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Medical misinformation swirled across social media during the pandemic, but some of it was in a class of its own: It came from medical doctors.
Doctors, of course, are just as human and error-prone as everyone else, but because they spend years studying science and how the body works, presumably they know more than average about how to interpret medical information. So why were they the sending out stuff that wasn't true?
A new study can't answer that question with any certainty, but it does try to quantify how many doctors were misleading the public, where they came from and what their specialties were.
Most surprising, perhaps, is that there were only 52 of them found in a fairly exhaustive search of social media sites.
"This was actually comforting to see that they didn't find more," said Dominique Brossard, chair of the department of Life Sciences Communication at the University of Wisconsin-Madison, who was not involved in the new study but studies medical misinformation.
Roughly 1 million Americans hold medical licenses in the United States, so 52 is a tiny fraction of the total.
It's not clear how far that misinformation spread, but once false impressions take hold, it can be very hard to change them, said John Robert Bautista, who conducts research on health misinformation at the School of Information at the University of Texas at Austin.
Misinformation that comes from doctors can be particularly damaging, he and Brossard said, because of the trust associated with medical credentials.
Even if another doctor corrects the misinformation, "people will get confused about who to believe and it's the profession that suffers," Bautista said.
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What the 52 said
According to the new study, most of the 52 sent out information that was false or misleading about COVID-19 vaccine safety and effectiveness ‒ despite tens of millions of doses delivered safely worldwide and millions of lives confirmed saved ‒ or promoted treatments that lacked scientific evidence.
A few disputed the effectiveness of wearing masks, which aren't perfect but are far better at preventing infections than wearing nothing, particularly when they're high quality and well fitting.
Some others promoted unsubstantiated claims or conspiracy theories about the government or the origins of the SARS-CoV-2 virus that causes COVID-19.
This kind of information caused real harm to people who suffered or died unnecessarily as well as to people who lost their faith in science when presented with misinformation about vaccine and drug development, said Dr. Sarah Goff, the paper's senior author.
"It was a concern about potential harm that really prompted me to get my students engaged in this study," said Goff, a primary care doctor and health services researcher at the University of Massachusetts Amherst.
Although a small percentage of people might not be able to take vaccines or have a bad reaction to a shot, there is no debate about the safety of vaccines at a population level.
"We used the scientific standards at the time we were looking at," Goff said. "If you don't trust science and you don't trust the CDC, you won't trust that it's misinformation."
The team defined misinformation as "assertions unsupported by or contradicting U.S. Centers for Disease Control and Prevention guidance on COVID-19 prevention and treatment during the period assessed or contradicting the existing state of scientific evidence for any topics not covered by the CDC."
The 52 were identified by communications they made on social media platforms between January 1, 2021, and May 1, 2022, after scientific studies had established that vaccines were safe and effective and that treatments such as hydroxychloroquine and ivermectin were not.
Goff said the study specifically refers to "misinformation," which is inaccurate information, rather than "disinformation," which is deliberately misleading information, because researchers did not try to determine the motives of the medical professionals spreading the information.
Still Brossard and several other experts in the field said information was changing so quickly during the pandemic and government messaging was often poorer than it could have been, leaving many people ‒ even doctors ‒ legitimately confused.
"The guidance kept on changing," she said. "Communication around the vaccine was horrible."
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Controlling the message
Goff said she could not speculate on the motives of the doctors spreading misinformation. Several offered telehealth visits and charged patients for providing therapies that were not supported by science, so perhaps they had a financial motive, Goff said. Some may also have earned money by growing their online presence, she said.
She and her co-authors chose not to name the 52 doctors, because they did not want to give the medical professionals more attention for their behavior. "Our purpose wasn't to call out specific people, more to call out the phenomenon," she said.
In March 2021, the nonprofit Center for Countering Digital Hate published a report finding than 12 anti-vaxxers were responsible for the majority of anti-vaccine content on social media. The report called out Facebook and Twitter in particular for not doing enough to control the false messages spread by this "dirty dozen."
It's not clear whether any one social media platform is worse than any other for spreading misinformation. They're all equally challenging, though Twitter ‒ now renamed X ‒ has been the most studied, said David Novillo-Ortiz, European regional adviser on data and digital health for the World Health Organization.
YouTube on Tuesday announced changes to its policy to rein in misinformation, particularly related to cancer treatment.
Bautista said he is particularly concerned now about misinformation spread on TikTok, a platform that largely reaches adolescents and young adults. Instead of a rapidly typed response as can be done on other social media platforms, correcting misinformation on TikTok requires someone to produce another TikTok video, which is time-consuming and may be outside the comfort zone of older professionals, he said.
There's no question that trust in government and public health officials declined during the pandemic, Novillo-Ortiz said. "We have a challenge ahead of us in how we can rebuild this trust."
He hopes for more investment in digital health literacy for both health professionals and the general public. "We are leaving people behind because we are not investing enough in digital health literacy," Novillo-Ortiz said.
Should there be consequences for doctors who spread misinformation?
That's a tricky question, all the experts said, in part because it's not always clear which facts are scientifically established and which are open to dispute.
The American Medical Association adopted a policy in June 2022 to limit medical disinformation, including ensuring that medical licensing boards can take disciplinary action against health professionals who spread health-related disinformation.
But a judge ruled in January that the state of California, where the study found the highest number of misinforming doctors, does not have the power to penalize doctors who spread misinformation or disinformation. "COVID-19 is a quickly evolving area of science that in many aspects eludes consensus," the judge decided.
Brossard of UW-Madison said she'd draw the line if a doctor used their professional standing to convince people of the accuracy of their information.
"If they use the title, you could construe that there should be consequences," she said.
As a professor, she cannot use her professional email to express a political opinion, though she can do that as a private citizen, she said.
"When does 'professional' stop and 'citizenry' start? That's something that hasn't really been defined yet and is certainly a conversation that people should have."
There's no question that mis- and disinformation have consequences for the public, Novillo-Ortiz said.
It can increase mental and physical fatigue, promote fear and panic, polarize the public and decrease the credibility of legitimate information.
"All of us play a role in fighting misinformation," he said. "This is something we can definitely do better to leave no one behind."
Contact Karen Weintraub at email@example.com.
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.
This article originally appeared on USA TODAY: Medical misinformation: 52 doctors misled public during the pandemic