Building and maintaining patient trust begins with the exchange of honest and open communication and accurate information. Once lost, this trust is nearly impossible to restore—which is why the torrent of misinformation and falsehoods we’ve seen during the COVID-19 pandemic has been so damaging.
To understand why, it’s important to know the difference between misinformation and disinformation. These two words are so much more than just one letter apart. Misinformation applies to incorrect or misleading statements often spread unwittingly by people who may believe they are true. Disinformation, by contrast, describes deliberate falsehoods spread with the intent to deceive, and to manipulate behavior and public opinion by sowing confusion and division. Both are damaging, but disinformation is unconscionable.
The COVID-19 pandemic continues to spawn falsehoods that are spread by a whole host of people such as political leaders, media figures, internet influencers, and even some health professionals—including by licensed physicians.
The words and actions of this last group may well be the most egregious of all because they undermine the trust at the center of the patient-physician relationship, and because they are directly responsible for people’s health. A handful of doctors spreading disinformation have fostered belief in scientifically unvalidated and potentially dangerous “cures” for COVID-19 while increasing vaccine hesitancy and driving the politicization of the pandemic to new heights, threatening the public health countermeasures taken to end it.
This is the impetus for new policy adopted by the AMA House of Delegates at the November 2021 AMA Special Meeting to combat public health disinformation spread by health professionals, based on the tremendous risks posed to our patients as well as the credibility of physicians as trusted sources of accurate, evidence-based information.
The costs triggered by misinformation and disinformation are staggering. A recent study by the Johns Hopkins Center for Health Security estimated that false or misleading information continues to inflict between $50 million and $300 million in total harm to our nation each and every day since May 2021, when vaccines to prevent COVID-19 became widely available.
The study authors arrived at this estimate based on the “significant correlation between believing misinformation and disinformation and not being vaccinated.” The authors also cautioned that their estimate of costs tied to COVID-19 falsehoods were conservative, based on reduced case counts and transmission observed in June and July 2021, before the Delta variant surge. Further, the authors calculated the harm caused by total voluntary nonvaccination in our country is at least $1 billion per day, based on standard federal public health methodology.
And of course, we cannot measure the pain suffered by the families and friends of the nearly 800,000 people in our nation who have lost their lives to the virus. That cost is truly incalculable.
A newly released survey by the Federation of State Medical Boards (FSMB) showed that complaints about COVID-19 disinformation by physicians and other professionals are numerous and widespread. Fully two-thirds of state medical boards reported an increase in such complaints, and more than one in five have taken disciplinary action against a license holder who has disseminated false or misleading information.
Our AMA continues to urge state medical boards to respond promptly to physicians whose conduct has been called into question for spreading falsehoods, particularly those related to COVID-19, in keeping with FSMB recommendations. State medical licensing boards must do their part by stepping up their vigilance and addressing the disinformation that undermines public health and vaccine confidence. And our AMA continues to implore media outlets, including influential social media companies, to remain equally vigilant to help their readers, viewers and listeners more easily separate fact from fiction.
Vaccination remains our only pathway out of this pandemic, but that path will remain blocked until the vast majority of those who are eligible to receive these life-saving shots choose to do so. We can reach this goal. Research has demonstrated that unvaccinated patients can and do change their minds based on their physicians’ recommendation.
I have experienced this firsthand when I discuss vaccination with my longtime patients. I remind them how they have personally trusted me, their family physician, to provide medical care and advice in situations ranging from sprained ankles to cardiac arrest. If I sensed that vaccine hesitancy remained, I urged them to take my advice now as they had in the past—and receive the vaccine. Many have said that I had in fact convinced them, and have asked how soon and where they could get their shots.
My experience, shared countless times over by my colleagues nationwide, demonstrates the power we wield as individual physicians—and the collective impact and reach of organized medicine—as agents of truth dealing solely in evidence-based science. Vaccine hesitancy and resistance can still be overcome if those who remain unvaccinated receive accurate, scientifically valid information, and make informed choices about their health after discussing their concerns with a trusted physician or another health professional.