With many people turning to social media networks for information during an urgent and often confusing public health crisis, it’s more important than ever that patients feel comfortable talking openly and honestly with reliable health experts especially when they have questions or need help. And it’s very helpful if clinicians have skills and strategies for working with patients who are confused, misinformed or distrust medical advice.
Communications expert Brian Southwell, PhD, has found that many physicians are uncertain how best to work with patients who are generally skeptical or hold false or inaccurate beliefs. Most physicians lack training in how to redirect and influence such patients, and even if they did, time is always short. Telling a patient that they’re wrong and giving them the “facts” may seem efficient but is rarely successful.
Southwell is co-director of the Program on Medical Misinformation at the Duke Center for Healthcare Safety and Quality. In a recent paper and interview, he offers analysis of the current information environment and advice for clinicians about how to engage in these sometimes difficult conversations with patients. He says, “The real key is listening,” and points out that patients who reveal their thoughts are showing their trust.
Southwell encourages physicians to approach these conversations with empathy and humility. He recommends listening to the patient to gain understanding. Is there something in the patient’s values or circumstances that’s contributing to the misperception or leaving them vulnerable to misinformation? Is financial pressure driving a patient’s decision-making? Has a previous medical error caused fear and cynicism? Is our country’s history of racism and health inequities contributing to misapprehension and distrust, for example of the COVID-19 vaccine? In all cases, it is better to offer empathy as well as informed, alternate advice and decision-making aids than to discredit the patient’s sources or intelligence.
At this time, many patients may feel inundated with conflicting advice, and clinicians, too, are wrestling with uncertainty as knowledge of COVID-19 quickly evolves.
Commenting on Southwell’s article in JAMA, David Stumpf, M.D., Ph.D., says the pandemic:
…reminds us that the art of medicine is often the “art of not knowing.”…Books and experts do not have the answers. This uncertainty requires humility, an open mind, exploration, and actions without full understanding. The most important action is listening to and observing the patient.
The success of those conversations depends on trust. Personal trust provides the opening that can successfully bridge information gaps and influence behavior. Trust is not a quick fix but can deliver long-lasting benefits.