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Recently, Quincy Harberger, MD, found himself discussing cardiovascular disease with his uncle. His relative, in his seventies, had been hospitalized for a stroke and received a stent. Several days after his release, his uncle felt better and began questioning his treatment plan. He asked Harberger whether he really needed the stent and the four new medications he’d been prescribed. 

“My uncle is a very independent, self-determined guy,” said Harberger, a family medicine practitioner and co-founder of First Cap Care. As a patient, he felt disturbed that no one had asked for his input on his medical plan. He was also wary of pharmaceutical companies and had read online that the new medications could cause bleeding and liver damage.

“What he was saying didn’t make any sense,” Harberger said. Still, he validated his uncle’s feelings. He told him he was right about one aspect: Being on several medications simultaneously can create chemical reactions that can be bad for you. Then he explained how stents work and why they can be lifesaving, using the analogy of a clogged sink. “Oh, so it’s like plumbing,” his uncle said. “I get this.” He took the medications.

Ethically, doctors generally shouldn’t treat family members. But what happens when you see them misinterpreting/dismissing good information or embracing bad information in plain sight?

It’s Dr Google…and Dr TikTok and Dr GPT

Fielding medical questions from loved ones “is a side effect of being in healthcare. It’s par for the course,” said Jessica Gold, MD, MS, chief wellness officer for the University of Tennessee (UT) System, associate professor of psychiatry at the UT Health Science Center, and author of a memoir, How Do You Feel? In medical school, “nobody teaches us how to publicly address misinformation. We learn how to establish rapport and share bad news with patients but not how to tell your family they should not be doing something.”

Because relatives have their own doctors, navigating these conversations is inherently complicated. It’s become even harder with the rise of health disinformation on social media. There’s now a greater chance that loved ones will learn about and consider an ill-advised or even harmful approach. Yet mentioning your concerns or challenging their decisions could cause a family rift or even end a friendship. 

The decline of trust in medical expertise hasn’t helped. “People think they don’t need a doctor because they have Google and, God forbid, the answer you give is different,” said Paul D. Burcher, MD, PhD, residency program director for the Department of Ob/Gyn at WellSpan York Hospital in York, Pennsylvania.

“I am 62, and the first 20 years of my practice, the number of times a patient would question what I would say, I can’t even remember,” said Burcher. “Now, I live in a conservative town where we’re seeing a 50% refusal rate for the Tdap vaccine during pregnancy.”

Hearing this type of hesitancy from a family member or close friends can be even more disconcerting. “None of us want to treat family members,” said Gold. “But we also have good knowledge, which is better than letting them go down rabbit holes.”

“I am frequently the first person my friends and family turn to when they see something ‘revolutionary’ on their social media feeds,” said Brandon Richland, MD, a plastic surgeon with practices in Orange County, California, and Las Vegas, Nevada. “It is a constant challenge to navigate these conversations without coming across as the clinical wet blanket at a family dinner.”

So how can you correct misinformation without turning holiday gatherings into battlefields and your best friends into your enemies?

Listen, Don’t Lecture

“The way I would deal with a family member is the same way I would deal with a patient,” said Burcher. “Let them speak and don’t interrupt them. The last thing you want to do is attack them and tell them why they are stupid, even though that’s what you probably want to do. Attacking them will harden their opposition.”

After you’ve heard them out, “affirm what you can affirm from what they said; there is going to be something,” said Burcher, who takes this approach with patients concerned about, for example, the risk for Guillain‐Barre syndrome from the COVID vaccine. He tells them the risk is very low but acknowledges it is “not zero.”

Richland learned the importance of listening and affirmation the hard way. A close relative of his had read on an online wellness forum that daily doses of Ginkgo biloba and ginseng could “clean the arteries” and improve circulation more effectively than the prescription blood pressure medication they had been taking. 

When they told Richland they planned to try this strategy, Richland immediately responded with data and warnings about bleeding and stroke risks. “I unintentionally made them feel foolish for their beliefs. Their reaction was immediate defensiveness. I was accused of promoting big pharma and overlooking more ‘natural’ remedies. It felt like a door slammed shut.”

His relative ended up taking the supplements for several months. Only after their annual exam — when they learned their blood wasn’t clotting properly and their blood pressure was still “dangerously” high — did they return to their prescription medication.

Since then, Richland tries to validate people’s feelings, explain the medical perspective in plain terms, and then gently redirect their approach. When one of his close friends told him they were considering an at-home plasma pen, which has been trending on social media, Richland refrained from immediately citing the scarring risks. Instead, he asked what result they wanted.

When he learned they wished to tighten the skin around their eyes, he told them he’d performed reconstructive work on patients who’d burned and scarred themselves with these DIY devices. He walked them through the anatomy of the eyelid skin and suggested a professional-grade alternative like microneedling.

“Because I validated their desire to look refreshed and explained the why behind the danger, they felt empowered rather than corrected,” he said. “They opted for a professional consultation instead, and their results were fantastic and, more importantly, safe.”

If your loved one disagrees or won’t listen to your advice, try not to get angry, Burcher added. “Once you respond with anger, you shut down the conversation. Any sign you are getting prickly is only going to push them away…. It’s hard, but you can’t force people to do things.” Of course, that’s easier said than done, especially when family and friends are considering an approach that could cause harm.

Remember Your Own Mental Health

Nadia K. Sirdar, MD, MPH, who owns Bethesda Modern Primary Care, a direct primary care practice in Bethesda, Maryland, still wonders if health conversations she had with two formerly close friends negatively affected those relationships. 

Seven years ago, before GLP-1s became a common weight-loss strategy, two of her friends, who neither had overweight nor were her patients, asked her to prescribe them the drugs. Sirdar politely declined to do so, and then sent them a group text with articles on GLP-1s and her recommendation to “hold off” until more studies became available.

One friend ended up receiving a different type of weight-loss medication from her primary care physician, whereas the other ordered a GLP-1 online without a prescription. She guiltily confessed to this when Sirdar mentioned her weight loss.

“This felt like maybe the beginning of the end,” Sirdar said. “I can’t divorce my identity as a physician from my identity as a friend. I felt like, ‘you are these brilliant and accomplished individuals…leaving evidence by the wayside.’” When science underpins your profession (and often your identity), a loved one disregarding the data can offend and disappoint. It might also reveal a major discrepancy in values, which can be a sticking point in relationships.

Sirdar said she “had to do this internal work and tell myself that I don’t have control over my friends. As a human, you give your sincere advice and hope they take it.”

These talks can tax relationships and take a personal toll. “It is a complex emotional landscape. There is a baseline of anxiety because I can generally foresee the potential [surgical] complications in my mind’s eye, the infections, the scarring, the vascular issues,” said Richland.

There is also a sense of playing dual roles, which can be an internal struggle. “It is hard to be ‘just a friend’ or ‘just a son’ when I have this specialized knowledge that someone I love is ignoring,” said Richland. “I feel a heavy responsibility to protect them, yet I must manage the frustration of being sidelined by a 30-second viral video.”

It takes a great deal of emotional restraint, Richland said, “to keep my voice calm and my approach curious when every clinical instinct I have is screaming, ‘JUST DON’T DO IT!’”

Sirdar was right to let go, said Gold. “They are adults…and it’s about acceptance. There’s only so much you can do and a limit to how many times you can say something. At a certain point, you can say, ‘I have talked to you about this before but won’t anymore to preserve our relationship,’” Gold added. It’s a choice that may also preserve your own mental health.

And keep in mind: Even if your loved one is resistant, your words might have made an impact. “The person might need to think about it a little bit, and maybe they’ll come back to you with a couple more questions,” said Burcher. “Don’t assume you will change someone’s worldview in one conversation. This takes work.”

Going into a conversation like this, accept that it probably won’t be easy. Offering knowledge and help while respecting a loved one’s autonomy can feel like a balancing act. But finding the tone that can reach someone you love and protect their health is well worth it.

All experts declared no competing interests.