Misinformation is seemingly everywhere these days, spread through social media, online forums, podcasts, and even word of mouth. While misinformation comes in many flavors, health misinformation is one of the most common arenas, and potentially the most dangerous.

Doctors face this reality every day. A recent survey by the Physician’s Foundation revealed that 99.9% of doctors encountered patients influenced by misinformation over the past 12 months. The survey found:

Nearly half (49%) said misinformation hurts medication and treatment adherence.

66% reported increased patient anxiety due to misinformation.

45% reported that patients often/very often refuse their recommended care or treatment recommendations.

Hospitalists — who often serve as stand-ins for primary care physicians (PCPs) — field an overwhelming amount of misinformation.

The onus to clear up the rampant medical misinformation often falls to the hospitalist, then. This can be especially difficult because hospitalists don’t have an existing relationship with patients. Managing patients armed with misinformation is a delicate balancing act, but with the right approach, hospitalists can not only restore their patients’ health but help restore their overall trust in medicine, as well.

Common misconceptions

It’s flu vaccine season and prime time for medical misinformation.

“Vaccines are the big ones,” said Thomas, “and they have been for some time, especially in pediatric care.”

The fallout from people not trusting vaccines is well on display with this year’s alarming measles outbreaks in several states. That can harm everyone, according to Thomas, because vaccines have always been a “group project,” or a collective strategy of prevention.

What patients often don’t realize is that if they bypass a vaccine and become ill, they may face a doctor who has never treated it, even if they have been trained in how to approach it. Measles is a good example — US had largely eradicated the disease before vaccine skepticism took over.

Michael Lou, MD, medical director of hospital medicine at Northwestern Medicine Palos Hospital, Palos Heights, Illinois, sees patients with many misperceptions surrounding vaccines.

“I’ll hear from them that the flu vaccine will give them the flu,” he said. “Or that you can still get the flu, even if you receive the vaccine. That’s true, of course, but it will be much less severe and will last a shorter amount of time.”

Lou’s approach when patients express vaccine skepticism is to remind them that vaccines protect not just them but also those around them.

At this time of the year, Lou’s hospital offers the flu vaccine to all patients upon discharge. With older patients, the staff also reminds them that a bout of flu can set them up for bacterial pneumonia, leading to a long hospital stay.

Other common areas of misinformation that patients bring with them to the hospital include the value of “detoxes” or cleanses, said Lou. Again, often stemming from health claims on social media, something seemingly innocuous can sometimes turn into a problem.

“We will see patients who take potentially harmful supplements like ashwagandha or participate in restrictive eating to detox,” he said. “Our bodies have their own systems in place through our livers and kidneys. Some of these supplements can lead to complications with existing medications.”

Thomas has encountered issues with patients who read their lab results in their portals before their visits, and/or before he can interact with them. They’ve often done their own googling and researching and drawn conclusions about results.

“Sometimes those lab results aren’t relative to the condition I am treating,” he said, “or the information they turn up is incorrect.”

Patients express distrust about all types of care, according to Richard Engel, MD, associate division chief of hospital medicine at Phoenix Children’s Hospital in Phoenix, Arizona. “The more extreme the situation, the more nervous they will be,” he said.

Engel cited a recent example of his recommendation that a patient receive a nasal gastric tube to help with nutrition. The family was hesitant and asked for time to think about it.

“They talked to friends, prayed, and used AI to generate questions for me,” he said. “When we met again, they granted permission. That was a good use of AI, but when they use it for answers to medical problems, it can be a problem because they don’t understand the context.”

How to combat misinformation

When faced with misinformation, hospitalists have several tools to help reestablish trust with their patients. It helps to remember that mistrust in the medical system is just one of many forms of mistrust right now.

“There’s a general undermining of trust in institutions today,” Engel said. “Patients are coming in more skeptical of our advice than ever before.”

To that end, Thomas sees value in acknowledging to patients that they feel misled by healthcare institutions.

“Unfortunately, there is a minority of the medical community who have actually spread misinformation,” he said. “Sometimes the call is from inside the house.”

Your task, then, is to create personal and institutional trust with the patients and their families.

“Sit down and interact with them at eye level, rather than physically looking down on them,” Thomas said. “Allow the patients the space to talk about what got them there, and don’t be judgmental.”

There are many reasons why a patient might not be taking his or her medications, for instance, which might have led to the hospital visit. Often, said Thomas, it’s not a case of petulance, but because it comes at the cost of simply trying to balance a complicated life.

“They may be managing elderly care or childcare and putting off their own health,” he said. “Acknowledge that things are hard and offer to find a path forward together by inviting them to be an active member of their healthcare team.”

Engel agrees and reminds that everyone wants to be heard.

“Set a tone of listening and hearing their concerns so that you’re not turning them off,” he said. “Most will come around when they can sense that you’re trying to help them.”

Clinicians, who try to meet people where they are, acknowledge how frustrating the healthcare system can be and establish that personal connection is key.

On a broad scale, when hospitalists use their interactions with patients to promote a positive image for the medical community, everyone stands to benefit. Medscape