Fighting The Pandemic of Misinformation | Joseph S. Thomas, MD, FHM | TEDxBuffalo

Key Concepts

• Physician Burnout and Mental Health: The profound psychological toll of the COVID-19 pandemic on healthcare professionals, characterized by overwhelming death, emotional distress, and the struggle with misinformation.
• Disinformation/Infodemic: The pervasive spread of false or misleading information, particularly concerning health, and its detrimental impact on public health efforts.
• Evidence-Based Medicine: Medical practice grounded in scientific research and data, contrasted with pseudoscientific claims.
• Physician-Patient Communication: Strategies to enhance understanding, trust, and shared decision-making between doctors and patients, especially when addressing misinformation.
• Combating Disinformation: Methodologies and approaches to counter false narratives, including transparency, empathy, and critical evaluation of sources.
• Social Influence and Beliefs: The powerful role of social groups and the fear of social exclusion in shaping individual beliefs, even over factual accuracy.
• Hopeful Skepticism: A critical yet open-minded approach to information, willing to consider new data with sufficient evidence.

The Personal Toll of the Pandemic and the Rise of "Doc with Bow Tie"

The speaker, Dr. Joseph Thomas, recounts a deeply personal moment on November 28th, 2021, when a tweet about all his COVID-19 patients dying while he was away for a holiday "hit him like a truck." This experience, six years into his career as a hospital physician, highlighted the ongoing struggle with COVID-19 waves despite the availability of new treatments and vaccines. He describes the overwhelming emotional burden, including the memory of patients saying goodbye to loved ones via phone or iPad, the physical discomfort of N95 masks, and the stark contrast between the reality of death and social media posts denying the pandemic's severity.

This emotional crisis led him to a moment of profound vulnerability, admitting to his wife, "I don't think I'm okay. I don't think I'm going to be okay for a long time." This realization underscored the need to confront disinformation, not only for public health but also for his own mental well-being. He references a 2023 study by Chamellia Adams, which found that physicians working during the pandemic's first wave experienced persistently high or worsening rates of psychological and physical health difficulties, even with adaptive coping strategies. This study provided a sense of solidarity, indicating he was not alone in his struggles.

Driven by the need to act, Dr. Thomas began his efforts to combat disinformation by posting on social media. He started with Facebook, then a blog, and Instagram slides, but found these platforms insufficient for reaching his desired audience. Recognizing the shift in information consumption, he created a TikTok account, officially becoming "Doc with Bow Tie." His approach to social media mirrors his in-person patient interactions: sitting down to establish eye-level communication, as supported by a study in the Journal of Hospital Medicine led by Dr. Blair Golden, which showed this practice enhances doctor-patient communication. He aims to explain diagnoses and treatments in an understandable way, inviting patients to be active participants in their care.

Navigating Misinformation and the Power of Social Influence

Dr. Thomas emphasizes that confronting misinformation with patients requires empathy and rapport-building, rather than dismissive or mocking responses. He stresses that the goal is shared: the patient's good health. On social media, this translates to sharing accurate information and debunking myths from a trustworthy and relatable source.

However, he acknowledges the significant challenge posed by a culture that has developed around the rejection of science. This rejection can shape communities, making it difficult for individuals to deviate from prevailing conspiracy theories, even if they recognize the incorrect premises, for fear of social rejection. He cites David Mcrainy's book, How Minds Change, which posits that "Social death is more frightening than physical death. We would rather be accepted by our social groups than be right." This highlights the deep-seated human need for belonging, which can override the pursuit of factual accuracy.

Dr. Thomas also addresses the tactics of disinformation spreaders, including those who claim to be silenced while having large social media followings or access to prominent platforms. He points out their tendency to make unsubstantiated claims about "root causes" and to promote unregulated supplements or treatments outside of medical insurance, often at a significant financial cost to the patient, with little to no evidence of efficacy. These individuals often employ "all or nothing" logic and oversimplification, making their claims difficult to counter. He invokes Brandolini's Law, which states that refuting disinformation requires an order of magnitude more energy than producing it.

Strategies for Combating Disinformation: Transparency, Humanity, and Critical Thinking

To counter these challenges, Dr. Thomas advocates for greater transparency and the acknowledgment of the "gray areas" in science. He challenges the stereotype of doctors as unfeeling, emphasizing that science, like humanity, is not black and white. He proposes building a "bridge of humanity" by acknowledging the difficulty of situations ("this sucks and I hate this for you"), which fosters connection and encourages patients to engage in their healthcare journey. This bridge can span gaps in knowledge, both for the patient and the physician.

He illustrates this with an example of a healthcare worker dismissing COVID-19 based on a 99% survival rate. Dr. Thomas reframes this by highlighting that 1% death translates to 3.3 million people in the US, shattering 3.3 million families. He also points out that survival doesn't negate long-term consequences, which are often overlooked in oversimplified statistics.

Drawing on Jamil Zaki's Hope for Cynics, he distinguishes between cynicism (a negative, closed-off view) and "hopeful skepticism" (critical examination open to new data with good evidence). He connects this to Dr. Golden's research on physician-patient communication, suggesting that medicine is replete with moments of hopeful skepticism supported by data.

To effectively dispel myths, Dr. Thomas suggests borrowing techniques from other fields:

• From Librarianship (SIFT):
  • Stop: Pause before sharing or believing.
  • Investigate the source: Evaluate the credibility of the information provider.
  • Find trusted coverage: Seek out reliable sources.
  • Trace it back to its original context: Understand the origin and purpose of the information.
• From Climate Science (Three-Step Method):
  • State the fact.
  • Identify the related myth.
  • Explain the fallacy: Why the myth is false.

He notes that while the COVID-19 pandemic may be entering an endemic phase, the "infodemic" continues. He calls for public engagement to identify and halt the spread of pseudoscience.

Actionable Insights for the Public and Healthcare Professionals

Dr. Thomas provides four key takeaways for combating disinformation:

1. Meet people where they are: Utilize a variety of platforms and formats (long-form blogs, short TikToks) to reach different audiences effectively.
2. Beware of oversimplification and fabrication: Pseudoscience thrives on making things up where scientific understanding is incomplete.
3. Follow the money: The Sunshine Act allows for transparency regarding payments from pharmaceutical companies to physicians. Conflicts of interest arise when physicians promote unregulated supplements or steer patients away from evidence-based treatments.
4. A moment of humanity provides context: Acknowledge the complexities and limitations of science and systems, rather than filling gaps with fabricated information. Look for individuals who are not profiting and aim to share information transparently.

The Impact of Efforts and a Call to Action

Dr. Thomas reflects on a question from his best friend: "Did you ever change anyone's mind?" He admits uncertainty but reiterates his motivation: "It was either try to educate people or cry in a corner." His wife reminds him of a pregnant woman who got vaccinated due to his posts about mRNA vaccines and pregnancy, dispelling myths about infertility. This personal anecdote highlights the impact he has on individuals in the "in-between" spaces, those who are not at the extremes of belief but are genuinely seeking to make informed health decisions for themselves and their loved ones.

He concludes by emphasizing the importance of widespread vaccine uptake for herd immunity and positions his educational efforts as a "vaccination against the infodemic." He hopes to inspire and empower viewers to join him in this fight.