Speaking up against health misinformation

Speaking against false health claims can extend scientific communication into advocacy. Scientists and medical communicators can contribute through everyday conversations, public writing and media appearances, while recognising the demands and personal risks of a public role.

The professional responsibility to speak

Scientists have a responsibility to speak knowledgeably about scientific issues affecting the public, sharing discoveries as well as producing data, manuscripts and dossiers. ^{1, 2} They should challenge misinformation, alternative facts and pseudoscience when robust findings are disregarded or treated as matters of faith. ^{1, 2} Speaking up can begin with friends, family and colleagues rather than requiring a social media presence, and no venue is too small. ^{1, 2, 3}

A scientific writer's usual role is to communicate about science, but gaining public support for science is important and effective communication may entail advocacy. ⁴ Medical communicators should proactively write accurate, fact-based information and act as credible sources; professional associations such as AMWA can help counter misinformation and teach members to contribute. ^{5, 6} Scientists and scientific associations should anticipate misinformation campaigns and prepare online strategies before they occur. ¹

Physicians, scientists and public health specialists can advocate through interviews, opinion pieces, podcasts, blogs and personal social circles. ^{7, 8} Gaps in accurate scientific information create room for bots, trolls and conspiracy theorists to spread doubt. ⁸ Scientific debate about climate change, vaccination or genetically modified organisms should be focused, relevant and convincing enough to withstand public scrutiny and influence political decisions. ⁴

Responsible public engagement

Scientists should seek social science and communication expertise to understand how audiences weigh news headlines, videos and tweets. ¹ Medical communicators should remain humble about the limits of their expertise and recognise what they do not know. ⁹ Critical analysis, context and a human perspective on scientific data can help them connect with audiences and improve the accuracy of health information. ¹⁰

Doctors can use social media to interpret healthcare news, guideline changes, drug recalls and new treatments, acting as filters for patients. ¹¹ In 2004, Kevin Pho began blogging after personal requests for advice through Google Answers suggested that patients were not getting enough information in consultations. ¹² His post explaining the cardiovascular-risk recall of Vioxx was appreciated by patients facing fear and uncertainty. ¹²

Public advocacy can also draw on networks of colleagues: in 2019, a physician-scientist and fellow advocates from children's writing, virology, clinical pharmacy, law and paediatrics used their combined Twitter reach of over 100,000 followers to challenge pseudoscience. ^{1, 13} Social media prominence can lead to newspaper writing, television interviews and participation in policy debate, as it did for Pho. ¹⁴

Scientific caution in front of the media

Scientific training can conflict with media expectations in three ways. ^{15, 16}

1. Scientific method: epidemiological findings describe associations at a given statistical power rather than mathematical proofs. Saying that all evidence to date does not support a proposed causal link may sound like hesitation or concealment to an audience expecting a categorical answer.
2. Personality: scientists may be uncomfortable as public advocates.
3. Training: scientists are used to analysing data and retaining caveats, whereas television calls for more definitive statements, especially when opposing speakers express certainty without supporting data.

¹⁶

On The Colbert Report, Paul Offit was told that the host would remain in character and that he should challenge the character rather than let its assertions pass. ¹⁶ Repeatedly returning to prepared talking points did not suit a programme whose audience came to laugh; the scientist's role was to be the straight man rather than compete with the comedian. ¹⁶ In one appearance, Offit's response to an industry-influence accusation, that his hospital was in the pocket of children, drew boos because the comedy audience heard an unintended sexual implication. ³

Personal and professional exposure

Inappropriate social media use has derailed young physicians' careers, so healthcare professionals should use it responsibly even while taking its opportunities to educate patients, address misconceptions and reach policymakers. ¹⁴ Public scientific advocacy can also bring hostility: Offit reported hate mail, occasional physical harassment and three legitimate death threats. ³

Public support matters to the continuation of publicly funded research; the voters who fund scientists can also stop funding them. ³