accepting that it is a problem.”

There are 4 steps that Gunter advises other physicians to follow when talking with patients who bring up erroneous health and medical information during visits.

Validate their desire to search: Tell patients it is fine to look things up on the internet, but also let them know that it can be difficult to find trustworthy information and that you would like to give them some advice.

Teach them how to search: If they are searching about a condition, Gunter tells her patients to add the name of a related medical organization, such as “menopause and NAMS,” which stands for North American Menopause Society. Or, she said, adding “fact check” to a search is also key, especially for any information about COVID-19 and vaccines.

Prebunk ahead of time: The first piece of information someone hears is the one they are most likely to believe, Gunter said, so she suggested being proactive even before the visit. Consider sending videos, links, and handouts, such as infographics, ahead of time. And address false beliefs up front.

Debunking false beliefs: Gunter said she does not believe the theory that trying to convince a someone that their belief is false is hopeless. Most patients, she said, are scared and looking for information online because they are not getting it from their providers, or they have questions that they are too embarrassed to ask.

Debunking requires genuine listening on the part of the provider to really hear patient concerns, she said.

“Be careful about scientific jargon and I actually think this is a big reason why medicine got so behind the eight-ball,” she said. Scientific jargon “causes people to zone out.”

Debunking also requires the physician to be “nice, authentic, empathetic, and humble” and to avoid using aggressive language.

Telling fear-based anecdotes about what could happen if, for example, someone does not get vaccinated and lands in the intensive care unit, in an effort to persuade will turn them off instead and create an omission bias. Outcome bias is where a bad outcome that is caused by doing something is worse than something that resulted from doing nothing, she said.

Another strategy is to ask patients why they believe what they do; sometimes, Gunter said, they don’t have an answer and it causes them to think about about it.