The medical misinformation crisis is a doctor-access crisis
My patient Claire and I were at odds. She was 44 years old and came to my clinic for a second opinion. The diagnosis was stage 3 rectal cancer. It started with blood in her stool and quickly turned to weight loss and abdominal pain. I agreed with her previous doctors’ recommendations of surgery, radiation, and chemotherapy. She asked about mistletoe, blue scorpion venom, and infrared lamp therapy.
We spoke for 30 intense minutes, but by the end of the visit, she remained unconvinced. It was all I could do not to chase her to the parking lot. Claire, whose identifying details I’ve altered slightly to protect her confidentiality, was going to die young from a disease that was curable.
She is not an anomaly. A recent survey from The Physicians Foundation found that over half of doctors cite mis- and disinformation as hindering their ability to care for patients. Almost 9 in 10 believe it has increased over the past five years. As an oncologist and internist for a decade, I can attest to this firsthand. I can recite the latest online trends without clicking a single link. On a daily basis, I debunk “cures” peddled by wellness companies and unproven supplements pushed by social media influencers. I untangle political spin questioning routine procedures, and I reassure against hallucinating AI chatbots that jump to worst-case diagnoses.
No one has a clear solution, though most focus on the way health care workers communicate. Medical societies, hospitals, and even the Office of the U.S. Surgeon General have released toolkits and trainings to help us engage those with whom we disagree. The general principles are to listen, ask questions, and respond with empathy, not judgment.
Yet these tactics assume something conspicuously absent: a doctor the patient can actually reach. It’s not a coincidence that medical misinformation is hitting hardest as access to medical professionals has deteriorated nationwide.
The average wait to see a new doctor in the United States today is 31 days — up from 26 days in 2022 and 21 days in 2004. Once believed to be a problem of geography (rural areas) or of specialty (family medicine), delays are now a staple of American health care. I try to refer my patients to a neurologist or psychiatrist, and they’re booking into the next year. Some clinics send me back a form letter — the wait is so long they’re not even scheduling. Try again later.
This is a full-blown crisis, but it’s one we’ve accepted, normalized, and, worst of all, misunderstood. The most common explanation invokes supply and demand. There is a doctor shortage, all while patients are growing older and sicker. Yet it doesn’t quite hold up against national data. It fails to explain why it can take 231 days to see an obstetrician-gynecologist in Boston, where doctors are plentiful. Nor does it capture why patients struggle to see their regular doctors. My own patients wait three months to see me.
The truth is less supply and demand and more a profound labor mismatch, in which doctors’ expertise and patients’ needs are misaligned. Today, the bureaucratic work required to advance a patient’s care has exploded. Cluttered electronic charts generate over five hours of record-keeping for every eight hours spent with patients. Physician practices spend over a dozen hours each week on the phone or drafting letters to insurance companies. Yet the core infrastructure to provide this care has not adapted. Payment models reward assembly lines of back-to-back visits as medicine’s sole currency and compress each into 15 minutes to pack more in.
The result is a cascading failure. A typical primary care physician accumulates 2,500 patients and needs 27 hours per day to care for them. When busy primary doctors can’t do it all, they refer patients to specialists for issues they could otherwise manage. Specialists do the work of generalists; generalists do the work of nurses; nurses do the work of medical assistants; and medical assistants do the work of functioning technology. With all our time misallocated, artificial scarcity then ripples into actual scarcity. Doctors are burning out, going part-time, and leaving medicine entirely in record numbers.
While losing physicians to paperwork sounds maddeningly fixable, most ideas to improve access neglect this reality. Churning out more medical students into a system that chews them up and spits them out does nothing to help patients. Increasing residency slots is the same dead end. Deploying doctors to rural areas doesn’t solve the nationwide problem. And increasing coverage for patients is not the same as improving access; even the best insurance doesn’t guarantee an appointment.
The consequences go beyond inconvenience. Patients, desperate for help and unable to receive it from professionals, seek it out wherever they can find it. The winners are the grifters who clear the low bar of simply showing up. The losers are everyone else.
The silver lining in this story is that the opposite is also true. Consistent access to a doctor directly increases trust in facts. Surveys show that while Americans have lost some trust in medical institutions, they continue to trust their personal doctors as the top source for health information. Meanwhile, they retain a healthy skepticism for others. While over half look to social media, for example, fewer than half trust it. Put the doctor you know against the most charismatic TikToker, and the doctor will usually win. I’ve been able to coax uncertain patients into essential tests and treatments and out of depleting their limited time and savings. Often it takes more than one conversation, and some patients are so submerged in misinformation that it doesn’t work. But most are not combative; they’re grateful for clarity. They don’t prefer Option B; they settle for it when Option A is unavailable.
To tackle junk medicine, we can and should fight the external fights. When it comes to health, we can push for social media regulation, hold companies accountable, safeguard AI chatbots, and put political pressure on public officials acting as a source of untruth instead of its correction. But it’s not enough. Playing Whac-A-Mole against misinformation is a losing strategy when it will pop up in other forms. And while some doctors turn to social media themselves to insert good content into a sea of bad, it’s not the same as a relationship that adapts to individual circumstances. What matters most is a reliable home base to set the record straight.
Health care organizations must invest in creative solutions to restore the division of labor that will let doctors see their patients and patients see their doctors. Broadly, these can be bucketed into tech, team, and time. Tech: Radically upgrade the electronic medical charts to serve the user, simplifying physician workflows instead of convoluting them. Team: The same paper showing that primary care physicians work 27 hours per day estimated 9.3 hours with supportive teams, including nurses, nurse practitioners, social workers, and pharmacists. Finally, time: Expand reimbursement beyond fee-for-service to capture time spent on patient care outside the assembly-line visits, such as phone calls and patient messages. Implementing any one of these changes will help prioritize the doctor-patient relationship as the myth-busting, lifesaving antidote it is.
Unfortunately, Claire died of curable cancer. I asked her to follow up with me, but with my first available appointment months away, she continued to consult other sources. Instagram suggested cutting sugar to starve the tumor. A podcast recommended ivermectin. Politicians stirred regret over vaccines received decades earlier. I lost her to the void of poor access; quickly, it was filled. Later, I learned that amid the noise, ChatGPT said something remarkably accurate, if not wholly impractical: “You should see your doctor.”
Ilana Yurkiewicz is a clinical associate professor of medicine and an oncologist at Stanford University and the author of “Fragmented: A Doctor’s Quest to Piece Together American Health Care.“
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