Medical misinformation and disinformation targeting various audiences have increased worldwide over the past years. The internet, social media, and search algorithms often lead users to increasingly polarized viewpoints. As a consequence, we have unlimited data and information, false and authentic, literally on the palm of our hands, ranging from sports talk to medical information. Unfortunately, this fact has hindered the ability of health care professionals to provide correct information to their patients and has reduced the efficacy of evidence-based medicine.

Misinformation and disinformation are two words widely used interchangeably. While misinformation could translate to false information, disinformation is the act of spreading it. The conscious effort of disinformation for political gains, fame, and other preconceived benefits is politicization. The implications upon our specialty and the patients we care for are a growing concern for many anesthesiologists.

Medical disinformation often is an organized campaign to spread fake or inaccurate news about medicine, treatments, or policies. Through social media and the internet, information reaches millions of people almost instantly. Although anesthesiologists may understand the nuances of studies and policies and be able to differentiate disinformation, our patients may not have the extensive scientific or critical thinking skills to discern the authenticity of the information they read or hear. This reality increases the problem’s urgency and raises questions about potential solutions to meet our patients’ needs and in delivering evidence-based care.

As anesthesiologists and other health care professionals were responding to the first U.S. outbreaks of COVID-19 in March 2020, they often operated with incomplete information and relied on quickly published research and data. Even now, as more reliable, evidence-based information on COVID-19 has become available, physicians have had to navigate the continued spread of unverified or false claims, as well as medicine’s evolving understanding of the virus with the emergence of new variants. ASA urgently responded to the public health emergency in the first months of the pandemic by publishing statements, research documents, over 35 critical care education modules, and a website that answered more than 100 frequently asked questions from anesthesiologists and other physicians treating COVID-19 patients.

Unfortunately, some medical experts have abused their positions to give credibility to some unfounded or flat-out incorrect claims. Some physicians and social media influencers are quicker than ever to put every discovery, treatment, or policy on social media, exaggerating their absolute efficacy, and not minding the misconceptions they give to patients and the public.

Combating that information, whether through traditional media outlets or through peers, is often a difficult journey. Coverage of scientific issues has frequently fallen to political reporters, business writers, and journalists covering other nonscientific beats who may lack the knowledge to accurately frame a medical study. When combined with an increasingly polarized political environment, there are no better conditions for disinformation and bias to spread. According to Scheufele & Krause, when scientists present two false or inaccurate figures through the media, the consumers are apt to grossly exaggerate the figures, spread false hopes, and create interactions to push further the “supposedly medical breakthrough.”

But what happens to our patients when they read or hear misinformation online? In summer 2021, ASA staff received questions from patients who cited a post found on Facebook and other social media. The now-discredited post read:

“Anyone who has been vaccinated against the coronavirus is prohibited from using any type of anesthetic, even local anesthetics or dental anesthetics, because this poses a great hazard to the life of the vaccinated person, and is very dangerous, and may die immediately. Therefore, the vaccinated person must wait 4 weeks after the vaccination. If he is infected and recovers, he can only use anesthetics 4 weeks after recovering from the coronavirus infection. A friend’s relative was vaccinated two days ago. He went to the dentist yesterday and died after being given anesthesia! After reading the warning about the coronavirus vaccine, on the vaccine box, we found that after the coronavirus vaccine was given, there was a warning not to use anesthetics! Please spread this information to protect your family, relatives, friends and everyone.”

Anesthesiologists are keenly aware of patient anxieties regarding their surgical care and work to assuage those fears. The above example is a textbook case of misinformation aimed at undermining a person’s decision to receive a vaccine or undergo surgical care. Promoters of this misinformation were able to twist logical precautions and contingencies into unfounded and illogical warnings that were promulgated by misinformation websites and some social media users.

ASA was prepared to combat misinformation with the development of a publicly available website that included information on vaccinations, elective surgery, and testing protocols. But the damage from that post was already done – social media posts like the one described above further erode the trust some people have in their physicians and surgical team.

Beyond COVID-19, massive marketing campaigns have described that supplements, gluten-free diets, and vitamins are the perfect substitute for prescription drugs. These campaigns triggered sales for these supplements during a time when prescription drugs were becoming alarmingly costly. This disinformation led some patients to believe they were getting the same medication at lower costs, whereas supplements may not show any efficacy. These supplements are not alternatives to expensive drugs, as was the claim. Economic gain may be a driver of many misinformation campaigns, not just for the manufacturers but also some medical “experts” and “researchers.” These individuals may endorse such products and health stories, promoting an experimental drug as a cure to raise false hopes and encourage potentially unnecessary treatments.

Whatever the root of misinformation or politicization, it has persisted in the health sector. This not only affects how anesthesiologists view the world, but also affects the questions, fears, and perspectives our patients have leading up to their surgical procedure. Using the erroneous social media post noted above as an example, especially its absurd statement that patients “may die immediately” after receiving both a vaccine and anesthesia, the descriptions of how we and our patients view information may be instructive.

Inability to recognize disinformation

Most people find it challenging to sort through medical information and news, including that posted by friends and family on social media sites, and critically evaluate the data in online social media environments. The majority of people lack media literacy.

Emotions

Our emotions greatly influence how we engage with false information and how much attention we pay to certain things.

The motivation toward fact-checking

People are more likely to believe information if it originates from a reliable source, aligns with their current beliefs and values, and appears widely accepted.

Debunking misinformation

According to a recent study on “false rumors” about health care reform, debunking incorrect information or news is possible, but it could also lead to further boosting the rumor.

Social media networks

The distinctive qualities of social media platforms (i.e., the ability to build desired networks and share or discuss content within one’s chosen network) are also the same ones that enable malevolent actors to abuse group decision-making processes to spread misleading information.

How can leaders in the health and medical fields perform their duties while attempting to deal with a divided and politicized public? Anesthesiologists and other medical professionals cannot be expected to rebut misinformation claims on demand in a medical setting. When considering COVID-19 vaccinations, anesthesiologists have often focused on encouraging vaccination among their patients, especially those with underlying conditions and those who are more open to receiving and understanding the benefits of vaccination.

“Medical authorities could develop training and educational resources to help professionals communicate with patients more effectively when they are presented with false information. Instead of arguments, this training should cover how to convince patients using consistent messaging, empathy, and understanding.”

Obviously, anesthesiologists can do a better job of educating and persuading the public about science and health issues, but how can health communication be strengthened to combat the threat of “false stories”? Medical authorities could develop training and educational resources to help professionals communicate with patients more effectively when they are presented with false information. Instead of arguments, this training should cover how to convince patients using consistent messaging, empathy, and understanding.

Although digital health resources are more accessible, obstacles and gaps in the public’s health literacy persist. Social media companies and physicians can play a complementary role in pushing accurate information to users of digital technologies. Social media companies like YouTube have also established algorithms that promote trusted sources from expert organizations on medical issues. Internet search companies, especially in the wake of COVID-19, have also amended their algorithms. Health policymakers could establish guidelines for researchers to follow when they upload their findings to media outlets. This partnership between health care stakeholders and social media could help promote health literacy programs for society, and health practitioners should gauge the efficacy of these programs.

Disinformation and politicization of health care are frequently cited as causes of the public’s weariness and disappointment in public health and medical officials. It will be continuously challenging to overcome these obstacles, but it is possible. Recall the successful campaigns in the past, like countering the anti-childhood vaccination campaigns spread across the world in the 20th century. With lifelong commitment and continuous efforts, we can overcome this menace spreading effortlessly like wildfire.