Welcome to Post-Truth Medicine
DURING THIS RECENT emotional and divisive election cycle, much ink was devoted to analyzing the brave new political world we now live in, a world in which just about anyone with an audience and a platform can issue statements that are accepted as fact by millions of people, often in the face of solid evidence to the contrary.
I’m talking, of course, about the world of post-truth politics.
Two major events in Western politics, the election of Donald Trump and Brexit, the U.K.’s vote to leave the European Union, have seen the elevation of personal belief to a throne once occupied by cold, hard truth, as well as the concomitant devaluation of facts to a mere subjective haziness. It used to be that only beauty was in the eye of the beholder. Now everything is. We immerse ourselves in what we want to believe and dismiss as biased or corrupt that which disrupts the comfort and convenience of our own perception.
But this problem is not isolated to politics. As faith in facts has diminished, so too has our trust in institutions: banks, churches, the “lamestream” media. Medicine, an institution that for more than a century has been firmly rooted in a tradition of trust, stands to lose much from this post-truth environment which threatens to erode its very foundation. In fact, it is already suffering: in 2016, only 39% of responders to a Gallup poll reported having “a great deal” or “quite a lot” of confidence in the medical system.
How do we compete for hearts and minds in an echo chamber full of
voices, where the winner is so often determined by volume rather than reason?
Case in point: vaccines. There is no debate in the scientific community over the safety and efficacy of vaccination. None. And yet somehow a seed of doubt has found fertile soil and thrived in the post-truth climate. Doctors find themselves having to pit their expertise against that of 1994 Playmate of the Year (and medical hobbyist) Jenny McCarthy, offering a false equivalence to both sides of an artificially created argument when, in reality, there should be no argument. But, sadly, that is not the reality we live in.
If the scientific method isn’t enough to satisfy the burden of proof, then what is? How do we convince patients that a medication will improve their diabetes—or even that uncontrolled diabetes is harmful to them—when something they read on the Internet gets equal weight as our many years of medical training, not to mention the mountain of literature that forms the basis of modern medicine?
How do we compete for hearts and minds in an echo chamber full of voices, where the winner is so often determined by volume rather than reason?
There’s a lot that we doctors don’t know (and we should be honest with patients when that is the case), but there’s also a lot that’s based in very credible research. I am not advocating for patients to trust their doctors blindly, but I do know that willful ignorance and anti-intellectualism are toxic to the doctor-patient relationship. We have already seen that when people embrace lies as fact simply because they want them to be true, there can be dangerous consequences. Doctors are the ultimate truth-seekers, without agenda or conflict of interest; we must be a bulwark against denialism in the post-truth era. Let’s not allow this ugly theme that is currently dominating political discourse to seep any further into our profession.
Note: A version of this article appeared on KevinMD.com on January 22, 2017.