By James Borders, MD
The Lexington Medical Society has chosen to promote COVID-19 vaccination as our top public health priority. As of this writing, approximately 40% of Kentuckians have received at least one COVID-19 vaccine injection and just under 18% have been fully vaccinated compared to 16.9% of Americans, placing Kentucky #22 in states’ ranking for those vaccinated. However, we are vaccinating at a more rapid pace than that of any of our 7 border states. It is widely believed that we need to achieve 70-80% vaccination rates in the general public to achieve herd immunity. A major obstacle preventing more widespread acceptance of COVID-19 vaccination is what has been termed “the social disease of disinformation”.
Those battling the largest Ebola outbreak in history in West Africa in 2014 encountered opposition to scientific advice due to false and misleading information spread through social media. The same is now true for COVID-19 as conspiracy theories abound involving such notions that receiving a mRNA vaccine alters DNA, causes infertility, or allows the government to implant a tracking device. Some in government are beginning to challenge creators of social media to take responsibility for the information disseminated through their platforms. One can argue that libel law should apply to such platforms if they provide a means for an individual to broadcast their ideas- that is, to “publish” them.
Studies to clarify the reliability of medical information obtained online have been published in the New England Journal of Medicine, Scientific American, and the Journal of Medical Internet Research. Google searches for common medical topics discover that less than 40% of websites that appear offer advice in line with published guidelines developed by established medical authorities. For example, when searching sleep safety in infants to reduce the risk of sudden infant death syndrome (SIDS), only 25-30% of the information was found to be in line with the best practice.
Many physicians admit to resorting to Google for their bedside medical information online searches. I dare say that many physicians use no more reliable information than that obtained through social media and Google searches to stay informed about the pandemic. What is worse is that some have become party to the spread of disinformation as they comment about their skepticism to their patients or on their social media accounts based upon such spurious sources of information.
I was surprised to learn recently that some specialists at one of our large community hospitals did not realize that their hospital still had a medical library, thinking that the internet obviated its need. Several years ago, a former KMA president remarked to me that, “the worst thing that has happened to continuing medical education is the internet”. I’ve often reflected on that comment for comic relief, knowing that the internet, properly understood and accessed, offers unprecedented CME opportunity. However, misused, the internet can be a threat to the health and safety of the patients we serve.
Physicians and patients alike need to assure that they use reliable internet sources to seek information about illness diagnosis, treatment, and disease prevention. We must assume that our patients and their families will use the internet for information about health, so advising them against internet searching on these topics is unrealistic. The following sites have widespread support among medical professionals as being trustworthy to give the medical layman accurate and understandable medical information. I would suggest making this list available to your patients:
- National Institutes of Health. This Web site provides readable and accurate descriptions of medical conditions by linking to trusted Web sites for specific information.
- American Diabetes Association. This Web site offers extensive detailed advice about diabetes, its treatments, and ongoing research. It also offers advice about nutrition and meal planning, exercise regimens, and lifestyle changes as well as links to support groups in communities.
- Mayo Clinic. This site offers extensive disease/condition information and has a helpful “Treatment Decisions” section, “Ask a Specialist” section and other calculators and health tools.
- Drugs.com. This site provides layman-friendly information about prescription medication, an interactions checker, and an unknown pill identifier.
- MedlinePlus. This site provides an extensive searchable medical encyclopedia as well as extensive information on wellness, diseases, drugs, and other health topics.
- Cleveland Clinic. This site provides well-organized information on diseases, treatments, procedures, drugs, and current research. It has extensive multimedia formats such as video health talks, online health chats, podcasts, and webcasts.
- Family Doctor.org. This site is sponsored by the American Academy of Family Physicians and provides not only information on conditions and treatments, but it covers broader medical topics such as choosing a physician, understanding medical bills, navigating insurance coverage, and patient advocacy. It covers topics in children’s health, development issues, and home care of common minor conditions.
It is just as vital that physicians search through reliable sources for the information they use to stay informed. Reliable sites are:
- The World Health Organization (WHO)
- American Medical Association
It is possible that reliable sites for physician use that require a subscription may be accessible without charge through the library of the hospital in which one holds privileges. Check with your medical librarian for details.
Our patients deserve to receive advice from physicians who have taken steps to assure that the information they are sharing with them is accurate and timely.
James Borders, M.D.