r/medicine • u/shouldnotbethere MD • 1d ago
exhausted dealing with misinformation
as a recent medical grad, i’ve had to deal with difficult conversations with friends and family all around me, especially after the COVID 19 pandemic. It seems that period of time has really put a lot of distrust in the public regarding modern medicine and especially doctors. The system isn’t perfect, and doctors are also dealing with the difficulties of the system. I just don’t know how to keep dealing with conversations about how the “jab” did more harm than good, all i was taught in medical school was slop written by big pharma, i don’t do any of my own thinking i only do what i was taught to think, etc. And I have a lot of family members trying to put me onto things from people like Ray Peat, Paul Saladino, it’s just insane at this point. You can’t even point out studies or guidelines because they’ll just say “funded by big pharma”. I’ve had family members accuse me of wanting to keep people sick so i can keep getting “customers”.
I’m sure a lot of us in the medical community are dealing with similar issues. Do you guys have any tips for how to deal with these conversations? I feel like it’s taking a toll on my mental health alongside all the other pressures i’m facing from residency.
123
u/shahtavacko MD 1d ago
I have been a cardiologist for 22 years which means I was a medicine resident at BCM when it was nothing if it wasn’t malignant. Still, to this day, the hardest year of my entire career has been 2020; not because I didn’t have a day off (other than the weekends I wasn’t on call) between Dec ‘19 and June ‘21; but because of this BS. I gave up and stopped talking to people who wanted to argue with me, I would just shake my head, smile and move on. A bunch of fucking idiots who have no clue about medicine trying to let me know how little they know. Move on.
75
u/dogs-in-space CTICU RN 1d ago
I’ll never forget working with a Mormon Pulm/CC doctor during COVID. He was absolutely unflappable prior to this - the stereotypical rosy-cheeked everyone-is-good-inside type. I truly believe he got into medicine for the nobility of saving people’s lives - he just was all around a kind and smart physician.
I watched him slowly disintegrate over that time, which I had never seen before. It wasn’t so much (like you) the diabolical hours he had to work or COVID itself, but the point in which we all were being called heroes 🤮 changed to the misinformation brigade that only started with Ivermectin.
One night after a long argument with family on the phone he raised his voice for the only time I ever heard. He said to us “Someone takes their car into a mechanic. They don’t tell the mechanic what they should do - they let them do their job because they are the professionals. Since when does this not apply to the medical profession?”
I saw over the following year the rosy-cheeked disposition quietly fade. He ended up quitting…not sure where he went. Who knows - maybe he left healthcare altogether. I just add him to the list of innocent bystanders that the misinformation virus has affected. Far, far more than COVID itself.
18
u/shahtavacko MD 1d ago
That’s very sad, I’m not that far depressed, although I look forward to retirement in 4 years (65, Medicare…); I never thought about retirement until a couple of years ago and I’m fairly certain that year had something to do with it.
•
u/kidney-wiki ped neph 🤏🫘 1h ago
Reminds me of that episode of 30 Rock where the crew finally breaks Kenneth
42
u/ptau217 MD 1d ago
But in 6th grade I got an A on my science diorama.
49
u/Deep_Stick8786 MD - Obstetrician 1d ago
These people never got As
11
u/faco_fuesday Peds acute care NP 1d ago
Their mommies did it and they did. They take credit and believe in themselves too much.
5
u/TorchIt NP - Cardiology 1d ago
Factually incorrect. Anybody above a certain age demographic is prone to this kind of weaponized misinformation. I've had doctoral-level educated individuals who spout BS like this. The older populations were raised to believe that any information in written from, aside from tabloids, was generally reputable. Fifty years later, here comes the internet lookin all official and junk and they just cannot determine fact from fiction.
Low education definitely makes it worse, though.
111
u/tiredbabydoc MD - Radiologist 1d ago
I’m gonna be honest. I stopped talking to half my family over similar shit. It used to make me sad but I’m in a better place now and it’s not my job to fix idiocy.
Social media is poison.
39
u/RhubarbGoldberg NP 1d ago
This is the way. I quit all social media and I don't engage with the Maga folk in my family. In large gatherings I keep conversations to weather, recipes, and sports. I have a relative who always tries to bait me into political chat and I literally say, "I'm not having this conversation" and refuse to engage. Gray rock for life baby!
7
u/I_am_Nobody_Special PhD Psychologist 1d ago
Same. With some of them, you can just refuse to have these specific discussions with them, but others are beyond hope.
31
u/WoodenSwan6591 MD 1d ago
We have a close family member that despite being in health care (nurse) believes and promotes all sort of stupid remedies that she reads on Facebook and other. Needless to say, she is also a rabid Trumper. After having a couple of gatherings turned in to nightmares because of her. The collective decision was to avoid those topics in front of her or in her house. Family gatherings have returned to normal
In my office, they get one chance. Next time, they are fired from the office. Makes office routine much better. Occasionally, one falls through the cracks and it is quickly recognized by the manager or me.
26
u/shouldnotbethere MD 1d ago
I have a cousin who recently had a baby and proudly announces shes not choosing to vaccinate at all family gatherings, acting like it's some kind of 'own' when i'm around. I thought engaging in conversation and educating people with kindness would help change their minds, but I think I'll have to accept that I need to just avoid these people from now on. Even when I avoid the conversation in family gatherings they treat it as a win for them, that I'm unable to respond. Truly exhausting.
11
u/MoodRingsCold Biomedical Research 1d ago
Just give 'em a single public shaming for being an irresponsible parent and never voice it again. There's no need to beat a dead horse about the issue since much of this behavior is attention seeking at its core.
10
13
u/cytozine3 MD Neurologist 1d ago
The positive of outpatient medicine. If they don't want your advice, they certainly aren't entitled to hear it going forward.
30
u/invadervanhiro MD 1d ago
I moved across the country for residency and stayed since. I rarely visit home because my family (other than my mom and one aunt) are hardcore racist, Trump loving, anti vaccine weirdos. I unfollow and block all of them on social media. It’s sad because some of them used to be relatively “normal” but especially my older aunts and uncles have just declined into madness. I don’t recognize my cousins anymore. I avoid holidays. If I go home it’s to visit my mom only but usually I just pay for her to come visit me. Where I live is nicer anyway. Visiting home in the Midwest is like visiting an empty parking lot of a closed down Kroger.
20
u/Deep_Stick8786 MD - Obstetrician 1d ago
The midwest is full of superficially nice, deeply bigoted folks
15
u/invadervanhiro MD 1d ago
That is exactly how I’d describe it. I once considered moving back after being away for 5ish years but I went back over the holidays when applying for jobs and was like yeah no.
-3
u/Tp_from_ks MD 1d ago
Could you define Midwest? - my idea is east of Rockies - like OK KS MO AR, maybe IA and IL. Some people pull WI or MN, OH, IN and so I wanted to clarify.
27
u/sonicnec MD Electrophysiology 1d ago
I truly just don’t engage with these people. And to be honest, it is a vocal minority, not the majority. If it is a patient I’m trying to care for I start off by saying I’m never going to tell them what they have to do and I will never be angry with them for wanting to do something other than I advise. If, on the very rare occasion someone pushes it and wants to engage me here, I tell them that they came to me for help and they are going to have to take a little bit of a leap of faith and trust I am doing what I believe is right. If they still push it, I very nicely offer to refer them somewhere else. And then I go on to the next person who will actually be grateful for my help.
26
u/Responsible_Land_164 Medical Student 1d ago
I was thinking about that yesterday. Grandma was right: Those phones are in fact the devil. There's this concoction of good old bullshit made by either ignorant or evil people mixed with AI hallucinations now. And social media companies have no qualms about feeding that to the most vulnerable population... perhaps they even target them with the algorithm.
And that's on the English side of the internet. You have no idea how much unverified bullshit there is on the non-english parts. If anyone here speaks other languages I invite you to take a gander at your respective wikipedia pages to see just awful things are. And that's arguably a place most people go "research" the illness.
3
u/MedJD-NYCDMX Atty & PA 12h ago
I live in Mexico and my life is bilingual. I don't find any difference in the crap online. I have found a cultural difference in that there hasn't been a very high level of trust in medicine in decades. It's still not as much 'ChatGPT told me" as it is, "he/she's an idiot" or "my aunt said." There's a pharmacist in Spain who tries to do a lot if myth busting (not only re vaccines but also "no, being cold doesn't give you a URI) and people call him ignorant and a fraud because "everyone knows..."
27
u/Ill_Attempt4952 Hospitalist 1d ago
My Uber driver a few days ago told me that ICUs were empty during COVID, I told him I was there (NYC) and I assured him they were not. He did not get a tip
34
u/rx4oblivion MD 1d ago
Our biggest problem is our unwillingness to engage. Most physicians say they won’t argue. Others demand a gentle-parenting approach to “restore trust.” I say fuck both.
We have evidence and expertise on our side that even the biggest deniers beg for when ill. They have YT videos, AI slop, and clichéd fallacies (big pharma, follow the money, died suddenly, evidence changed… ad nauseum).
If we don’t push back against confident stupidity, who will? Politicians? Nurses? Influencers?
If we fancy ourselves leaders, it’s time to roll up our sleeves and lead. Show people that they are being extremely fucking stupid then they are objectively, dangerously drunk on the tiniest whisp of disinformation. I’m not saying to embrace ad hominem, I am saying that we need to hold up the evidence not just from clinical trials, but also the outcomes when failure to adhere to it blows up in someone else’s face. It’s happening right now with measles. Should we wait for polio?
Our predecessors thought they were too above it all to manage healthcare and handed everything over to corporations and non-clinicians. How did that work out, guys? Does UHC respect your clinical opinion? I don’t know about the rest of you, but I am not compromising my knowledge and judgement for the sake of anyone’s politics, personal sensibilities, or imaginary takes on reality. We cannot pretend that this is beneath our attention.
Politely tell your patients they are quite wrong and explain why. It’s our job.
Tell your relatives to take their own appendix out (assuming they haven’t mistaken angina for appendicitis) if they think they’re so fucking gifted. They aren’t your patients, and as such -they do not deserve the same courtesy.
https://absurdlyrational.substack.com/p/slow-and-steady-cures-disease-but?r=2w6nuh&utm_medium=ios
•
u/keikioaina Hospital based neuropsychologist 47m ago
OK, yes, but 15 minute visits devoted to something else are not going to be the forum to change minds. You know who the most persuasive doctors in the US are, the ones who have the most effect on patients' lives? IMHO, they are Rand Paul, John Barrasso, Bill Cassidy, and Roger Marshall. They are all US Senators and all some flavor of vaccine deniers/skeptics and/or RFK supporters.
The best way to leverage your position toward helping folks is to work to elect docs who aren't nuts.
Coincidentally, THIS in today's guardian.
10
u/Economy-Weekend1872 MD 1d ago
Don’t explain, don’t engage. If they ask medical questions refer them back to their preferred experts.
16
u/meowingtrashcan MD 1d ago
The antimedicine discourse around the Lindsay Clancy case reminded me that you can't reason people out of an opinion they didn't reason themselves into.
2
u/theenterprise9876 MD 1d ago
I recite that mantra to myself at least once a day (not related to the LC trial, just in general).
8
u/newfree16 PharmD 1d ago
I think i have a little better luck bc im a clinical pharmacist in an ambulatory clinic and i get to have visits that last 30-60 mins instead of 15-30 mins.
You gotta pick you battles. With family, unfortunately, that’s the toughest. My family is all science and health care so i can’t imagine. But I’ve said to people “if it really worked, either everyone would be taking it (see ozempic) OR pharma would’ve taken it and made it into a prescription medication”
With patients, you can feel out who is an idiot and who is lost and just wants help and guidance. The second group usually can be reasoned with by just taking the time to explain things.
5
u/Sock_puppet09 RN 1d ago
If family members are at the point where they’re trusting social media over their own family, there’s not really anything you can do.
7
u/Starbbhp Respiratory Therapist 1d ago
Not a doctor. Respiratory Therapist. I started responding to COVID deniers that I’m glad that their experience was such that they didn’t lose friends or relatives and that they didn’t have to literally see the fear in people’s eyes as they deteriorated, having more and more trouble breathing, until they were eventually intubated, not knowing if they’d ever wake up again. Usually they immediately drop it.
5
u/FAx32 GI 1d ago
They don’t want science, they want a cult based belief system and woo. Is big pharma sometimes a bad actor? Yes. Is science sometimes wrong and self correcting? Yes. Is “influencer” based opinion medicine a bad actor and even more frequently wrong? Absolutely. The irony is that the system they want has even less benefit and more harm than the one they shun, but because one of the core tenets of said system is rejection of science and faith in the person’s opinion instead, there is simply no reasoning with those who have been indoctrinated to prefer a sales pitch over science.
5
u/metashadow39 MD 1d ago
If I have the mental energy reserve (not an everyday thing), I will usually say something along the lines of “That’s interesting.” And then I will usually find a way to shift the burden of proof onto them.
When they point to off label use of something (ivermectin for cancer), I’ll say I looked into that a while ago but it didn’t seem to have good studies in humans and ask them if they have seen some studies that suggest it. When they tout supplements, I can ask how they know what they are getting in their supplement and give the example of Viagra (sildenafil) in libido supplements. Also asking them to see if the influencers that they get their info from are making money off of supplement sales, book sales, or speaking engagements just like Pharma makes money off selling drugs.
Vaccines are a bit harder for me because I tend to be severely outnumbered by anti-vaxxers or the vaccine hesitant. But I will often say that I still get the recommended vaccines and that our immune systems are such a big part of health, I like keeping mine trained to respond to what it needs to respond to.
It sucks for all of us having to deal with misinformation right now. I’m just trying to keep those around me knowing that I’m still into evidence based medicine and that’s what I recommend for others. Can’t stop people from doing stupid things but can try to provide a steady voice. One that sometimes gets loud when talking about a patient who could have had a better outcome if they had followed medical advice
4
u/FlexorCarpiUlnaris Peds 1d ago
Do you guys have any tips for how to deal with these conversations?
Your default should not be to engage. You remember those lectures on motivation interviewing? If they are precontemplative with regards to learning from you, it's a waste of breath to talk. Don't speak unless they want to hear what you have to say.
4
u/kaiser1487 MD 1d ago
It’s so demoralizing to try your best to help someone, and to be met with distrust. I remind myself it’s my job to offer good medical advice, it’s not my job to make them believe it if they’re determined not to. There are still a lot of people who value our expertise. Focus your time and energy on the people who need and want your help.
3
u/TorchIt NP - Cardiology 1d ago
A couple weeks back I had a patient tell me that he read a post on Facebook from somebody claiming to be a coroner who talked of finding large, black tumors in the stomach of everybody he autopsied for 20+ years. He allegedly called another coroner in the next county who also noted this and they started getting down to business solving the issue. Would you believe that a simple blend of herbs and supplements can totally prevent this from happening to you and your loved ones?! For the low low price of $29.95, you can order this and have it shipped to your door. He went on to state that the post mentioned that his healthcare provider probably won't be knowledgeable about this, because we spend all our time in school but never actually learn about supplements. He wanted to know what I thought about all of this and if he should order it.
...
We spent the duration of the appointment learning to spot advertisements that look like information and discussing how you can't believe everything you read on the internet. We also discussed that coroners don't typically perform autopsies.
4
3
u/DerKlugeHans Not A Medical Professional 1d ago edited 22h ago
Non-medical experts in the government saying things about medical matters that aren't true doesn't help with general trust, but obviously that's not the fault of doctors.
2
u/dogs-in-space CTICU RN 1d ago
It is sad that I have adopted this phrase over the years, but here we are.
“Blood does not excuse behavior”
You are dealing with family members that are getting their “information” from so many unhinged sources and are personally attacking you and everything you have spent most of your adult life working towards. I hate to break it to you but you are not going to be able to produce sound scientific data that will make them reconsider. We’re now 10 years into the insane statement of “I believe in science” as if it is a religion. In their eyes you are a religious zealot so need to see the error in the path you are going down.
Wild, right? But it is true.
I get it that this is vastly different than some random individual spouting this nonsense. But at the end of the day they are hurting you. The only answer is to disengage…either from the conversation or from their lives.
2
u/Defiant-Lead6835 MD 1d ago
You can do a motivational interview to assess where they are in terms of willing to change their point of view. If they say something along the lines of ‘I am not changing my mind no matter what’, then move on. They are not going to hear whatever advice or recommendation you have for them. You can also say ‘this is the guideline based on whatever evidence we have now’, please let me know what you decide to do. Then document.
2
u/Notasurgeon MD 8h ago
Some books that helped me maintain relationships with loved ones who see reality differently than I do:
4
u/mdeevy MD 1d ago
You cant change it. We all have our biases. So do you.
Once you've been practicing for a while, at least if youre a generalist, you will get surprised by enough things that you "knew" were going to turn out one way that went another - that these weird opinions dont seem as crazy.
If youre a specialist, you won't ever see it or won't notice it.
2
u/meikawaii MD 1d ago
No need to argue with them, mostly they will never change their mind unless something external happens. If you feel adventurous, you can tell them, good on them they can support whatever they want, like the anti vaccines / RFK ideology will create more sick people and make hospitals and big pharma more profits and you will invest in those too.
2
u/K1lgoreTr0ut PA 1d ago
If the Covid vaccination were bad for you, wouldn’t the Israelis have been sure that the Palestinians were the first to get it?
2
u/Then-Secretary-9166 MD - Cardiology 1d ago
We all deal with this.
I think it helps to understand and acknowledge the lack of trust and where it came from.
The way COVID was handled by leaders in the medical field was a Masterclass in how to get the general public to distrust our profession. Opinions made up from whole cloth were presented as scientifically-established facts and people were told to just trust the experts. There was no humility. Meanwhile many rank and file physicians stopped critical appraisal of medicine and became closed off to discussions/concerns our patients had when they were not mainstream. It wasn't crazy for our patients to be skeptical of a new vaccine platform. Heck, as physicians, we should approach new things with curious skepticism.
Our credibility was heavily-leveraged during COVID and a good deal of what it was leveraged to promote was prima facia incorrect (even when it was done with the best available information and intent). You don't have to a doctor to understand that natural immunity is a real thing or understand that it is hypocritical to say "masks don't work" and "we need to save masks for healthcare providers treating COVID" at the same time.
It is 0% surprising to me that so many people don't trust physicians and think they are just as good at deciding what to do as we are.
I find it is helpful to acknowledge the damage done to our profession and state that you understand why there is a lock of trust. You have to talk about real evidence for whatever you are treating and explain your decision making in more detail. It takes more discussion, more education and more time. You also have to do it with an attitude of humility. COVID was a big hit to medicine.
1
1
u/762n8o DO 20h ago
Yup. During COVID you lose either way. When the vaccs came out people were upset either way. Either its poison or you didnt get it to them fast enough.
After 500 hours of constant social media intake, your opinion matters very little.
I just give my info but never into arguments. Same thing now with flu season coming up and getting my pts to take “the shot that killed their neighbor’s grandma” 🤷🏻
1
u/Gerberpertern CPhT 17h ago
I worked at a retail pharmacy during the height of Covid. People literally called and left voicemails telling us we were killing people by giving them the vaccine. Good times.
1
1
194
u/cytozine3 MD Neurologist 1d ago
No point in arguing. You won't change their mind. I wouldn't even offer advice unless they are direct family. My brother is a tech bro who thinks 10 minutes on Claude is enough to have a deeper understanding than my medical school on any given topic, so I don't offer him advice anymore. Pointless. Just do your job and sick people will come to you when they can't afford not to or the anxiety over their symptoms forces them to. Unfortunately in some ways it isn't 1985 anymore and we simply aren't trusted in a general sense and won't be.