Medical Misinformation and Disinformation

The DEI Shift's mission is to create a podcast series on diversity, equity, and inclusion (D.E.I.) in medicine that sparks discussion and provides practice-changing data and stories for a physician, student, allied health professional, and health care leader audience. Listeners will be able to gain useful information to improve their practices and environments, to gain empathy, cultural competency, and humility, and to learn more about emerging D.E.I. concepts. The DEI Shift will discuss issues related to gender, race, sexuality, religion, ability, socioeconomics, and so much more.

Co-Hosts: Dr. DJ Gaines and Branden Barger

Guest: Dr. Tracey Henry

Editor/Assistant Producer: Emily Han

Production Assistants: Alexandra Babakanian, Leyna Nguyen

Learning Objectives

1. Define the terms misinformation, disinformation and malinformation
2. Describe the 3 psychological factors that drive the spread of misinformation and disinformation
3. Identify strategies physicians can use to combat misinformation and disinformation, such as psychological inoculation or “pre-bunking”

[0:00-1:16] Welcome and Introductions

• Introduction of our co-hosts, guest, and the episode topic

[1:16-2:44] Introduction to Guest: Dr. Tracey Henry

• Dr. Tracey Henry
  • Associate Professor of Medicine at Emory University
  • Assistant Health Director of the Grady Primary Care Center
  • Director of the Health Equity Advocacy Policy track for Emory’s GME programs
  • Faculty student advisor
  • EMPACT Program Director
  • Inaugural curriculum thread director for Diversity, Equity, Inclusion and Racial Advocacy 

[2:44-4:38] A “Step in Your Shoes” Segment

[4:38-6:50] Medical Misinformation and Disinformation Definitions

• Medical Misinformation
  • Defined by the US Surgeon General in his 2021 report on “Building a Healthy Information Environment” as information that is false, inaccurate, or misleading according to the best available evidence at the time 
• Medical Disinformation
  • Defined by the US Surgeon General in his 2021 report on “Building a Healthy Information Environment” as medical misinformation that is intentionally to serve a malicious purpose, such as to trick people into believing something for financial gain or political advantage
• Medical Malinformation
  • Uses factual information with an intent to harm and deceive
  • A real-life example of this was the viral spread of a picture showing a certain culture licking their plates, stating that they were intentionally spreading COVID-19 this way. While the picture was factual in terms of them licking their plates, they were not intentionally trying to spread COVID-19

[6:50-13:36] Psychological Drivers of Misinformation, Disinformation, and Malinformation

• The complexity of credible information and lack of media literacy allows for misinformation and disinformation to spread fast
• Factors that influence how people absorb information and form beliefs
  • Social contagion
    • An effect that refers to a person’s tendency to think and act like the people around them, such as their friends and family
    • Behaviors can spread through social networks
    • Conforming to situations helps people feel accepted
  • Framing
    • Refers to when ideas that a person hears from other people and the media connect to ideas that already exist in that person’s mind
    • People form memories and mental cues by storing the bottom line of a piece of information and not necessarily the facts
    • The bottom line may not consist of factual information, but it may only sound structurally coherent to someone and can evoke powerful, negative emotions from them
  • Worldview 
    • Pre-existing internal stories based upon a person’s mental view of cultural knowledge, beliefs, and life experiences
• Psychological drivers make it difficult for someone to hear information that contradicts what is internal to what they think and believe

[13:36-16:35] Challenges of Combating Misinformation, Disinformation, and Malinformation

• Misinformation dilutes the pool of legitimate information
• Social media platforms keep users engaged through sensationalism
• Misinformation provides comfort of an explanation in unprecedented times that cause anxiety in people
• Misinformation is a nidus of infection
  • Times of uncertainty provide an opportunity for people with malicious intent to manipulate the situation

[16:35-18:00] Consequences of Misinformation and Disinformation

• The spread of misinformation and disinformation is a detriment to society and a threat to public health
• It sows a seed of distrust in science and healthcare treatments
• It can lead to poor health outcomes and death, which were seen with misinformation surrounding the COVID-19 and MMR vaccines 

[18:00-19:56] Difficulties in Responding to Medical Misinformation and Disinformation

• According to the AMA Journal of Ethics, a physician’s professional obligation is to confront false beliefs
• Confronting false beliefs is typically done in a clinical setting, but less so outside of this setting
  • This may lead to some hesitancy in confronting false beliefs and information that are shared outside of a clinic setting, which was especially seen in the beginning of the COVID-19 pandemic

• However, the obligation of physicians and health professionals extend beyond the boundaries of a clinic setting

[19:56-22:12] Ways to Respond to Misinformation and Disinformation

• Psychological inoculation, or prebunking
  • The opposite of debunking
  • Prebunking borrows from the logic of vaccines
    • Exposing people to small doses of misinformation will allow them to recognize and reject misinformation in the future
    • It essentially triggers people to produce “mental antibodies” against misinformation and can lead to psychological herd immunity that can prevent the spread of informational disorders

[22:12-27:05] Using Strategies in One’s Own Medical Practice

• Instead of prebunking, debunking is usually seen in clinical practice because people have already been exposed to misinformation
• Provide media literacy and media education to patients
• Educate patients on what is fact or fiction and the credibility of sources
• Acknowledge your patients’ fears
• Don’t shame or blame patients for their beliefs
• Discuss the reasoning behind healthcare decisions as it pertains to their personal values
• Remain calm while speaking with patients and take the time to listen to them
• Give patients the time and space they need to discuss important topics
• Offer patients a fact-checking tool
• Be empathetic with patients, perhaps by sharing a personal story, to make them feel safe about discussing important issues
• Educate patients on how scientific research works and that researching new diseases, like COVID-19, takes time

[27:05-29:32] Strategies to Increase Our Media Literacy

• While engaging in social media is one avenue to combat misinformation and disinformation, we must ensure we do this in the correct way so that we do not unintentionally spread misinformation
• Use reputable information sites, such as the CDC, local health departments, and reliable medical experts (those who are verified on social media platforms)
• Check to make sure that the information you share is the most accurate and up-to-date

[29:32-31:26] Take-Home Points

• Prebunking isn’t the only solution, but is a good first line defense against medical misinformation and disinformation
• When educating your patients, provide them with facts, build on your patient-physician relationships, and focus on shared goals
• Don’t challenge someone’s core beliefs, but meet people where they are at and go from there
• To address medical misinformation and disinformation on a global level, we need to implement a cross-sectoral approach 
• For helpful strategies to combat medical misinformation, read the US Surgeon General’s 2021 report on confronting health misinformation

[31:26-31:58] Closing

[31:58-33:08] Outro

• Twitter and Instagram: @TheDEIshift
• Email: thedeishift@gmail.com
• Website: www.thedeishift.com

Reading & Learning Resources:

• US Surgeon General 2021 report on Confront Health Misinformation
• Finding a Vaccine For Misinformation
• AMA Journal of Ethics article: “Why Health Professionals Should Speak Out Against False Beliefs on The Internet”
• AMA Adopts Policy To Combat Misinformation
• Misinformation and Public Opinion of Science and Health
• Where We Go From Here: Health Misinformation on Social Media
• Australian Government to Introduce Laws to Combat Misinformation, Disinformation

Credits:

Co-Hosts/Producers: Dr. DJ Gaines and Branden Barger

Executive Producer: Dr. Tammy Lin

Co-Executive Producers: Dr. Pooja Jaeel, Dr. Tiffany Leung

Senior Producers: Dr. DJ Gaines, Dr. Maggie Kozman

Editor/Assistant Producer: Emily Han

Production Assistants: Alexandra Babakanian, Leyna Nguyen

Website/Art Design: Ann Truong

Music: Chris Dingman

Disclaimer: The DEI Shift podcast and its guests provide general information and entertainment, but not medical advice. Before making any changes to your medical treatment or execution of your treatment plan, please consult with your doctor or personal medical team. Reference to any specific product or entity does not constitute an endorsement or recommendation by The DEI Shift. The views expressed by guests are their own, and their appearance on the podcast does not imply an endorsement of them or any entity they represent. Views and opinions expressed by The DEI Shift team are those of each individual, and do not necessarily reflect the views or opinions of The DEI Shift team and its guests, employers, sponsors, or organizations we are affiliated with.

Season 4 of The DEI Shift podcast is proudly sponsored by the American College of Physicians Southern California Region III Chapter. 

The DEI Shift theme music is by Chris Dingman. Learn more at www.chrisdingman.com.

Contact us: thedeishift@gmail.com, @thedeishift, thedeishift.com

Contributors

Tracey Henry, MD, MPH, MS, FACP - Guest

DJ Gaines, MD, ACP Member – Co-host/ Producer

Branden Barger, MD – Co-host/ Producer

Maggie Kozman, MD, ACP Member – Sr. Producer

Pooja Jaeel, MD, ACP Member – Co-executive Producer

Tammy Lin, MD, MPH, FACP – Executive Producer

Tiffany I. Leung, MD, MPH, FACP, FAMIA, FEFIM – Co-executive Producer

Emily Han - Editor/Assistant Producer

Alexandra Babakanian – Production Assistant

Leyna Nguyen – Production Assistant

Ann Truong – Staff

Reviewers

Pooja Jaeel, MD, ACP Member

Tiffany I. Leung, MD, MPH, FACP, FAMIA, FEFIM

None of the contributors or reviewers for this educational activity have relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Release Date: July 29, 2022

Expiration Date: July 29, 2025

CME Credit

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American College of Physicians and the DEI Shift. The American College of Physicians is accredited by the ACCME to provide continuing medical education for physicians.

The American College of Physicians designates each enduring material (podcast) for .5 AMA PRA Category 1 Credit™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABIM Maintenance of Certification (MOC) Points

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to .5 medical knowledge MOC Point in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program.  Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

How to Claim CME Credit and MOC Points

After listening to the podcast, complete a brief multiple-choice question quiz. To claim CME credit and MOC points you must achieve a minimum passing score of 66%.  You may take the quiz multiple times to achieve a passing score.