Combating Misinformation in Your Physical Therapy Practice

Misinformation runs rampant through our social circles and across the entire country—and it’s little wonder why. Did you know that false news actually travels six times faster than accurate stories? Furthermore, this study found that “falsehood diffused significantly farther, faster, deeper, and more broadly than the truth in all categories of information.” Some researchers have even found that content is more often shared when it induces a strong emotional response—like anxiety or anger. 

Since the onset of the COVID-19 pandemic, faulty medical science has come to the forefront of the misinformation scene in America—and across the world. This is an especially nefarious type of false information, as it has real consequences to public health. As healthcare professionals, I believe it is our duty to do what we can to protect our patients—in this case by standing up for facts and real science. But there’s another complicating factor to consider: much of this medical misinformation is wrapped up in politics—which, due to our nation’s hyperpolarized political climate, makes it excruciatingly difficult to talk about.

Know that you’ll run into these conversations eventually. 

I often hear people say, “Keep your politics to yourself and out of the clinic.” And for the most part, I agree. I think that clinic leadership needs to clearly outline the types of conversations that are appropriate and acceptable in a practice. (Of course, any situation in which a patient is—or could be—harmed in any way is 100% unacceptable.) 

But no matter how hard you try to dodge these topics, it’s almost impossible to completely avoid them—mostly because you work in a healthcare setting. Conversations and questions about COVID-19—and thus, dubious facts about COVID-19—are bound to come up, whether they are therapist-to-therapist, patient-to-patient, or therapist-to-patient. And when they do, you can employ some of these strategies to protect not only your patients and your practice, but also yourself. 

Don’t be afraid to embrace different opinions—to a point.

There is no shortage of echo chambers in this day and age. And when you’re surrounded by people who constantly affirm your own opinions and never challenge them, you wall yourself off from opportunities to learn, grow, and make more well-rounded decisions. For this reason, I urge you not to simply reject different opinions because they don’t align with your own. It's critical that we listen to and learn from each other with open-mindedness and mutual respect.

Know your boundaries. 

That said, it’s incredibly important to know your boundaries—and be willing to protect them. I, for example, am happy to debate the merits of the PTA and OTA payment differential. I’ll listen to both sides of the dry needling efficacy discourse, and will gladly enter a discussion on the reality of healthcare equity inside of a practice or with a patient. 

But, I’ve drawn some lines in the sand based on my personal core values—lines that I will not cross, especially in a clinic or business setting. In other words, I have boundaries—and I’m sure you do too. Your line in the sand may look different than mine, but the important thing is that you know where it is and are willing to disengage when someone crosses it. It’s okay to say, “I would rather not talk about that subject. Let’s move on to another one.” 

Personally, I gave my clinic staff a scripted “out” by asking them to say, “Because of the controversial nature of these topics, we prefer not to discuss them during our treatment time in the clinic.” It’s helpful to share ways to avoid potentially sticky situations in professional settings—especially when these types of conversations add no real value to patients’ treatment outcome.

Strategize before diving into a conversation. 

Once you’ve established your personal ground rules and boundaries—or developed them as a group in your clinic—for these types of conversations, it’s time to strategize the approach. Combating misinformation is a tricky tightrope to walk; it requires finesse, patience, and a knack for keeping your cool.

Get your own facts straight. 

Everyone is susceptible to misinformation—no matter how much we’d like to think that we are not. That’s why it’s critical to fact-check your own beliefs and understandings before sharing them with others. Spreading your own brand of misinformation can tarnish your credibility—and it may be difficult for others to trust that you’re approaching them with cold, hard facts. 

To ensure that you have your own facts straight, you must first vet all your sources. To do that, start by asking yourself three questions: 

1. Is the source trustworthy?

Is the information coming from a verified expert who has intimate knowledge of the field? What are the expert’s credentials? (I wouldn’t trust a diagnosis for low back pain that came from a dentist, for instance.) Is your source a fact intermediary (e.g., a news site)—and if so, is it sharing information from a verified expert? Does your source have any conflicts of interest? 

2. Is the science sound?

If your source specifically references a scientific study, do you have access to the study—and have you reviewed it? Is the study peer-reviewed? Was the study well-designed? In other words, does it have a large sample size and a diverse set of participants? Does it account for extenuating factors that could alter the conclusion? If the study is an examination of other studies, do those studies meet these standards? 

3. Is the information framed to trigger an emotional response?

When information is intentionally framed to elicit an emotional response (especially emotions like anger or anxiety), it deserves a second round of scrutiny. When we’re overwhelmed by emotions, it’s easy to overlook factual inconsistencies and/or jump to conclusions—even though we don’t have all of the information we need. Consider these two hypothetical statements: 

• The CDC retracted its statement regarding vaccine distribution. 
• CDC officials lied to the public about vaccines. 

Both of these statements could describe the same incident—where CDC spokespeople shared inaccurate information about vaccine distribution. However, the one that’s emotionally charged (i.e., the second one) makes a lot of assumptions about the spokespeoples’ intentions. It paints them as bad actors—when in reality, there was no proof of malicious intent. Be wary when sources seem to encourage readers to feel a particular way about the information being presented. Admittedly, it is difficult to avoid clickbait—especially because search engines use algorithms to show you things that are more likely to pique your interest. So, be sure to seek out actual peer-reviewed research, reputable industry journals, and apolitical organizations in your efforts to fully understand the topic at hand.

Seek to understand.

I have to admit, using “combating misinformation” as a turn of phrase is a bit extreme. If you approach this conversation like it’s a fight, you’re setting yourself up for failure. You won’t be able to understand where the other person is coming from, and you therefore won’t be able to address the root of their concerns. When holding these difficult discussions with others, it’s critical to seek to understand why they believe what they believe—and how it fits in with their worldview. If they’re clinging to misinformation because they’re afraid, then you’re more likely to make progress by addressing that fear than by barraging them with information that doesn’t touch it at all. 

Inquisitiveness will serve you well in these situations. Ask open-ended questions like, “Why do you think that?” Or, “How do you think that’s possible?” This will help you facilitate a discussion—instead of inciting an argument. 

Don’t expect to change anyone’s mind. 

It’s hard for people to admit when they’re wrong—especially when they realize that they’ve been misled. That’s part of why dispelling misinformation is so difficult. No one wants to feel duped or like they made an unwise decision. So, don’t expect people to flip a 180 after one conversation. Instead, look for small wins. If they question one disreputable news source, that’s a win. If they disregard a single inaccurate study, that’s a win. The main goal should be providing a broader spectrum of data—and breaking the misinformation echo chamber. 

Act as a reliable medical resource for patients—but don’t push it.  

Be very cautious when entering these conversations with patients. I firmly believe that, as much as we can, PTs must take politics out of patient care. There’s no place for it when our sole professional purpose is to help our patients improve their physical function. Plus, we have an obligation to treat every patient—no matter who they are or what they believe. 

However, I also believe that as trusted medical providers, we have a responsibility to share up-to-date, scientifically proven medical information when asked. So if, for instance, a patient asks your opinion about the vaccine, you have an excellent opportunity to share the CDC’s latest information about mRNA vaccines. If that patient shares their misgivings, that could be an opportunity to share that, per the CDC, the worst recorded reaction to the vaccine thus far has been anaphylaxis—which is why protocol requires patients to stay onsite 15 minutes after vaccination. 

Just understand that you won’t get through to everyone. Some patients may be so entrenched in their beliefs that they’re not willing to listen to (or accept) any scientific information you provide. That’s okay. That’s when it’s time to disengage or respectfully agree to disagree. 

Enforce your boundaries with your peers and leaders.

If a clinical peer isn’t necessarily spreading misinformation to patients, but instead talks about it occasionally to coworkers, then it may simply warrant a private discussion. Approach your peer openly and with good intentions. Using “I” statements and sharing how the other person’s words may have affected you as a peer and coworker can be a good start. And be sure to use some of the conversation strategies outlined above: be inquisitive, but know when to disengage. 

However, if you notice that a clinical peer is spreading misinformation in a way that could negatively affect patients—especially if the misinformation conflicts with clinic policies (e.g., advocating against masks when they’re required)—then it’s best to inform a supervisor and let them take it from there. 

Don’t feel like you have to compromise your values. 

But what if leadership is unwilling to curb the misinformation spread? Or worse, what if clinic leaders are the ones spreading the falsities? 

Depending on your relationship with the leader, this may be an opportunity to have an open dialogue with them—especially if it affects an existing clinic policy. Ask them how they arrived at their beliefs (and their COVID-19 policies), and—if possible—share differing data or information. At the end of the day, you always have a choice of where you work and who you want to work for. Feeling safe, respected and cared for in your work environment is paramount for doing your best work—and ultimately, achieving the best patient outcomes. 

Know your employment standards—and hold employees accountable to them. 

As a clinic leader, you have an obligation to provide a safe work environment. If an employee is spreading misinformation and causing a disruption—or misleading patients—then you must take action to ensure they are adhering to all employment standards and company policies. If the employee is violating an existing employment standard (e.g., putting patients at risk or hindering teamwork among clinicians), then a tough conversation is in order. Outlining early what communications and behaviors are acceptable and off-limits is key to ensuring that everyone, including patients, can enjoy a safe and professional clinic experience.

Medical misinformation is spreading at unprecedented speeds—and it can distract us from our goals as PTs: treating and educating patients and helping them improve their quality of life. At the end of the day, I firmly believe we must make patients the priority—and sometimes it takes combating misinformation to do it.