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Doctors Should Also Be Fighting
“Fake News”

I see them every time I wait in the inescapably long lines at grocery store. They’re offering me so much. Fat-melting foods that “work like gastric bypass.” Sleep masks that prevent breast cancer. One day diets. And, of course, the perennial “medical miracles.” All these revelations can be mine with a simple magazine purchase.

It’s easy to dismiss the medical advice being propagated through the supermarket checkout aisle. Who would take health advice from a magazine sitting next to a box of Snickers and the National Enquirer? This visceral elitism, however, is causing doctors and scientists to miss out on a powerful avenue for improving people’s health.

Mainstream health advice was “fake news” before it had a name.

It has remained rampant and popular because doctors have refused to engage with the popular press, except for their own profit. When we reject bringing our ideas to the most unpretentious of media outlets, then only mercenaries like Drs. Mehmet Oz and Andrew Weil adorn the covers of these rags. We cannot always stop quackery from being disseminated, but we can drown it out with accurate and nuanced information.

So here’s a challenge for my scientific and medical colleagues: publish your next article in Woman’s World. Or maybe in Family Circle, Real Simple, or Glamour. These magazines, and others like them, have circulations of over 1 million readers. If we insist on publishing medical knowledge only in obscure journals that are read by a few of our colleagues, we are ceding the public conversation to people without the appropriate experience and intentions. University press offices have started to aggressively “fill the gap” in health news. However, relying only on press offices to promote our work to the public allows these large organizations to prioritize their own success and aggrandizement above the public’s health. Effusive reports about preliminary trials and mouse studies contribute to “fake news” rather than counter it.

Academics are well aware of the flaws of modern peer review and journal publication. Except for a handful of high-impact journals, most articles are read only by the editors, the author, and their grad students. We publish in peer-reviewed journals because that’s what it takes to be taken seriously. Academic promotions are tied to journal publications. Scientific ideas are only considered “legitimate” if they appear in the academic press. The widely-recognized importance of citation counts and impact factors make it clear that journal articles are a fiat currency in academia as much as they are about the spread of scientific research. Predatory journals have exploded in the modern era to profit from manipulating this currency.

The value of peer-review and specialized conversation should be not dismissed. Sure, only a dozen people will read your article, but sometimes they’re the “right” dozen people. The peer-review and journal system should be improved, not destroyed. However, by showing we are willing to publish outside of academic publishing’s cultural hegemony, maybe academics can take back some of their power from journals as arbiters of scientific and medical knowledge. This exercise also offers us valuable practice in communicating our ideas not just to the people who study them but to the patients and citizens who will be directly affected by them.

The Woman’s World challenge isn’t just for our benefit. It’s also for the benefit of everyday people who crave medical information and use the convenience of the popular media to receive it. Too many people today still lack the access and financial capacity to receive all the medical care and education they need. Too many health resources target wealthy, educated patients, rather than reaching out to every community that needs this knowledge. I dare say that there may even be a hint of sexism at our dismissal of “women’s” magazines as an influential medium for the public good. The intelligentsia’s surprise at Teen Vogue’s quality reporting is emblematic of this mild chauvinism. Since academics, doctors, and other professionals still equate exclusivity with value, I am challenging us to try populism on for size.

I call this a challenge because I recognize it’s not an easy transition from journal to supermarket broadsheet. These magazines frequently promote sensational and unproven health ideas, and we don’t want our ideas associated with this stigma. We have a situation right out of a game theory textbook: we would all benefit from improving the information in the popular media, but no one wants to take the risk first.

The style and connections required for mass media publishing are separate from those needed for academic publishing. It can be scary to start from square one. There have been some admirable attempts to help doctors and academics break into this world. The OpEd Project supports academics who want to publish in the mainstream media. The Conversation publishes syndicated articles by academics. For years, Health News Review has been taking the mainstream media to task for poor health reporting. We need all the support we can get as we strive to communicate our ideas in an appealing, clear way.

Now let’s take another small step. We can improve the public’s health by asking every doctor and scientist to complete the challenge of submitting one article or idea to a mainstream publication. Patients should be encouraging their doctor to write for their local paper. Magazines should be reaching out to respected doctors and academics who remain “undiscovered.” We can have a tremendous impact if we start to think beyond impact factors.

Benjamin Mazer, MD is a resident in pathology at Yale-New Haven Hospital. His views are his own and don’t represent those of his employer.

5 replies »

  1. PJ gets it right. The mass magazines want flashy stuff. Most of what is in our journals will be of no interest. Having access to good information via good PCPs is a start. However, there are other things we can do. It would be good if we had more physicians with good writing skills who could write for the more popular magazines. What you mostly see in these are “medial writers”. Some of these are good, and many are well intentioned, but a lot of times when you read an article that pertains to your specialty you wonder what the hell they are writing about. It also helps, I hope, to have more involvement in the community. Our network does a number of outreach programs, including docs and nurses being involved in Q and A sessions. Several of us are involved in our local churches. The wife and I (she is a former pediatric researcher and physician) do that for our church and several of my staff do that at theirs.

    Sadly, I think that one flashy article in a popular magazine or a bit on cable news touting the new “cure for cancer” or “vaccines are bad for you” will still have a big impact. Snake oil salesmen are actually pretty good at what they do. When people want to believe something you can’t stop them.

    Steve

  2. I think we need to redefine fake news here

    And look at it more broadly. There are literally thousands of sources on the internet offering health and medical advice .. Doctors need to keep an eye on the things they’re hearing from patients and politely apply a dose of reality

    At the same time, I’d recommend keeping an open mind

    Not all alternative medicine is fake news and a willingness to listen can go a long way in establishing good relations with patients

    I’d suggest keeping an eye on the trends in your specialty

    If you’re a generalist, this can be challenging but still manageable

  3. Announcing the next “new cure” sells magazines. Facts about sleep, exercise, and nutrition do not. Back in the 1950+ era, the health spending process was driven by the appearance of many “cures.” Given the over-all scope of Unstable HEALTH, there was a growing, unrealistic, belief that the next cure was just around the corner. Even now, fund raising events continue with the mantra of “Finding the cure for X-Y-Z” . Many people are disappointed with their health care when a cure is not possible, even though the illness may be otherwise a relative innocuous “disruptive event.” The search for herbs, unique mega-vitamin combinations or special diets continues to attract many people who are dissatisfied by the health priorities of their healthcare industry. ‘Fake news’ has never been limited to politics.
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    The best antidote for HEALTH related fake news is a caring relationship with a source of Primary Healthcare that is equitably available to each citizen, community by community. In the midst of healthcare reform and unlike all the other advanced/developed nations, our nation does not have a means to implement this standard by locally driven collective action involving each community’s stakeholders. Since 1914, the agriculture industry has had its Cooperative Extension Service for each county or group of counties. Remember this industry is the most efficient and effective among the the world-wide advanced/developed nations. A mirror process for healthcare does not exist and our nation’s healthcare is the least efficient and, for maternal healthcare, is almost the least effective.
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    The Design Principles for managing a common-pool resource have already been validated by Nobel Prize winner Elinor Ostrom. We only lack the will to start a comprehensive basis for healthcare reform. Given collaboration, transparency and trust, the occurrence of “fake news” will become irrelevant in the face of renewed HOPE about each person’s HEALTH.