Misinformation and Medicine

FNP2writer, ASN, BSN, MSN, NP

I have a patient I am confident has bladder cancer. They first came to me when their urine turned dark red, and they could not urinate without self-catheterizing. I have explained my concerns to this patient multiple times. Unfortunately, their response is staunch disbelief that cancer could possibly cause their symptoms. Instead, the patient remains convinced their symptoms are a side effect of the single dose of the COVID-19 vaccine they received two years ago. The basis for this belief is information regarding the harmful effects of the COVID-19 vaccine the patient read on the internet, saw on television, or heard from peers. None of this information comes from a medical professional. Any evidence I present contrary to the knowledge the patient gained from these sources is immediately dismissed as if I am too ignorant to understand the medicine I practice. This is just one example of the alarming effect of social media and misinformation disseminated by traditional media on patient care.

Daily, patients say to me, “I’m not a doctor, but I did some research online.” Countless patients have come to me asking for prescriptions for ivermectin and are angry when I do not provide what they want. I never discouraged patients from using the internet as a tool. However, I do encourage the use of reputable websites and guide them to sites with accurate information, as this can help guide informed discussions regarding their care.

Patients turning to the internet for medical advice is not new, and neither is “fake news.” Since the inception of the first medical websites in the 1990s, people search the internet for answers to their health concerns. The internet, as a source of all information, is constantly growing relatively untethered. This includes information with a questionable basis in fact. Ideas once considered fictional, outlandish, or conspiracy theories found in supermarket tabloids are now accepted as mainstream. Healthcare is not immune to conspiracy theories treated as factual information, which has led to growing mistrust of healthcare professionals.

Widespread mistrust of healthcare can be traced to the beginning of medicine and seen with the long-term trend of vaccine hesitancy, which goes as far back as the inception of the smallpox vaccine. Unfortunately, with the pandemic, the effects of misinformation found online and presented by the media have widened the distrust patients have regarding medical care overall. This makes providing the highest quality of care to patients difficult across all aspects of medicine and puts the lives of patients at risk when they doubt or refuse to accept evidence-based health care.

When the pandemic started, the idea of “fake news” was already ingrained into much of the population. The pandemic provided the perfect storm for distrust and misinformation to take hold, spreading like wildfire. The efforts to control the spread of the COVID-19 virus led to major changes to everyday life, affecting the entire world. As the impacts of the changes challenged “normal” life and led many people to struggle, mistrust of health professionals moved to an all-time high. Videos were posted online by people at hospitals trying to dispel the fact of the locations being overwhelmed. Dangerous treatments like the ingestion of bleach became touted as cures. Rumors spread that health professionals received payments for every patient they could get a positive COVID-19 test on. Misinformation continues to be so rampant that reputable medical sources like the World Health Organization, The Centers for Disease Control and Prevention, Mayo Clinic, and Johns Hopkins continue to post and update information regarding the myths surrounding COVID-19. Unfortunately, with the increasing distrust of what is traditionally regarded as acceptable sources of healthcare knowledge, patients are no longer willing to consider these sources as reliable and continue to turn to internet videos and online advice from questionable sources. Pew Research indicates trust in medical professionals dropped from 89% in April 2020 to 78% in December 2021.

As healthcare providers, the frustration we experience when patients come to us with questionable science and doubt what we know to be sound becomes burdensome. The problem lies in how to turn this around to keep patients from causing more harm to themselves. Research published in Health Psychology revealed people with lower education levels, interest in alternative medicine, and existing distrust of healthcare are more likely to believe medical misinformation such as ineffective cancer treatments and false information regarding vaccine safety. The researchers found participants who accepted one source of inaccurate information were more likely to believe additional sources of misinformation.

There is no easy answer to the pervasive misinformation and “fake news.” Nurses remain the most trusted profession, and we need to use this to our advantage. Continue to educate with factual information. Provide compassionate patient care in ways that continually build and grow that trust. As always, we will not be able to save everyone. But the ones we save will be worth the effort.

References/Resources

Americans’ Trust in Scientists, Other Groups Declines

Education level, interest in alternative medicine among factors associated with believing misinformation