When Kristin Flanary’s husband collapsed from sudden cardiac arrest at home, she called 911 and performed 10 minutes of cardiopulmonary resuscitation. Emergency Medical Services arrived, and the hospital staff worked to save his life — and did. But afterward, amid the trauma of nearly losing her spouse, one detail stood out: Throughout their family’s experience with a cardiac arrest and two cancers before that, only one medical professional ever thought to ask how she was doing.

“Trust isn’t only built through clinical competence,” said Flanary, who posts online as “Lady Glaucomflecken” and is married to “Dr. Glaucomflecken,” aka ophthalmologist and internet comedian Dr Will Flanary. “It’s built through humanity. Small choices in language, tone, and attention can make an enormous difference.”

Within that gap between clinical excellence and human connection lies real medicine. And one reason medical disinformation has found such fertile ground on social media is the lack of humanity inherent in algorithms and those who manipulate them.

“[Anonymity] lowers the cost of cruelty, harassment, and bad-faith engagement,” Flanary said. “It also makes it easier for people to spread dangerous medical disinformation without accountability.”

Some physicians have decided the fight for trust can no longer be confined to exam rooms — it has to happen on social media, where millions of people are already searching for answers, while a collection of opportunists, saboteurs, and bots wants them to believe and embrace the worst.

Why Disinformation Wins

Mikhail Varshavski, DO, known as “Doctor Mike” to his 30 million followers on YouTube and Instagram, calls the current landscape “a perfect storm of events,” with disinformation now “coming from all sides.”

How it happens: A jacked-up piece of bad info permeates social media via nonexperts posing as experts, nonhuman bots, influencers, and bad actors worldwide. The “novelty” of information makes it more attractive, according to a 2025 analysis of how disinformation spreads. Something sounds groundbreaking or contrarian or dramatic or scary and goes viral.

The problem isn’t only that bad actors have learned to weaponize social media. It’s that they’ve become better at it than many of the institutions charged with protecting public health.

“They put out something scary-sounding, and it gets 10 million views,” Varshavski explained. “And then the large health agencies come in and get 10 likes on their authoritative post.”

The gap is wide enough that it’s “the equivalent of [agencies] not doing anything whatsoever,” Varshavski said.

Flanary is especially frustrated by disinformation that comes from the people and institutions meant to protect the public. “When it comes from government leaders or federal health agencies, it carries the weight of authority,” she said. “It doesn’t just confuse people, it legitimizes doubt. It tells people, ‘You don’t have to trust evidence.’”

Varshavski agrees. “[Disinformation] is hurting people’s understanding of how science works and how physicians make decisions. When you lose that level of trust, that affects the healthcare system as a whole because it hurts our doctor-patient alliance, ruins communication when we’re talking about topics like vaccines.”

More than 100 million Americans, about one third of the population, face barriers to accessing primary care, according to a 2023 study by the National Association of Community Health Centers and the American Academy of Family Physicians. That’s nearly double the 2014 figure. What fills in the gaps? 55% of adults use social media for health information and advice at least occasionally, with higher shares among young adults and Black and Latinx communities, according to a 2025 KFF health information and trust tracking poll.

The collision of limited healthcare access and unlimited online content has created what Jen Gunter, MD, a social media-savvy ob/gyn and author of The Vagina Bible, calls “a hellscape.”

Feed the Need for Genuine Information

Gunter has spent years confronting medical mis- and disinformation, particularly in women’s health. (Note: Disinformation is deliberate, while misinformation is unintentional.) In her view, the most effective disinformation doesn’t appear out of nowhere. It exploits real problems.

“Many women have difficulty accessing care, and so there are valid concerns,” Gunter said. “But those are very easy to exploit. Instead of filling the gap, the misrepresentation or pseudoscience basically exploits known gaps, and then you’re saying words that are true, like, ‘People have been dismissed. Evidence is thin because research hasn’t been funded.’ But instead of the next sentence being, ‘We should fix that systemic problem,’ it’s, ‘I have a supplement’ or ‘Buy my course.’”

Format matters, too. Gunter notes short-form video platforms such as Instagram Reels have accelerated the problem. “Influencing is harder to do on paper, and it’s easier to do when you’re pleading with someone or talking with someone, or it’s easier to play to emotion,” she said.

A key strategy that plays on our dwindling attention spans: Front-loading the video with bad info. “With reels, people maybe watch the first 30 seconds or maybe even the first 15 and then move on, and if that disinformation is front-loaded, then that’s all that people have heard.”

Doctors who want to make legit videos can do the same thing — just front-load with the good info.

One worry: Does debunking bad information help amplify that bad information? (Which aligns with the old online advice, Don’t feed the trolls.)

Gunter rejects that. She’s adamant that presentation matters. “You need to make the good information the star,” she said. “Here’s factual information about how your body works. You might have heard blah, blah, blah, but let me tell you what’s actually correct.”

She advises patients to look for doctors who cite guidelines from professional societies. “I would really get people to vet people with the guidelines,” she said, and to be wary of anyone who insists the guidelines are always “out of date,” which she calls “a conspiracy theory.”

When in Doubt, Humanize

For Flanary, the current crisis of medical trust stems partly from a system that’s “dehumanizing by default.”

“[Healthcare] is built to move fast, document everything, minimize liability, and maximize profit. It is not built to meet people’s psychological needs in a moment of vulnerability,” she said.

When people feel dismissed or rushed, experiences that are common given how healthcare is structured, they go looking for certainty elsewhere. The second opinion (aka someone telling them what they want to hear) is a click away.

“When people feel harmed by the system, it becomes easier for misinformation to sound like rescue,” Flanary said.

This disinformation strategy focuses on physicians as a group being untrustworthy. Online, Flanary rarely engages with accusations that clinicians are lying or “bought.”

“Those comments are rarely made in good faith, and responding often just feeds the performance,” she said. When she does respond, she aims for calm transparency and relationship-building, acknowledging fear without validating the conspiracy. Humor is also a central part of “the Glaucomflecken” brand.

Remember your real audience, she says. “The real work isn’t converting the person who is accusing you. It’s protecting everyone else reading the thread who is still undecided, scared, or quietly trying to figure out what’s true.”

It’s Time to Show Up to the Fight

Varshavski says disinformation flourishes around anything tied to mortality. “People are afraid of making a decision that’s bad for their health,” he said. “And on the flip side, they want to make decisions that are going to make them live longer. So the bad actors have realized that you can weaponize both sides of the sphere through fear and ultrapromise.”

Varshavski developed a process for fighting disinformation:

Pay attention to the disinformation you’re seeing as a consumer. If you’re being targeted, other people like your patients are being targeted at high volume, he says. Awareness helps clinicians know what to ask patients and what to flag early.

Use the skills the bad guys use. To reach people where they are, Varshavski had to learn from the very people spreading disinformation. Not their deception, but their fluency with the platforms. “I realized that they’re great speakers, that they understood the platforms well,” Varshavski said. “Titling, thumbnailing, and being comedic, self-deprecating, and entertaining needed to come first in order for the medical information to land.”

Support individual creators/colleagues who are doing good work, even those who aren’t healthcare professionals. “Not everyone is going to be an influencer, and that’s okay,” he said, but this is critical: When clinicians don’t watch colleagues’ short videos to completion, they’re starving the algorithm of a signal that this content matters.

Pressure academic institutions and medical associations to show up online in a more persuasive way. “We’d like to see [them] get more involved in the social media space,” he said, warning that absence allows the information vacuum to persist.

For years, Varshavski says, major agencies treated social media as “beneath them.” Conferences and journals matter, “but we failed to realize the importance of mass communication to the general public,” he said.

The Cost of Staying Silent

Despite the blowback, these physicians see social media as essential terrain for medicine today.

Gunter calls the environment “potentially hostile,” but also “potentially excellent, informative.” She advises people to “curate and vet your feed” by checking whether doctors support professional guidelines and being wary of content that feels “super amazing” because “if there’s something that is truly groundbreaking, you wouldn’t have just heard it from a doctor on social media.”

She still receives messages from people who say her videos prompted them to ask their doctors important questions and get needed care. “That’s amazing,” she said.

Varshavski frames his presence on social media as an extension of family medicine’s core principle: “We go to where our patients are. If they’re in the ER [emergency room], we’re there. If they’re admitted to the hospital, we’re there. Nursing homes, home visits — we go everywhere. That’s the beauty of my specialty. And one place where I felt like we weren’t there for our patients was on social media.”

That’s why these physicians persist. Not because the fight is easy or the odds are favorable, but because patients are already online, already searching, and already vulnerable to exploitation. In a social media ecosystem that will always promote engagement over facts, they’re trying to rebuild trust one post, one reel, one honest answer at a time.

This article is part of an ongoing, year-long Medscape series examining the decline of public trust in medicine. More content is available here.