‘Misinformation’ is the wrong word for evolving science

One of my favorite radio guests on “Doctor Radio” on SiriusXM throughout the COVID pandemic has been Heidi Larson, founding director of the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine and a world leader in addressing and potentially overcoming vaccine hesitancy. 

The first time I interviewed her, I was certain she was going to use the words “misinformation” or “disinformation,” but it turned out the opposite way: She criticized these terms and the attitude of the people using them as condescending and off-putting to patients. I found myself cheering her approach. She prefers the concept of having a “conversation” with your patients, finding out what their concerns are, and responding with sensitivity, facts and insights, while fully understanding that the patient has the right to refuse. 

She noted recently in the esteemed New England Journal of Medicine that physicians and health care providers are “still among the most trusted persons when it comes to health care advice,” and cited a Wellcome Global Monitor survey noting that “73 percent of the respondents said that they would trust a doctor or a nurse more than others; the percentage was 90 percent in the higher-income countries.”

Larson went on to say “vaccine acceptance can increase, but health care providers need to offer support and encouragement and listen to what matters from the patient’s perspective. Equipping physicians with information on the nature and scope of circulating concerns in their communities may help them address such concerns in the clinic, while also informing appropriate interventions at the community level.”

The term “misinformation” is not only off-putting but also implies that someone has a monopoly on the truth and someone else is automatically wrong. The idea of censoring someone or removing them or their views from social media, as happened temporarily this week to Florida Surgeon General Joseph Ladapo for tweeting a study that appeared to show an increased death rate from cardiac causes in male teens 28 days after receiving the COVID mRNA vaccine, goes against the very purpose of our democracy. 

Don’t get me wrong, I think it was misleading at best for the Florida study to not address the risk of dying from the cardiac complications of COVID itself in the male teens who were unvaccinated, and to fail to announce that the study actually showed a lower death rate for all causes in this age group. I also disagree strongly with Ladapo’s warning against young men receiving the COVID mRNA vaccine without a full risk/benefit analysis but at the same time, I defend his right to say so.

Even more disturbing Is Gov. Gavin Newsom’s (D-Calif.) signing of legislation to allow the state medical board to discipline physicians and surgeons who spread so-called misinformation about COVID-19 during patient care. Misinformation is defined as “false information that is contradicted by contemporary scientific consensus contrary to the standard of care.”

But the problem is that so-called scientific consensus may take generations to develop. There is still no consensus on the proper prophylactic use of aspirin or the frequency or effectiveness of the Prostate Specific Antigen or even the colonoscopy, for example.

During the pandemic, science was evolving and changing, and yesterday’s facts became tomorrow’s fiction as the virus itself evolved and became more transmissible and more immune-evasive. It soon became apparent that vaccines or masks didn’t completely prevent spread  and yet, pointing that out or disagreeing with mandates was considered to be misinformation, and still is by Newsom and others.

I remember being criticized early in the pandemic for considering the potential of hydroxychloroquine before we had a targeted antiviral like Paxlovid. I was also judged for pointing out that lockdowns and closures were inefficient at best, frequently ineffective and caused massive collateral damage, or that masks had to be worn properly and consistently to be effective at all. The fact that I ended up being correct on many of these things isn’t the point, it was the lack of inquisitiveness and the dogma of some public health officials staking out inflexible positions that were most disturbing.

The sign of a secure confident position in science or medicine is one that is open to challenge and debate, one which welcomes disagreements and openly acknowledges humbly that the pandemic has been a learning experience for all. We can certainly do better next time but we must start from a place of inclusiveness rather than derision.

Marc Siegel, M.D., is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent and author of the new book, “COVID; the Politics of Fear and the Power of Science.”

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