The Occasional Perspective - 8/29/25

Opinions and Reflections

Considering What We Can Do In Gaza – Over the years, I’ve been a supporter of Doctors Without Borders (DWB), an organization that responds to health care needs and problems all over the world. I received a letter, actually – one of multiple mailings, asking for support. Given the needs that are clearly evident in Gaza due to malnutrition but, also because of the needs worldwide, I wanted to pass along some information contained in the letter. About 45% of the deaths in children under five are related to malnutrition. In addition, when children are malnourished, the immune system becomes impaired thereby increasing the risk of death. Here are some of the important points made by DWB in their request for assistance – which represents the worldwide commitment (I don’t have the Gaza specific information at this point):

• DWB has treated 3,724,500 cases of Malaria
• DWB has provided 4,623,700 routine vaccinations
• DWB assisted 337,000 births, including cesarean sections
• DWB provided 16,459,000 outpatient visits
• DWB admitted 499,500 children to outpatient feeding programs
• AND, the list goes on…

Furthermore, 96% of their funding comes from “individuals” with 2% from corporations and 2% from foundations plus 87% of their funding is allocated to program activities like the ones mentioned above. I realize there are lots of ways to “make a difference” but having considered and examined all of the health care programs that exist, I believe Doctors Without Borders is one of the best. In fact, they received the Nobel Peace Prize back in 1999 for all of their work – which continues to date!! In fact, if I were a bit younger and more up-to-speed on my clinical side, I would want to join them. But, I’m getting a bit long in the tooth. They are working the front lines and need our help. Consider it…

The Explosion of Health Care Misinformation! – In the last couple of years, there has been an explosion of sorts related to health care misinformation. It’s a relatively recent but rapidly accelerating phenomenon that is being driven by interface of several issues. First, there’s the increased reliance by the general public on “influencers” who promote themselves as experts on any number of issues. In fact, some are experts, but many are not! Then there is the use of technologies like ChatGPT, OpenAI, Google, etc. as the source of information. And, in addition, there’s been an obvious decline in trust of traditional health care resources like physicians, the information they provide to their patients, hospitals, and other health institutional information resources. Here’s a look at the details:

• Ubiquitous Access to Social Media – First, there are very low barriers to publishing on the web. Information is often shared instantly by anyone without fact-checking. Second, is the use of algorithm amplification. On many of the platforms (e.g. Facebook, Instagram, etc.) amplification techniques that create an emotionally charged or sensational statement about some health issues are used to promote the content which drives engagement. Engagement drives revenue! And, there are also the Echo chambers that get created where social media “filter bubbles” reinforce preexisting beliefs which reduces the information exposure to corrective information by the individual browsing the internet.

• Declining Trust in Authorities – Whether we like it or not, those of us who are the professionals in the health care sphere are experiencing a decline in trust. There is skepticism toward public health agencies, medical professionals, and mainstream media. Just witness the impact of our newly ensconced Secretary of Health and Human Services and his unwarranted, inaccurate observations related to vaccines that are clearly NOT supported by science. Rather than a reliance on science, we are witnessing a reliance upon opinion but not just any opinion. Rather, it’s opinion that supports a pre-existing perspective. Such approaches diminish the data, rigorous scientific analysis, and the role and authority of the professionals. And, the approach is creating polarization on many different fronts.

• Complexity and Rapidity of Evolving Health Information – Science – up to this point – has been evolving rather quickly (NOTE: We shall see what happens with dissolution of NIH funding related to health care research over the next couple of years). The difficulty is that there are often technical nuances related to the information that is often simplified for public consumption.

Beyond these three problems, certain common themes are evolving related to health misinformation, including:

• Conspiratorial Framing: In the current environment, it is especially easy for an “influencer” to suggest a hidden agenda by the government, the pharmaceutical industry, medical institutions, or even the professions.
• Miracle Cures and Quick Fixes: One-off answers to complex problems are often presented in addition to the advocacy of certain supplements, fad diets, or other untested therapies.
• Misinterpretation of Legitimate Research: It’s not uncommon to see information that is taken out of context or derived from preliminary findings without recognition of the specific context, and exaggerating the implications by the “influencer” or simply passed along by an unsuspecting reader.
• Fear-based Narratives: This is an increasingly common problem with the overstatement of risks related to vaccines, medications, or procedures; and,
• Cherry-Picking Data: Increasingly, we are seeing that isolated studies, anecdotes, or research studies that have not been reviewed for scientific validation that fit a specific, desired narrative of the individual are distributed and spread on the web while simultaneously ignoring broader evidence.

The end result of these problems is that we are seeing evidence of public health risks such as lower vaccination rates, delayed treatment, or – in some cases – use of harmful remedies. The erosion of trust makes it much more difficult for health authorities to provide appropriate care for people in need of services. And, the impact on policy is an evolving and dangerous result driven by politics rather than science.

So, what should we do? It’s seems that there are several mitigation strategies that need to be deployed by the health care system, including: (1) Proactive Communication with clear, timely, transparent messaging from trusted voices, (2) Digital Literacy Education by proactively teaching people to evaluate sources and claims critically – one of the most difficult tasks we face in solving this problem, (3) Requiring Platform Responsibility by establishing policies that require web sites to manage misinformation and deplatforming chronic offenders, (4) Deploy Rapid Response Systems by creating mechanisms for fact-checking and the debunking of emerging falsehoods before they spread widely.

Long story, short – we’ve got our work cut out for us!! Managing the web is yet another aspect of providing quality health care. From my perspective, it cannot be done solely by individuals. Rather, it will require the involvement of the professions and the institutions. In the current environment, there does not appear to be a clear course that we could take. But the issues need to be addressed. Somehow, we need to mobilize the professional and institutional organizations to take on this important, evolving role.   

The Passing and Lack of Listening– You may have seen the notice on Substack of the passing of William Webster at age 101. He is notable as the only individual in the history of the United States to have held the lead position at the Federal Bureau of Investigation (FBI) and the Central Intelligence Agency (CIA). He sent a letter to Congress during the hearings where Kash Patel and Tulsi Gabbard were evaluated by the Senate Committee. His letter to the Members forewarned us on the implications of their appointment to those positions.