Medicine under attack: How physicians can help their patients navigate the disinformation age

Health and Human Services Secretary Robert F. Kennedy Jr. has cut federal health care staff and research funding, swapped out members of the Advisory Committee on Immunization Practices, and continues to entertain claims about potential harms of vaccines, medicines such as acetaminophen, and fluoridation in water.

Meanwhile, physicians affirm medical misinformation — that is, inaccurate information, and disinformation, inaccuracies disseminated intentionally — are influencing patient inquiries in the examination room and possibly their behavior toward health for themselves and family members.

From the top down and from the examination room up, it feels like the spirit of inquiry, scientific research, and reasoned debate about health and policy are devolving into a war on medicine in the United States.

“Grim, is how I would describe it,” said Paul A. Offit, MD, director of the Vaccine Education Center and professor of pediatrics in the Division of Infectious Diseases at Children’s Hospital of Philadelphia. “I think science is under attack, I think science is losing its place as a source of truth. People are simply declaring their own truths, including people in prominent positions of leadership.”

How did we get here?

The COVID-19 pandemic shed new light on the role of vaccines in health care and policy. The current wave of medical skepticism is rooted at least partly in claims linking the measles-mumps-rubella (MMR) vaccine to the development of autism in the 1998 study published in The Lancet, and since retracted. The paper, led by physician Andrew Wakefield, still resonates, although major medical organizations and the advocacy group Autism Speaks have refuted it. Wakefield lost his medical license in the United Kingdom in 2010.

“Unfortunately, what we saw was decreased MMR vaccine uptake that hit especially hard the U.K. and parts of Europe, and still to this day, we see this question and concern about whether the MMR is associated with autism,” said David Higgins, MD, MPH, MS, a pediatrician and assistant professor at University of Colorado Anschutz Health. “The Andrew Wakefield paper and concerns about the MMR vaccine and autism is a really good example of how a falsehood, and in this case, a fraudulent falsehood, takes hold and perpetuates now decades later.”

Since then, the United States has been roiled by health care-related crises that have helped perpetuate this environment: the fight over the Affordable Care Act of 2010; the COVID-19 pandemic; the U.S. Supreme Court’s Dobbs v Jackson decision of 2022 that returned abortion regulation to the states.

Now, in 2025, Kennedy serves as a top adviser to President Donald J. Trump and leads the effort to Make America Healthy Again. Kennedy, Trump and Congress have faced harsh criticism over health care policies and actions, although physicians also have praised the administration’s efforts to reform prior authorization and make prescription drugs more affordable. And doctors generally agree with the concept of a systematic approach to treat the nation’s chronic disease epidemic.

But the information environment has changed during the last 30 years. The 24-hour news cable television news cycle of the 1990s has evolved to a nonstop churn of content on people’s smart devices, and it seems like every new development in medicine or health care policy evokes fervent political reactions.

The question of science under attack in the United States is a complex one, said Colleen Denny, MD, FACOG, chief ethics officer for the American College of Obstetrics & Gynecology. Patients have more access to information but without obvious ways to understand its quality and influences, she said.

“It’s a lot more complicated to be a patient than it was 20, 30, 40 years ago, before the invention of the internet,” Denny said.

There has been an erosion in trusting only the medical establishment to give answers to medical questions. “That’s not all a bad thing,” Denny added, citing examples such as physicians not giving patients information about their care, or making it difficult to see their own medical records.

“However, there are more opportunities for patients to mistrust what physicians are telling them because of these other sources that they're weighing just as heavily as they do in their conversations with physicians,” she said.

In a survey by medical liability company The Doctors Company, 64% of physicians named misinformation on social media as their top challenge in practicing medicine. In summer 2025, The Physicians Foundation published its poll results showing 86% of doctors believe medical misinformation and disinformation has increased in the last five years, and 57% said it has had a significant effect on their ability to deliver quality patient care. This fall, a Medical Economics flash poll found more than 71% of physicians said their patients were definitely more skeptical about vaccine safety, and more than 95% raise concerns about vaccine safety during immunizations.

The situation around use of Tylenol (acetaminophen) during pregnancy illustrates why patients — and their doctors — alternate through alarm, confusion and reassurance.

The White House this year publicized Mount Sinai and Harvard findings suggesting potential increased risk of autism if women use acetaminophen during pregnancy. ACOG countered with a practice advisory reaffirming “acetaminophen remains the analgesic and antipyretic of choice during pregnancy.”

As of right now, the best practice is for pregnant patients to use the lowest effective dose for the shortest amount of time. But the experts split on the quality of the evidence.

ACOG has numerous resources for physicians and patients and AAP has issued its own recommended vaccine schedule for infants. Many doctors value the guidance apart from current declarations of the federal health agencies.

Yet, this also creates the risk of fragmented, incomplete and confusing messaging, Offit said. Denny agreed, adding that the nation needs more research generally on health conditions during pregnancy, an especially vulnerable time for patients because they don’t know who to believe.

The good news is physicians remain among the most trusted vocations in the country, according to the 2025 Gallup poll on job credibility, though the rating has slipped in recent years.

“In general, there's still a great deal of trust that patients place in physicians and that we care for them,” said John J. Kalata, DO, MS (Med), FACOFP, a family physician and second vice president of the American Osteopathic Association.

“There is a bit of erosion in science and in medicine, particularly, and I think it has to do with a lot of information that's out there, whether it's warranted or not warranted,” he said. “Patients are inundated with information, and it's very hard for them to sift through fact from myth. And I think that really does flavor a lot of our discussions in the exam room.”

The new normal — and what’s still normal

What is the best way for physicians to respond to patients who may seem convinced by medical misinformation or disinformation?

“I wish I had that answer and in a tight, complete playbook,” said Jason Goldman, MD, MACP, president of the American College of Physicians. “Unfortunately, I don’t think there is one right answer. I’ve tried every strategy, and I really have to tailor it to the patient.”

But there are reasons for physicians to feel encouraged and confident when dealing with patients. Vaccines have generated a huge amount of misinformation and disinformation, but the physicians said their peers need to remember that vaccines are one of the greatest victories for health in human history.

Discussing shots, physicians should remember: COVID-19 and flu shots present their own challenges, but overall, true antivaccine sentiment is extremely rare. Most infants get vaccinated, and the vast majority of parents and patients want shots that ensure good health, Higgins said. He cowrote the article “The Risks of Normalizing Parental Vaccine Hesitancy” because if there is a misperception about how common vaccine hesitancy is, it can have detrimental effects at multiple levels: bad decisions in the policy realm and the exam room.

Avoid assumptions

In the current environment, physicians must avoid making assumptions about patient attitudes toward vaccines, or the conversations will go nowhere, Higgins said.

“If I, as a pediatrician, walk into the room and I’m expecting every family I see is going to be very hesitant to vaccinate their child, I’m going to enter the conversation about vaccines with a lot less confidence,” Higgins said.

The better approach is to enter conversations believing the parent or patient is open to the idea of vaccinating. Tell the parent or patient that a vaccine is scheduled and you believe it is important for their health, Higgins said.

If patients have questions, physicians should answer those and use motivational interviewing methods to get to the root of their concerns. Then, asking some open-ended questions can help patients open up about their concerns and help them feel heard. Asking patients for permission to share important information can make them receptive to it, Higgins said.

The truth sandwich answer

Doctors also need to remember that an inquisitive patient is not necessarily anti-vaccine, Higgins said. When patients ask about a medical myth, offer a “truth sandwich” answer: Lead with a fact, acknowledge a claim, affirm that it is untrue, and end with a fact.

“When you sandwich that myth with truth on either side, the patient or parent walks away from that little conversation that you had with the truth at top of mind, as opposed to the myth being the thing that they focused on,” Higgins said.

A new way of speaking

The physicians agreed that doctors will deliver the best care when they are empathetic, truly listen and communicate clearly with patients. Yet, the time may be ripe for additional, formal training in techniques to speak to patients one-on-one and en masse.

The Physicians Foundation poll found 97% physicians felt highly, somewhat or fairly confident in being able to identify and correct misinformation or disinformation that patients bring to appointments. A full 40% said they were not at all confident that patients could find reliable, evidence-based information online.

Foundation President Gary Price, MD, MBA, said that difference reflects a disconnect and a call to action for the medical community.

“I think we've fallen behind in understanding how many of our patients are getting their information and what leads them to trust a source,” Price said. “And we can't just deliver them the results of studies anymore. We have to learn to communicate and meet our patients where they're getting their information, where they're placing their trust. And that's something new for the medical profession.”

Starting with medical students

For years, physicians and medical students devoted time to medical knowledge and patient care skills. Communication and professionalism did not necessarily have articulated best practices but “were sort of taught by osmosis” at bedside, Kalata said.

“In medical school, I think it's very important for schools in the first couple years of training, and then when the medical students get out and into clinical rotations, for us to really emphasize listening skills, empathy, trying to put yourself in the patient's shoes,” Kalata said. “And I think there needs to be more and more thought given to how we formalize that in our medical training, because it can't be just by osmosis and just by attaching someone to a preceptor nowadays.

“And I think we're getting there,” he added, with in-office patients and virtual patients to assess how aspiring doctors develop a humanistic approach to patients.

“Beyond that, listening skills are not automatic,” Kalata said. “Having the students really slow down and listen to patients — the mystery is in the history, really, and teaching students that is super important.”

Becoming a Google doctor

The physicians agreed it could help to take their messages to the masses online.

“We need to acknowledge that our competition is misinformation and that we have to meet people, patients, where they are. I think doing that is quite hard,” Denny said.

Techniques to develop a web presence have gotten easier, but some in medicine need an attitude adjustment.

“Historically, especially in academic medicine, we've sniffed at this form of communication with patients,” Denny said. “We call people TikTok doctors, or if people have cute little videos on Instagram or something like that, there's a sense that that's not really doctoring.”

But that’s where patients are getting health information, “so we need to be there,” Denny said

"You know, cute little videos, they're popular for a reason, and we need to figure out how to make them,” she said.

There’s another hindrance: time. Social media influencers work full-time developing content and understanding algorithms that get it in front of viewers. “To ask someone truly a practicing physician to do that, is difficult,” Denny said. While time-consuming, it also could serve as advertising, particularly for physicians in independent practice, she said.

Reaching out to the community

For physicians not ready to go viral online, Higgins described a community-based approach. Many people look to physicians as credible voices. Schools, faith communities and libraries have trusted relationships with people and could host a question-and-answer or town hall-style event with reliable and nonjudgmental information. “For clinicians who are also parents, connecting with [parent-teacher associations], youth sports leagues, and after-school programs is a natural way to build relationships and make science and health accessible in everyday spaces,” Higgins said. “I coach a competitive girls' soccer team. No, I am not always having science, health or vaccine conversations, but the parents bring up these topics with me because they know me as both coach and pediatrician.”