Paging Dr. Internet, we need a diagnosis. In this series, Mashable examines the online world's influence on our health and prescribes new ways forward.
After more than a year and a half of hobbling through a pandemic, we’ve learned to depend on public health information like never before. And we've become accustomed to getting it whenever — by scrolling on Instagram, reading a news article, Googling, or maybe all three.
"Across all age groups, everyone is relying on the Internet more and more as a resource for their health information," says Dr. Austin L. Chiang, a gastroenterologist and assistant professor of medicine at Jefferson Health (Thomas Jefferson University Hospitals) in Philadelphia who has almost half a million followers on TikTok.
There is so much of that info out there, and we have the power to choose where and when we get it. That’s a good thing...but it's not without its problems.
One issue, Chiang says, is that not all content is created equal. For example, since the first cases of COVID-19 were documented in 2019, leaders from China, Iran, Russia, and the U.S. have all played their part in mis- and dis-informing media and the public for political ends. In the U.S. alone, there has been much back-and-forth on whether to take the pandemic "seriously" (which everyone should); whether the virus becomes less contagious in warmer weather (which isn’t supported by the data); whether masks even "work" (they do); and so on. "With so many voices screaming," wrote Dr. Matt Morgan, who works at the University Hospital of Wales, in an open letter to patients in November 2020, "it’s hard to hear the whispers that really matter."
What if we could hear the whispers over the screams? What if everyone had the tools to spot junk science? Stronger media literacy and science understanding could have prevented very preventable suffering and death.
As we come up on its two-year anniversary, the pandemic could still do some good — if we take the time and energy to learn from it. To start, three medical experts share what they would advise their own patients to do while searching for health information online.
Remember that the content doesn't know you personally
Whatever health-related info you come across, it will never know your specific case.
Resident psychiatrist Dr. Mehdi Elmouchtari at State University of New York Downstate (SUNY Downstate) in Brooklyn says he likes to see patients come in having done their homework. It shows curiosity, and can make collaboration between the patient and doctor easier. "I'm big on shared decision-making," he says.
"If the patient feels empowered by their ability to look up information on their own," he says, then all power to them. The caveat: "As long as they understand that the information they find on the Internet doesn't know them and doesn't know their situation, I think it'd be pretty productive on both sides." So, research away, but don’t let your own digging warrant ignoring an actual doctor. Rather, let it spark conversation.
Dr. Stella A. Safo, an HIV primary care physician and assistant professor of Medicine at the Icahn School of Medicine at Mount Sinai Hospital in New York, is all about keeping the patient-physician conversation going, too – both in and out of the doctor’s office. She reminds patients to email her when they have questions through her hospital’s online portal, MyChart.
Don’t let your own digging warrant ignoring an actual doctor.
Through the portal, patients can see their medical records, review test results, schedule appointments, and send their doctors electronic notes, or emails. Given that all this can be done at any time and at no extra cost, it might be worth checking with your physician’s office to see if they offer a portal like MyChart.
Just knowing they can depend on contact with her through the portal, Safo says, helps her patients be more thoughtful when consuming health content. "I find it's helpful because a lot of times, when people know they have someone behind them, they'll self-evaluate and think, 'This seems like it's not a great source.'”
Emailing her, she adds, can make up for any lost time in doctor's appointments, which can sometimes feel rushed.
Chiang finds new patients sometimes go to him after seeing one of his TikTok or Instagram posts. He's encouraged by this, because "there's only so much that can be packed into a social media post, or a 15-second TikTok video.” It signifies that his health content is working as a means to get people to the doctor, not merely as an end in itself.
Keep skepticism alive and well
Albert Einstein has been quoted as saying, "Blind belief in authority is the greatest enemy of truth." In general, the health content we find online tends to come with a sense of authority, so you should make sure to keep an eye out for red flags, or reasons to doubt what you’re seeing.
The first red flag, Safo says, is social media. “I tell people for the most part to be careful of what they're seeing on Facebook, Twitter, and Instagram,” she says. “Even though you can get lots of good stuff from that, there's just, especially with Facebook, such a potential for there to be disinformation depending on who you follow."
Information on social media is also more likely than rigorous research to base claims on anecdotal evidence alone. Posts that emphasize "I" or "my," Safo says, can have sentimental value, but should not be used to declare universal truths. "If that's the majority of the evidence they're basing something off, it's worth speaking about if there's any additional considerations," she says. This can be with your doctor, or through searching the topic on reputable sources (we've listed a few below).
Going from social media to search engines, Safo says that sometimes her patients Google medications to understand their treatment options. This is all fine and good, but she reminds them that the first results might be websites of the same companies that profit off of the medications. They're commercials; they're going to use language that promotes rather than qualifies. "It's a good starting place, but let's talk more about what you're finding," she says to patients. Another sign information is from pharmaceutical companies? It shows up with “Sponsored Ad” somewhere in the result.
Health content that tries to sell you something, or that doesn't remind you to consult your doctor, Elmouchtari notes, should receive skepticism. "Usually with well-regarded resources, there's going to be something where they say, 'have a conversation with your doctor about this or that,' whereas a lot of the less-reputable ones will try to usurp that role,” and try to sell you something “better” than what your doctor offers.
He says to remain cautious of sites that assume that "natural" remedies, such as herbs, are automatically better than any drug: "There's a lot of very cynical people out there who use those terms and those ideas to try to sell stuff that's actually quite dangerous to patients." Natural practices where possible, like exercise and eating a balanced diet, can prevent needing to take pills. "But taking some kind of herb or supplement to totally replace a pill is not [recommended],” he says — especially without consulting a physician first.
At the end of the day, Chiang encourages people to question everything, his own content included, and bring it to their doctors. "Dig in a little deeper than just a headline," he says, especially if what you’re reading seems sensationalized, or says that science "proved" something. Technically, science never proves anything; it only accepts or rejects ideas according to evidence.He also says to pay attention to the following:
- What are the primary sources?
- Who is being quoted?
- Where is the data coming from?
Are these legitimate sources?
"It does take a bit of extra effort and homework," he adds, but it’s the same effort we would put into researching a major purchase, like a new car, new house, or your favorite tech gadget. “When people see my content, they should approach me the same way," he says.
Know that we only know the latest research
Remember when Pluto was considered a planet? Well, as of 2006, it wasn't anymore. Years later, astrophysicist Neil deGrasse Tyson was still telling people to "get over it."
This may not be what we learned in 5th grade astronomy, Elmouchtari says, but science changes over time. "That's an important thing to understand, and it's something that's not really taught well in schools."
If Safo were able to advise school science curriculums, she would have them emphasize a core principle of scientific discovery: that we're always learning something new. "In our culture, there's this sense of 'Why did you change your mind? Why did you tell me masks weren't good, and then you said masks were good?' There's a definitiveness that we want. But science is not based on definitiveness."
If we understood this, Safo adds, we could avoid a lot of unfounded distrust in science. "I think there is a certainty that's desired that ends up causing issues when information has to change," she says. "If we understood that information would expand and change, I do think that it would make us more open to it, and less believing that if the information changed, it's a lie or conspiracy."
This isn't to say that everything we think we know about science and health could change tomorrow; many findings have been consistently supported by rigorous research, peer review, and data over the years. But especially when new circumstances, such as the COVID-19 pandemic arise, fresh data comes in. Accordingly, recommendations and policies change. "This isn't people flip-flopping on their stance," Dr. Chiang says, "but just acting on the best available information out there."
Consider certain sources with more confidence than others
Chiang, Safo, and Elmouchtari recommend the following sources when surfing the web for health information.
For people who want simpler, verified descriptions of health information:
- Check nonprofit academic and medical centers that are focused on education and research, such as the Mayo Clinic and the Cleveland Clinic
- Refer to university hospitals, such as Johns Hopkins Medicine, that tend to have patient education pages.
- Turn to hospitals that have clinics built around specific diseases and conditions, which will usually have educational resources.
For people who want more technical descriptions from reputable sources:
- Try Google Scholar, PubMed, and other databases where research is published after a rigorous peer-review process.
- You can also go to resources such as UpToDate and The Journal of the American Medical Association (JAMA), which offer updated and technical information, though often there are subscription costs.
Where do we go from here?
In addition to being a physician, Chiang serves as president of the Association for Healthcare Social Media (AHSM), the first 501?(3) nonprofit society for health professional social media use. AHSM was founded on the idea that social media can be a helpful public health communication tool — that is, if mis- and disinformation are reigned in. “Right now, we're trying to pick up the pieces," he says.
Safo, too, sees ways our medical systems can better serve patients. She is founder of Just Equity for Health, a health care improvement company that uses advocacy, education, and care model design to reimagine equitable health care, particularly considering the racism and sexism that harm Black, Indigenous, and other patients, practitioners, and communities.
These organizations can work to combat misinformation and inequities in health care in the future, as our systems adapt to the times, just like science.
Every week, it might seem like there's something new to debate about the pandemic. But behind it all, Dr. Chiang says, "there's a larger issue about how to conceptualize all of this that needs to be addressed." Part of this, he adds, has to do with how we interpret what we're reading on the internet, and "that in itself is something that we have to reframe altogether."
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