• by Les Luchter , Staff Writer, October 5, 2023

To counter the spread of medical misinformation on social media, “we need credible messages that will cut through the noise and drown out the crap,” Dr. Jesse Ehrenfeld, president of the American Medical Association (AMA), said last week during a webinar hosted by Permanente Medicine.

Anthony Fauci told him a year ago that the only way to respond to all the misinformation is to “turn up the volume.” 

“For all of my ‘Spinal Tap’ fans, turn it up to 11,” Ehrenfeld declared to thousands of Permanente physicians attending the webinar from around the country. “We’ve got to bring credible voices into the space and drown out the junk.

People are “deliberately spreading falsehoods” in major media as well as social media, of course, and the AMA has asked all of them “to try to help their readers separate fact from fiction, to reduce the disinformation,” Ehrenfeld said. “That’s not going so well.”

The challenge of combating medical misinformation is not new to the AMA, however, with Ehrenfeld noting that the organization got started in the 1840s “by calling out and raising public awareness of quack remedies and junk science. People were selling snake oil, and we said, that’s not good for the profession.”

But now, he said, “these misinformation campaigns have become very sophisticated and very widespread.”

On the bright side, he added, while “we have seen from study after study and polling data that trust in science and medical institutions has eroded since the pandemic, studies also show that even people who mistrust medical institutions [e.g, the Centers for Disease Control] still trust their doctors.”

Demonstrating where “I am exhausted from having conversations like this over and over and over,”“I am exhausted from having conversations like this over and over and over,” may lead, Ehrenfeld gave a recent example from his own anesthesiologist practice in Wisconsin: A cardiac surgery patient refused to get a blood transfusion in a life-or-death situation because of fears that he’d receive the COVID vaccine through the blood.

“I am exhausted from having conversations like this over and over and over,” Ehrenfeld said. “Do I take 20 minutes and sit there, and walk through the science, the safety, the evidence, or do I just go about my day? “Unfortunately, more and more physicians who are exhausted, who are burnt out, continue to just move on.”

Physician burnout, of course, leads to physician shortages: “This isn’t a theoretical crisis,” he noted. “It’s a serious problem we’ve got to address today because It takes 10 years to train and educate a physician. The work to ensure that patients don’t experience a severe physician shortage in the next decade has to start today.”

Part of the solution, Ehrenfeld said, depends on Congress making it easier and quicker for international medical school graduates to practice in the U.S. “People born in other countries, but working in the U.S., already make up a quarter of our physician workforce,” he noted.

But physician diversity remains a large concern, he said, decrying the recent Supreme Court decisions eliminating affirmative action from higher education. “When we have diverse communities served by diverse physician workforces, patients do better,” he explained.  “We’re very concerned about what is likely to happen in the coming years around who’s admitted into medical schools.”

The Supreme Court’s overturning of Roe vs. Wade, meanwhile, has combined with anti-LGBTQ+ and anti-gender affirming legislation to lead to what Ehrenfeld calls the “criminalization of care.”  “There should not be a politician in the exam room,” he declared. “We oppose the interference of government in the practice of medicine."

“We’re very worried about what’s become increasingly hostile rhetoric,” Ehrenfeld continued, and that “these very well-coordinated medical disinformation campaigns, all of this anti-science aggression online is now resulting in threats, intimidation and physical violence.

“I’m really worried, though, that people are starting to become numb to these experiences…We are not asking for a witch hunt. We are asking for people who threaten healthcare workers with violence to be held accountable.”

Add to all of this another potential source of medical misinformation -- “fabrications and inaccuracies” emanating from AI -- plus other headaches like prior authorizations and declining Medicare reimbursements -- and it’s no wonder that Ehrenfeld concludes, “It’s a tough time to practice medicine.”

Yet, he says, “I continue to see my colleagues show up and try to do the right thing in spite of the obstacles we throw at them, the hurdles that they constantly have to jump.”