My first encounter with each patient follows a similar pattern. I hit the hand sanitizer near the door, stroll in rubbing it into my hands, and greet them.
“Ms. K? Hi! I’m Dr. Joseph Thomas, I’m from Internal Medicine and I’ll be helping take care of you today.”
And then I pull up a chair and I sit down, as research suggests this can help promote effective doctor-patient communication.
Whether it’s discussing Ms. K’s illness or treatment, or processing what the specialists have said, we talk about what is going on with her. It is tough to be efficient when I have many more patients to see, but it is important to involve her and help her understand the treatment plan, since medicine is a team effort and she is a key participant. I put myself at her eye level rather than standing over her. I explain so that she can understand.
While some view medicine as a space that should be apolitical, I believe any science-respecting politicians have something to learn about viewing their constituents the same way doctors view their patients.
The 2024 election was, in some ways, a referendum on public health and healthcare in the U.S. On Twitter/X and Threads prior to November 5, it seemed like for every piece of disinformation my colleagues and I debunked, three more would take its place. Many worry that disinformation will only get worse, as the “Make America Healthy Again” initiative threatens to undermine several public health achievements of the last century, from water fluoridation to widespread vaccination.
The memetic nature of disinformation undoubtedly had a huge influence on the election — and will continue to influence public health. Over the next several years, physicians must do everything in our power to counter the onslaught, in order to protect American health.
With the health department appointments (pending confirmation) of known conspiracy theorists and doctors who share baseless claims, I have already had to explain why Robert F. Kennedy Jr.’s (RFK Jr.) demonization of food dyes is unfortunately consistent with his conspiracy theories and anti-vaccination rhetoric (all distractions from real issues with American diets and healthcare), and why Mehmet Oz’s MBA does not erase decades of criticism from medical professionals and politicians alike regarding his elevation of unproven supplements.
RFK Jr., Oz, and other public figures who have made names for themselves with pseudoscience do so by framing public health messaging as oversimplified. In one tweet from RFK Jr., he accuses the FDA of a “war on public health,” as if all the agency can say is, “vaccines good, fluoride and raw milk bad.” (This is despite the fact that many of the treatments and products he claims the agency has “aggressively suppressed” have, in fact, been shown to be ineffective or unsafe.) Public health messaging has always tried to convey nuance, but in today’s “scrolling” world, it is easy for the details to get lost. The one thing RFK Jr. does get right is that this is a battle on multiple fronts: it’s not just about health, it’s political too.
In a previous op-ed, I discussed Brandolini’s Law: “The amount of energy needed to refute bullshit is an order of magnitude bigger than needed to produce it.” While that is still true, we must focus our energy differently, and not resort to sharing more bullshit to counter the disinformation.
So, how do we convey nuance in our complex world?
Annie Andrews, MD, MS, a pediatrician who previously ran for Congress and has since started the first political action committee for kids, urged, “We need to train up some physician communicators who understand the gravity of this moment, and are willing to say what needs to be said. ASAP.”
Many healthcare and public health professionals on social media, including me, are already trying to counter the widespread disinformation. So much so that when I first started combating disinformation online, I worried I was entering a saturated market. Yet, no matter how much I share others’ content, there are still people in my corner of the internet who might not see it. They may not see as much content at all, or it may get drowned out by the algorithm (some social media platforms limit “political content,” claiming that users want a shift away from the news, but I worry this has allowed misinformation to flourish).
To counter the avalanche of disinformation that is likely heading our way, politicians and physicians will need to do and keep in mind the following things:
- Meet people where they are. In the hospital we get on a patient’s level physically by sitting. To fight misinformation, we must be on the apps creating and sharing content to reach users.
- Explain how it relates to them. The recurring line we saw leading up to the election is that groceries and gas are more expensive and that only one candidate could fix it. Our job over the next 4 years is to frame our arguments against misinformation in a context important to our audience.
- Explain the risks without fearmongering. Some will say we should just let people drink raw milk, avoid fluoride, or make their own choices regarding vaccination, but they may not be aware of the dangers, particularly to children. The anti-vaccine rhetoric in a film tied to RFK Jr. was connected to the preventable deaths of 83 people from measles, including children, in Samoa. In a similar vein, early in the pandemic in 2020, Oz said that reopening schools is an “appetizing opportunity” because it would only kill 2-3% more people.
- Narratives require numbers just as much as the numbers require the narrative. This is me paraphrasing something said to me by Avital O’Glasser, MD, a hospitalist and associate professor of medicine at Oregon Health & Science University. In other words, facts may not care about our feelings, but addressing both will be important in encouraging votes and helping people understand.
- It’s not about control, it’s about health, safety, and education. ‘Nuff said, I hope.
If we are to maintain public health measures we already have and take any steps toward positive change in this next phase of American healthcare and politics, we as physicians must lead by example, so the politicians who can make this change can meet their constituents the same way we meet our patients — with respect, nuance, and partnership.
Joseph S. Thomas, MD, is a hospitalist with Buffalo Medical Group in New York. He is also a clinical instructor at the University at Buffalo Catholic Health System in the Internal Medicine Training Program, and a deputy editor of digital media for the Journal of Hospital Medicine.
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