Docs judge patients' beliefs in medical misinformation

A recent report from Stevens Institute of Technology is shedding light on how the industry's medical misinformation problem can affect the patient-provider relationship.

The report, published in the journal Medical Decision Making, showed that patients fear that their doctors will judge them harshly if they express an incorrect medical belief, and for a good reason. In a survey of 200 physicians, the research team found that doctors negatively view patients who believe incorrect medical information.

"People worry about their doctors looking down on them -- and it turns out that's an entirely rational concern," Dr. Samantha Kleinberg, the lead researcher on the project, said in a statement. "Our study suggests that doctors really do judge patients harshly if they share information or beliefs that they disagree with."

Kleinberg and colleagues assessed how belief in medical misinformation affects the patient-provider relationship by surveying three groups of people: patients, patients with a chronic illness and physicians. The survey questions queried whether patients thought providers would harshly judge them if they held beliefs, which were ranked on three tiers of reasonable, unreasonable and conspiracy theory.

Notably, both patients with and without chronic illnesses feared their providers would judge them if they expressed an incorrect medical belief. When assessing more unreasonable or conspiratorial beliefs, patients feared greater judgment than when assessing more reasonable beliefs.

Those fears were corroborated by the physician surveys, according to Kleinberg.

We found that our subjects viewed people negatively if they held mistaken beliefs -- but viewed them much 'more' negatively if they held more unreasonable or conspiratorial beliefs.

"We found that our subjects viewed people negatively if they held mistaken beliefs -- but viewed them much morenegatively if they held more unreasonable or conspiratorial beliefs," Kleinberg said.

But it wasn't just physicians who judged patients for incorrect medical beliefs. Patients themselves said they'd judge others for their incorrect medical beliefs, a finding that surprised the researchers.

"We'd thought people who had diabetes themselves might be more sympathetic, but it wasn't the case at all," Kleinberg explained.

These findings were disheartening for the research team, Kleinberg said. Separate studies have found that it's quite easy for laypeople to encounter medical misinformation online, with popular social media websites like TikTok and YouTube having popular content that contains medical misinformation. This comes even as those same social media platforms attempt to set up guardrails to protect consumers from medical misinformation.

Indeed, laypeople do seem to try to be discerning when encountering medical misinformation, with an August 2023 KFF poll showing that very few ardently believe false claims.

Still, medical misinformation is common online, with four in 10 Americans saying they've heard a false claim about COVID-19, reproductive health or gun violence online, the KFF survey showed. Nearly three-quarters said certain misleading statements were "probably true" or "probably false," leaving an uncomfortably large gray area, KFF indicated.

The Stevens Institute of Technology researchers said it isn't a patient's job to parse true from false.

"Laypeople aren't expected to have medical expertise, so doctors often have to correct mistaken beliefs on health issues. That shouldn't be something that leads doctors to view patients more negatively," Kleinberg asserted.

But so long as patients continue to fear judgment from their providers, it might be hard for clinicians to actually correct the record. Patients who worry their clinician will view them negatively for a falsely held medical belief might not be as open during patient-provider communication. This can detract from the medical encounter and prevent clinicians from discussing important public health topics with patients.

"If we want to have clear communication between patients and healthcare professionals, we need to change the way that doctors think about patients who are misinformed," Dr. Kleinberg says. "Doctors need to overcome their tendency to judge patients, and actively encourage patients to share their thoughts -- even their incorrect ones -- much more freely than they currently do."

These findings come after the COVID-19 pandemic and the public health measures that accompanied it destroyed public faith in healthcare institutions. That, plus the heavy politicization of healthcare, has created a landscape that can easily give life to medical misinformation.

In an April 2023 Morning Consult poll conducted on behalf of the de Beaumont Foundation, physicians asserted that medical misinformation has made it harder to treat patients and has impacted patient outcomes.

More than three-quarters agreed that it's on them and their peers to combat false medical claims, but they note that it'll be an uphill battle. Patient trust and the small but loud group of physicians partly responsible for peddling false medical claims might make it difficult to dispel misinformation.

Sara Heath has covered news related to patient engagement and health equity since 2015.