The topic of misinformation isn’t new to the medical community—and physical therapy is no exception. How many PTs have encountered faulty science and non-evidenced-based practice at some point in their career? If I had to guess, I’d say the vast majority. False information is pervasive, especially in high-stress situations, which makes health-related crises especially prone to the misinformation machine.
According to a 2018 study from MIT, “falsehood diffused significantly farther, faster, deeper, and more broadly than the truth in all categories of information.” And according to research from the University of Pennsylvania, the more anxiety or anger a piece of content induces, the more it’s shared online—but if you’re a social media user, I’m sure I don’t have to tell you that. Since the dawn of the digital age, there are few worldwide incidents that have induced such omnipresent panic and outrage as the COVID-19 pandemic.
The amount of information being blasted on all forms of media—both online and traditional—has been staggering, and every source of information claims to be the only one you can trust. But no matter what your opinions or beliefs are regarding the novel coronavirus—and the vaccine—we know that a lot of this information is, at best, misleading and, at worst, unequivocally false. With so much information before us, it can be difficult to parse out the most accurate and up-to-date findings. Even more difficult is the challenge of rooting out and combating faulty intelligence when you come upon it.
Speaking from experience, I can tell you that addressing misinformation is immensely fatiguing. With so many varied sources claiming to be the sole purveyors of truth, it’s becoming more and more difficult to pinpoint the source of problematic data and counter any inaccuracies. To make matters worse, social media platforms have confirmed that they curate the content appearing on your feed based on your searched topics and what they believe you’re most likely to click on—meaning they’ve essentially created an echo chamber of information. Add to that the politicization of science and the emotionally-charged rhetoric that has woven itself into many discussions about COVID-19 and vaccinations, and these conversations may seem next to impossible. But when the health of the population is at stake, we have an oath to uphold to do no harm and stand up for real science and facts. We cannot drop the ball now.
1. Mentally prepare yourself for these conversations.
Generally speaking, the treatment floor is not the ideal venue for a politically charged discussion. In fact, many places of business have general guidelines for what is and is not appropriate fodder for conversations with customers—and for good reason. If your practice has not established such guidelines, then you or your clinic’s leadership team should do so immediately.
That being said, even though we are not immunologists or epidemiologists, we are healthcare providers—and our patients look to us as experts on all things health-related. And even if that weren’t the case, the ubiquity of the coronavirus pandemic has made conversations and questions about COVID-19—as well as dubious facts about the virus—an unavoidable topic in the clinic. For that reason, we must forge ahead with the understanding that difficult conversations will arise, which is why it’s so important to educate ourselves on not only the facts, but also the fictions.
2. Remain empathetic and open to differing perspectives.
Living in the age of information is somewhat of an oxymoron: we have more access to content, data, and research—both trustworthy and suspect—than ever before. And yet, many of us find ourselves surrounded by people who hold beliefs similar to our own and reaffirm opinions we already have. It certainly makes sense—people often connect over shared values and perspectives. The problem is when these echo chambers leave us unchallenged—because without challenge, there can be no growth. For this reason, I urge every physical therapist and practice owner to approach differing opinions from a place of empathy and grace. For one thing, dismissing another person’s beliefs is a quick way to shut down any chance for further conversation. But more importantly, many people’s beliefs about health-related topics develop out of genuine frustration, anxiety, and fear of the unknown. By remaining empathetic, we are more likely to reach a place of mutual understanding.
That said, you should never feel obligated to engage in a discussion or debate that crosses your personal boundaries. This is especially important when it comes to emotionally-charged conversations. For example, I welcome discussions with patients or peers on the reality of healthcare equity. But if the conversation veers into territory that encroaches on my personal core values, I will respectfully disengage. I’ve learned that there is absolutely nothing wrong with voicing your boundaries and asking to move on to a different subject when they’ve been crossed.
When I was in private practice, I supplied my team with a script that they could fall back on should they need an “out.” It went something like this: “Because of the controversial nature of these topics, we prefer not to discuss them during our treatment time in the clinic.” This helped us avoid any unnecessary escalation, which is the last thing you want in a treatment setting.
3. Develop a strategy.
These polarizing topics become particularly hairy when you find yourself thinking of responses on the fly. We can’t always know what to expect from these discussions, but developing a well-thought-out approach ahead of time can keep things from getting heated and devolving into a mess you can’t come back from. This may be an opportunity as a clinic leader to help set boundaries—or, at least, pre-plot a way out of a difficult conversation—for new grads or inexperienced employees.
No one is correct 100% of the time. For example, the CDC’s guidance regarding mask use during the early days of the pandemic (i.e., that wearing a mask is no more effective at reducing the spread of COVID-19 than not wearing one) was later found to be incorrect, which forced the entity—as well as many reporting outlets—to recant and correct their statements regarding masks. To me, this is proof that no one—not even the US Centers for Disease Control and Prevention—is infallible, nor should anyone be above changing their beliefs based on new information. Unfortunately, this correction also bred mistrust, which goes to show how important it is to get your facts straight before sharing your beliefs and understandings with others.
So, the first step to your strategy should be vetting all of your sources. To do so, ask yourself the following questions:
- Is your source trustworthy? Does the information come from an expert in the field? Do you know the expert’s credentials? If you’re getting your information from an intermediary such as a news website, who is supplying the information to that outlet? Is there a conflict of interest?
- Is the science evidence-based? Be sure to look into any studies your source has cited to ensure they hold up to quality standards. Specifically, you’ll want to verify that the research is peer-reviewed and that the researchers had a large and diverse sample size.
- Does the information trigger a strong emotional reaction? Some information is delivered in such a way that intentionally plays on the reader’s fears or anxieties, and when emotions are running high, the reader is less likely to scrutinize that information before reacting to it. Telltale signs of this issue include vivid, demonstrative language and clickbait-y headlines. To refer back to the topic of mask-wearing, let’s look at these hypothetical examples:
- The CDC has retracted its original guidance regarding the use of masks.
- The CDC lied about the effectiveness of masks in protecting against the coronavirus.
Both statements could describe the same event. However, the first one uses neutral language to communicate what happened, while the second makes an assumption about the intent of the retraction. As someone who has done a fair bit of writing and learned a lot about marketing in the past decade, I can tell you these types of statements are designed to make you click. And you’ll notice that apolitical outlets, reputable industry journals, and peer-reviewed research publications will avoid this type of language. That’s because the ultimate goal of these sources is to provide facts and data and allow the reader to draw their own conclusions.
The COVID-19 pandemic has put so much on the line for so many, and I’m not just referring to physical health. The lockdowns, travel restrictions, and social distancing measures have created significant financial and emotional hardships—in fact, you’d be hard-pressed to find someone who hasn’t been negatively impacted by the events of the past 12 months.
With so much fear, anger, and emotional turmoil, it’s only natural for people to rationalize it in a way that makes sense to them. But not every person holds the same values and beliefs you do, which means the conclusions they draw will not always align with your own. To one person, the fact that they haven’t been able to reopen their business or visit their family out of state is a result of area lockdowns. To another, it’s the result of government mismanagement. And to yet another, people who refuse to wear masks and continue to have social gatherings are the ones to blame.
Now, I’m not here to cast aspersions about fault, but I can understand each one of these perspectives—whether or not I agree. In my experience, understanding differing perspectives is critical, because it allows you to address the source of the beliefs—which often is anxiety or fear. This does far more good than barraging someone with studies and statistics that will do nothing to alleviate that anxiety or fear.
When having these conversations, don’t forget the value of asking clarifying questions and—more importantly—truly listening. Instead of hitting someone with a “well, actually…,” try asking open-ended questions like:
- Why do you think that?
- What makes you feel that way?
- How do you think that’s possible?
Your ultimate goal should be to facilitate discussion—not start an argument.
Look for small wins.
It is very rare for a person to flat-out admit they were wrong—at least, not after one or two conversations. No one likes to think they could’ve been duped or easily misled—and people certainly don’t like feeling like their intelligence has been called into question. So, instead of trying to change someone’s mind, celebrate small wins. This could be as simple as someone questioning a disreputable news source or disregarding an inaccurate study. At the end of the day, your goal should be to break the misinformation echo chamber.
4. Be a reliable medical resource—but don’t overstep.
These conversations should be handled with care, and in my opinion, they’re best left to the patient to initiate. For better or worse, health care has been politicized in our country, and that can get in the way of delivering quality patient care.
That said, as trusted medical providers, part of our oath to “do no harm” includes sharing accurate, evidenced-based medical information when asked. We must also trust our peers in the medical community—peers who must also practice by the Hippocratic oath—whenever new research is released. So, for example, if a patient asks you about your thoughts on vaccination, you could provide them with the CDC’s latest information about mRNA vaccines. If the patient is hesitant, do not push them aggressively (after all, the decision to receive the vaccine is theirs to make). But if they show a willingness to hear more, you may want to share that, per the CDC, the most adverse confirmed reaction to the vaccine has been anaphylaxis. (This accounts for reports of cerebral venous thrombosis [CVT] and blood clotting, which the European Medicines Agency [EMA] and WHO have not linked to the vaccine.)
Bottom line: Your goal isn’t to change minds; it’s to share accurate information. And even when you do, some folks will remain entrenched in their beliefs. That’s not a reflection of your skills and knowledge as a healthcare provider.
5. Enforce your boundaries in discussions with your peers.
Even if your team isn’t talking about these topics on the treatment floor, conversations between coworkers may happen around the proverbial watercooler. Much of what I wrote above can also be applied in peer-to-peer discussions. Broach the topic with good intentions, and ask open-ended questions to gain a better understanding of your colleague’s perspective. And of course, be sure to disengage if the discussion becomes too contentious.
6. Set employment standards—and hold employees to them.
That said, some misinformation can be detrimental to patient care—and this goes beyond COVID-19 or vaccinations. In some cases, misguided conjectures may go against clinic policies (e.g., advising against mask use when masks are required in the clinic). As a clinic leader, it is your duty to promote a safe and equitable work environment. And whenever an employee joins the team, they do so under the agreement to uphold the standards you set forth. If an employee spreads harmful misinformation, then you must take action. In that case, it’s vital that you pull them aside, try to root out the reason for their belief, and then show them the purpose behind the policy or why the information they’re spreading is harmful.
If a staff member violates an existing employment standard, then you’ll have no choice but to have a difficult conversation with them. In this case, do your research and outline exactly what you wish to address. This is why it’s crucial to not only establish your practice’s communication guidelines—including what is off-limits—during employee orientation, but also continue to discuss the policy as controversial topics come up. This is essential to creating an environment that is safe and professional for everyone.
Misinformation isn’t a recent development—especially in our field. But when it spreads, unearthing and dispelling it can create a significant challenge for clinic leaders—and it can negatively impact your patients. But I believe combating misinformation isn’t impossible. All you need is the right strategy—and plenty of empathy.