In December 2025, Annals of Internal Medicine and the American College of Physicians held a panel discussion on health-related misinformation and disinformation. The panelists, physicians with expertise in clinical care as well as communication, were tasked with discussing strategies to use with patients who express misinformed views and make decisions about their health based on those viewpoints.

“The most powerful current threat to public health is not an infectious disease or climate change,” wrote Christine Laine, MD, MPH, editor-in-chief of Annals of Internal Medicine, and coauthors in an editorial commenting on the panel discussion. Rather, “it is the rampant spread of health-related misinformation and disinformation.”

Laine, a professor of medicine in the Division of Internal Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, told Medscape Medical News that although there are many definitions, “misinformation” tends not to be intentional, unlike “disinformation.” 

Darilyn Moyer, MD, executive vice president and chief executive officer, American College of Physicians, noted that health-related misinformation and disinformation aren’t new, “Smallpox was one of the deadliest infectious diseases in human history. When the vaccine was first developed by Edward Jenner, who was inoculating people with cowpox because it was noted that milkmaids were protected from getting smallpox — many people were told they would turn into cows if they got the vaccine,” she told Medscape Medical News. Today, social media has “accelerated the emotional contagion of false information — especially during COVID.”

Addressing this problem goes beyond presenting accurate information, said Moyer, an adjunct clinical professor of medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, who moderated the program. “It’s a matter of heart and mind —meaning, you can’t overwhelm people with data. You need to speak from the heart.”

Clinical Vignettes

The panel consisted of three experts: Helen Burstin, MD, MPH, a general internal medicine physician and the chief executive officer of the Council of Medical Specialty Societies; Kimberly Manning, MD, a general internal medicine physician in the Department of Medicine, Emory University School of Medicine, Atlanta, and vice chair of Community Engagement; and Megan Ranney, MD, MPH, an emergency physician, researcher, and dean of the independent Yale School of Public Health, New Haven, Connecticut. Ranney is also a professor of public health and a professor of emergency medicine at Yale.

The discussion focused on three vignettes.

• Vignette 1: A 70-year-old woman with type 2 diabetes, chronic obstructive pulmonary disease, and obesity refuses influenza, COVID, and respiratory syncytial virus vaccines, accusing the physician (with whom she has had a 3-year relationship) of not “keeping up with all the new information about the serious side effects of vaccines.”
• Vignette 2: A 32-year-old woman with a history of migraine headaches, who is nearing the end of her second trimester of pregnancy presents to the emergency department with a severe headache. When acetaminophen is recommended, she refuses to take it, concerned that it will cause autism in her unborn child.
• Vignette 3: A 60-year-old man with a history of hypertension, hyperlipidemia, and myocardial infarction is following all lifestyle and pharmaceutical recommendations for secondary prevention except for taking statin drugs. His total and low-density lipoprotein cholesterol and triglycerides remain elevated. He says statins can “ruin” the brain and muscles, so he takes supplements recommended by a naturopath instead.

Investigate Your Biases

Manning recommended dealing with these patients by first “checking your biases.” And if you work in an environment where your patients have limited health literacy “you can ask yourself, what if some piece of what the patient is saying is right?”

The more open a physician can be to the patient’s lived experiences, and those of the patient’s family, friends, and culture, the more helpful the physician will be in attempting to bring a different perspective to the patient.

Manning also suggested investigating one’s own feelings when accused of not being up to date on recent data. Do you feel hurt, frustrated, or defensive? “I check in with me,” she said. “I have to make sure I’m in the right space to answer the [patient’s] question.”

“I make sure I sit down, slow my actions and not feel rushed, which the patient might see as passive-aggressive, patronizing, indifferent, or paternalistic. This makes people feel bad and can destroy the [therapeutic] alliance — particularly in vulnerable populations.”

Maintain Connection and Respect

Manning suggested acknowledging the patient’s self-advocacy — for example by affirming that the patient in vignette 1 is advocating for themselves around vaccines. This leaves the door open for further engagement.

Asking open-ended questions is a good starting point, according to Burstin. “Listening is caring, so don’t close the conversation.” Appreciating that the patient’s openness is a “gift” further facilitates the conversation. “This replaces judgment with connection,” she said.

She also recommended echoing back what you’ve heard the patient say, asking permission to share information, and looking at resources the patient might bring to your attention. This approach removes pressure and shows respect.

Setting and Relationship

The panelists noted that the clinical setting and the duration of the physician-patient relationship are relevant. In vignette 1, the physician has an established relationship with the patient. “Chances are that this patient might know that I have two sons in college, just as I know how many grandkids she has, and she might know that I went to a Beyonce concert,” Manning said.

She recommends “leaning into that lived experience, if it feels comfortable.” That type of rapport can lead to a different type of sharing when you present data supporting vaccines. “It might be reasonable for me to tell her about my mother receiving these vaccines. I can then say, ‘If this was your mama, and she read what I read, what would you tell her?’” When you share your own experience, your recommendations often resonate with patients.

Manning acknowledged that disclosing information about your life or health with a patient is a “very personal decision” that depends on the patient and the physician’s comfort level. But even without personal sharing, knowing the patient can help inform the conversation so it speaks to the patient’s life circumstances, goals, and values.

By contrast, vignette 2 occurred in the emergency department, where the physician had no prior relationship with the patient. Personal sharing may be appropriate in this setting too and may be part of “creating a human connection,” Ranney said. For example, she might tell the pregnant patient that she’s also a mother who remembers the questions and fears she had during own pregnancy.

After a bond has been established, try to understand the patient’s goal: is she here to obtain headache relief or to be reassured that the headache doesn’t pose a serious threat to her pregnancy? Once that’s been clarified and you’ve determined that the headache really is her typical migraine, you can offer her choices that are safe for pregnancy and present data. For example, although some data suggest an association between acetaminophen use and autism, association is not causation. The conditions that cause fever or pain (which are the reasons people take acetaminophen to begin with) can also cause fetal anomalies.

Ranney reminded listeners to “document the discussion, since unfortunately, no one can ever guarantee that a pregnancy will be normal, and it’s important to keep medical malpractice in mind.”

The panel also recommended advising the patient to follow up with her obstetrician or neurologist and providing some reliable sources for the patient to obtain evidence-based information.

Language Matters

Moyer cautioned against using the word “misinformation” when speaking to patients, because some may perceive it as a way to categorize them negatively.

The panelists agreed. Ranney said patients may feel the physician is implying they “aren’t smart enough to know what’s real and what isn’t.” Instead, try to determine why a particular point of view has salience to the patient. “Don’t get into a face-to-face, full-on argument with a patient, family member, or member of the public,” she emphasized.

Moreover, the word “misinformation” may imply that the physician is “certain,” when scientific knowledge is continually evolving. Burstin said, “Some patients may see this as inconsistent, but it’s crucial to explain to them that this is actually a good thing.”

She added that when addressing the statin-resistant patient in vignette 3, “there’s so much to congratulate him on — he quit smoking, he lowered his alcohol, he exercises and has done almost everything right.” His success is a good place to start the statin conversation.

Motivational interviewing can be a helpful strategy in “debunking” patients’ misconceptions and in fact is a cornerstone of communication in clinical care, Burstin said. This process involves asking why the patient is choosing to follow a path that differs from the one the physician is recommending while acknowledging the patient’s beliefs and then sharing evidence that supports the physician’s advice, if the patient is receptive.

One important aspect of debunking misinformation, according to Burstin, is explaining to the patient that many sources of health-related information are unreliable. For example, artificial intelligence is often inaccurate. Some entities may intentionally mislead the public for financial gain, disseminating false claims about products. Helping to cultivate curiosity and even sow seeds of doubt about current beliefs may set the stage for the patient to be more open to receiving information from reliable sources.

Time Constraints

The panelists acknowledged that dealing with misinformation is often hampered by time constraints. The strategies “sound lovely in this idealistic hour-and-a-half webinar,” but in real-word clinical settings, there may be insufficient time for more than a brief intervention, Ranney said.

For this reason, “you have to choose your battles.” For example, she said, you may not be able to address a patient’s reluctance to have three vaccinations, but perhaps you can focus on one. “And if all you can do is understand why they don’t want the vaccine, but you succeed in keeping the relationship [with the patient], that’s also a win.”

None of the planners or faculty reported having relevant financial relationships to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Batya Swift Yasgur, MA, LSW is a freelance writer with a counseling practice in Teaneck, New Jersey. She is a regular contributor to numerous medical publications, including Medscape and WebMD.