>> From WXXI News.

This is Connections.

I'm Evan Dawson.

Well, our connection this hour was made in the doctor's office.

A patient is nervous but clearly has something to say.

After the doctor explains a course of action, the patient jumps in and says, I was reading online that this is not the best idea.

How often does this happen?

A generation ago, very infrequently.

Today, it happens all the time.

A new survey finds that more than 6 in 10 American physicians reported that their patients have been influenced by misinformation or disinformation.

In the past year.

The problem is particularly acute in rural health care settings.

According to the Physicians Foundation.

The Rochester Academy of Medicine is launching a new series of public presentations called Demystifying Misinformation.

The first one is this coming Thursday evening.

We're going to talk to some of the people involved in crafting programs meant to try to provide more clarity and understanding and better communication in general about medicine.

Let me welcome our guest this hour, Dr.

Daniel Taramasco is a hospitalist with the Rochester Regional Health Daniel Taramasco.

Welcome.

Thank you for being with us.

And welcome as well to Dr.

Laura Whitebell.

Laura is associate professor of writing at the University of Rochester.

Welcome to you as well.

>> Thank you for having us.

>> And I think we can guess how Dr.

Taramasso got pulled into this.

But, Laura, do you want to describe how they decided to to get you in in on this series on how we communicate?

>> So I was invited because I work on misinformation.

I'm a writing instructor at the University of Rochester.

I'm an associate professor of writing.

One of the courses I teach is on misinformation and conspiracy theories.

>> Well, well.

So we've got a lot to talk about here.

And in fact, let me just look at a headline I saw this morning, and I want to ask, briefly ask both of you if you think it falls within the realm of what you're going to be focusing on this week.

Helen Branswell at STAT news, one of the leading health reporters, reports today the following quote Canada has lost its measles free status because of the long running measles outbreak there.

And with it goes the measles elimination status of the entire zone of the Americas, which had been the only division of the World Health Organization to achieve measles elimination, end quote.

How much of that story do you think is Laura, is attributable to misinformation or disinformation?

>> I would say a lot of it, yes, is attributable to misinformation.

>> Yeah.

From what we can tell, especially with the stories down in Texas earlier this year.

Daniel Taramasco what do you think there?

>> it's it's sad and it's very scary.

but yeah, the amount of misinformation, especially with relation to vaccinations, I think is, is the absolute contributor to why we're seeing this.

>> Yeah.

I mean, I don't want to overstate it, but it is it's probably fair to say it is tragic that we are losing a measles free.

I mean, measles is not chickenpox, which is, you know, not nothing either.

But I think so many people who haven't had it, me included, or, you know, communities like mine growing up kind of figured it was gone.

It was no big.

And then as time passes, you might convince yourself, well, it's no big deal.

Or maybe I was misinformed about this.

Yeah.

and I don't know why we drift that way.

We're going to talk this hour about how our beliefs form or why we kind of move in the direction of thinking, well, maybe there's something more to know about this.

And maybe someone was lying to me.

But when it comes to measles, there's something kind of tragic about it.

I mean, a child died earlier this year.

We haven't had children dying in a decade in this country.

Measles, right?

>> Yeah.

The the I think the biggest problem with vaccinations is that they've been so effective, you know, where we no longer see a lot of these illnesses.

So when you're advised by your physician, oh, you should you should get this vaccination for this illness that you've never seen personally or even know anyone that's maybe had personally.

you now start to underestimate the severity and the seriousness of the decision that you're making.

>> Well, I want to encourage the audience today.

This is an open conversation about how we communicate, and I want to know if you think your questions routinely get answered.

Well, when you are in health care settings, do you have enough time to talk through questions?

Because I don't want anybody hearing my voice today to think like, well, you know, we're just going to be condescending to people who have doubts or have concerns.

That is not the purpose at all.

That's not the goal at all.

If that comes across at all from the host, I'm failing.

So I don't want to do that.

I want to honor the fact that people have all kinds of questions, and they get it from all kinds of sources for all kinds of reasons.

But nobody wants to harm their children.

Nobody wants kids to suffer or die.

Nobody wants their family to suffer or die.

So I want to hear from you.

Do you feel like you have enough time?

Do you feel like you get good information?

Do you feel like you're well educated?

Are you concerned about the direction we're going, and do you feel like there's information or misinformation or disinformation in your sort of radar?

It's 844295 talk.

If you want to call the program toll free.

8442958255263 WXXI.

If you call from Rochester 2639994, email the program Connections at wxxi.org.

Or you can join the chat if you're watching on YouTube and I hope you subscribe on YouTube and it's great to have you along here.

Laura.

Let's start with the idea of what misinformation is or what the difference between misinformation and disinformation, and how you want us to think about those terms.

>> That's a great question.

Thank you.

we tend to use the word misinformation as a sort of umbrella term.

especially in kind of general conversation.

however, scholars tend to think that misinformation is only one kind of false information.

So misinformation technically is information that is false, that is spread without malicious intent.

On the other hand, we have disinformation, which is information that is spread maliciously.

It's kind of attempting to harm with its spread.

then we have things like mal information, we have conspiracy theories, we have rumors, we have propaganda, satire, all of these different kinds of false information kind of live together, but at different a general term is hard to find.

So a lot of scholars use the word disordered information.

that doesn't really roll off the tongue very easily.

So in general conversation I used to usually use false information or incorrect information.

and it's important to know the difference between all of these things, because I think it can help us respond to a person if we know that they are spreading or have heard some disinformation or some or a rumor, et cetera.

>> The way I have thought about it over the years is I hear misinformation and I think mis mistake, as in I've made a mistake.

Not intentionally so versus disinformation you are trying to create sort of havoc or a problem.

It's like if if there's a bridge out up ahead and someone asked me for directions and I heard that the bridge is back up and running, and that was wrong, but I thought it was correct.

And I told you, yeah, I think you're safe to go that way.

That would be misinformation.

But because it was a mistake, it wasn't intentional or malicious disinformation, I'd say, yeah, you'd be safe to go that way.

When I know that you're not.

And something really harmful could happen.

is that a fair way to think of it?

>> Yes.

That's a great way to think about it.

I really like that analogy.

and it's important because if I come back and I realize you've made a mistake, you've given me some misinformation, I would probably just say, hey, by the way, the bridge bridge isn't working.

You can't get across.

Whereas if you have spread some disinformation, I would want to respond in a very different kind of way.

>> Okay.

A very important start there.

Now, when you teach on the subject of conspiracy thinking, et cetera.

how do you approach this kind of work?

Again, from a place of humility and trying to avoid the kind of perceived condescension that might turn people off?

>> I think the first thing that I always discuss with my students is that if we believe in some false information it can be for a number of different reasons and very few of those reasons are to do with naivete or ignorance or foolishness.

there's lots and lots of differences, lots of reasons why we might believe in this kind of information.

the second thing that I often do with my students is remind them that this comes from both sides of the political aisle, so no one is sort of immune to false information.

and thirdly, in practice in the classroom, we often talk about conspiracy theories that say that, see, that feel less fraught to us.

So, for example, we talk a lot about the 1969 moon landings, which is a very famous conspiracy theory.

And with that distance, we can maybe have conversations that we can then apply to more urgent or more pressing problems that we want to discuss.

>> When a student snickers at an idea, when you say, well, let's talk about the moon landings.

And there may be, let's say there's a room of of people who are split on the subject.

What is laughter?

Do.

>> Depends on the source of the laughter.

>> Like if I'm laughing at the idea when I'm among people who might believe the idea, what does that do to my ability to have a dialog?

>> It becomes very difficult.

You have to address it immediately.

You have to say to the person, hey, let's talk about why that's funny.

and often that can lead to a productive conversation.

I'm very fortunate.

I teach small classes so we can build a very strong culture of respect and openness.

in the classroom, so often just saying to a person, hey, let's let's talk about that response can have can lead to a really great conversation.

>> Well we'll welcome feedback as we go throughout the hour, because I'm curious to hear how people feel like their questions are being received here in general.

Dr.

Tomasko, I can't ask you to pinpoint one particular reason for some of these survey results.

there's a lot of different reasons, and we're going to work through some of those layers.

But I will say when I see that survey, more than six out of ten doctors are now saying that their patients are coming in with misinformation or disinformation, that it is way more than it used to be.

That it's more acute in rural settings.

And these are not small numbers.

So what is the profession do about it?

Because you're not anyone who has worked in medicine in any sense, doesn't have a lot of time.

No, you don't have time.

You don't have time with patients, barely have time, you know, to kind of communicate what needs to be communicated, let alone field the kind of questions that say, well, I read online x, y, z. So so what do you do with that?

>> Well, I can even say within my own career from when I started 15 years ago.

you know, you would get the occasional patient that says, oh, I googled this on, you know, online.

And you're like, oh God, what did you Google and how did you misinterpret it?

but.

>> I've done that, by.

>> The way.

>> Probably last week.

>> Yeah.

I mean, we all have.

but with with now with how the algorithms for various social media platforms.

I'm when a patient brings to me an idea or misinformation, if you will, I might not just be competing against something they googled.

I'm competing against maybe 20 different, you know, social media influencers all saying the same thing.

And now I'm saying the exact opposite.

>> and you're right.

We don't have a lot of time.

It it takes a few minutes to put out a conspiracy theory.

it takes a much longer time to disprove that conspiracy theory.

I try my best to go over literature review.

You know, the the evidence for what I'm recommending.

And in a way that the patient's able to make an informed decision.

And then when that fails, because it will sometimes you you make an analogy, you know, I, I drive a car.

I've been driving a car every day since I was 16, but I'm not about to tell my mechanic that I watched a YouTube video and I know how to change my, you know, I know how to fix my transmission, right?

And I remember one patient in particular.

I was spending a lot of time going over recommendations for getting the COVID vaccine.

And this person had a lot of risk factors and they really would benefit from it.

And I tried everything I went over, I just I spent probably, you know, a half an hour with this person.

And I finally sat back in my seat and I was like, you know, this is complicated.

wouldn't it be great if we had people that went to school a really long time and learned biochemistry, physiology, immunology, pathology, microbiology, virology that could advise us on what to do about our health.

And and the patient looked at me and was like, yeah, that would be great.

And I'm like, well, what the hell do you think I'm here for?

You know, and.

>> That's me.

>> Yeah, I'm.

>> The person in that story.

>> And that worked, by the way.

>> That worked with this patient.

>> They it put it into perspective.

>> But I apologize for interrupting.

Yeah, it worked because what kind of what kind of touch did you feel like you had to have with that patient?

Because I know you're feeling frustrated in the moment.

Yeah.

But if you again, if you laugh at somebody, they're probably walking out of the room.

>> Yeah, yeah.

And and the fastest way to get a patient to shut down is, you know, being condescending or being smug.

And I've often told patients, you know, we all want to go to the doctor who's nice, makes us feel good and says nice things and makes us warm and fuzzy.

That doctor may not be the best one for you, though they may not actually be the best qualified doctor for whatever it is that you're seeking.

Some doctors are.

I mean, yeah, you know, you know, and you.

>> Know, we may have to bleep.

>> Live broadcast but but sometimes you know so.

>> I'm gonna I'm gonna rephrase that in case, in case we had to dump that for the audience.

Dr.

says some doctors are jerks.

>> Yeah.

There you go.

But sometimes they're giving you sound advice.

And, you know, I think it's it's when it comes to communicating with your patients, you don't want them to shut down.

And the fastest way to do that is to be condescending or to make them feel now bad about their, you know, you don't want to make them feel like an idiot.

and I think you have to find that common ground.

And I think by putting it in that perspective for that particular patient, it's what got them to say, oh, gosh, yeah.

To take a step back and say, I might be wrong about this.

>> I was talking to a listener, long time listener of this program, who was saying that sometimes they want me as the host to be firmer with callers or, you know, sometimes you let people go on too long.

And I basically said, you know, I want to be respectful and I want to listen, and I want to understand how people form their beliefs because nobody is lying in bed at night thinking, I've got a bunch of terrible information and I'm a bad person.

Exactly.

You know?

But ha ha, that's not, I don't think what the human condition is, but so I think I said something like, well, I don't want to treat someone like they're an idiot.

And this person was like, but what if they're an idiot and going like, well, that's not the point.

Yeah.

To you, that may be the logical response, but that is not an effective way to get at how we are hearing each other.

Yeah.

And why we put up walls.

>> Absolutely.

>> And the reason people put up walls is when they start to feel not respected, disrespected, laughed at.

Yeah.

and that's caused huge problems for us, I think.

I think not just in medicine, but in a lot of places in this country, a lot of realms.

Yeah.

So so having said all of that we're going to get back in a moment to some of the things that Dr.

Taramasso has been thinking about, including what are the safeguards in a system that has become more awash in this kind of stuff?

And have the safeguards been threatened recently?

And what that means before we even do that?

Can you describe doctor white Belt, when you are working with students on effective communication, we've established don't condescend, but some beliefs are really, really hard to crack.

I mean, belief is often tied to identity.

And when it's tied to identity, there's very little that will move people off it.

I always think an interesting question is, what would it take to change your mind about this?

It's a question I ask myself a lot when I say, like, okay, do I have a firmly held belief?

How firmly held, how shaky is this belief?

What would it take to change it?

Is my mind open at all?

And if it's not, why is that so?

How do you start to peel back those layers?

And what's the kind of communication that may be more effective?

>> I don't think that that's something that can be done with one simple conversation.

I don't think that that's something even really that is individuals.

It's very easy to achieve, to just change somebody's belief system, to change someone's mind.

going back to thinking about different kinds of false information, if someone has been misinformed, it can often be relatively straightforward to say, oh, hey, here's some information.

I have.

>> The bridge is actually still out.

>> The bridge is actually still not working.

which I think can be effective, particularly maybe in a kind of doctor patient setting.

studies show that the more variety of information sources we have access to, the less likely we are to believe in false information.

So I think something we can do that's maybe more long term.

>> Can you say that again?

I want to make sure I understand that last point.

>> Yes.

The wider the variety of information sources we have access to means that we're less likely to believe in false information.

>> The wider the variety.

Not just more sources, but a variety of kinds.

>> Of sources.

Yes.

>> So not just a perfect echo chamber of your previously held beliefs.

>> Exactly.

Yeah.

Don't listen to ten blokes on the internet.

You can listen to one bloke on the internet, but then find some other sources of information and those, you know, we're humans, so we have networks of information.

We have family and friends, we have the news, we have you know, our experts like doctors.

So think about all of those sources of information as adding to your pool of information.

And I think this this can help stop false information.

So coming back to your question, I think encouraging people to access different sorts of information, different types of information can be a good strategy.

>> I really appreciate this point.

and I it reminds me of something I've heard years ago, and it might be apocryphal or I might be remembering it incorrectly, but it was something like, if you get on an elevator with five other people and you're going 30 floors up and you have a conversation, and all five people think about the world exactly like you do, by the time you get off the elevator, you will be more extreme in your beliefs.

Whereas if the other five people have a range of different views and you spend those minutes talking about things with some constructive, oppositional ideas, you're going to come off that elevator actually a little bit more moderate in how you see things.

And I mean, whether that's perfectly true or not, I think it illustrates the point that says if we to your point, if we are only getting information from this narrow set.

So if you're on MSNBC every night, why are you doing that?

If you're on Fox News every night, why?

I mean, diversify it and at least see what else is out there.

And listen to the smart, interesting other voices.

Because I guarantee you there are smart, intellectual, interesting voices who are progressive, who are conservative, who are culturally conservative or culturally progressive, and everything in between.

But now the next question then becomes, Laura, why don't we do that?

Because we have more opportunity to do that than at any point in human history.

But we are not choosing to do that.

>> I think there's two reasons.

I think that the way that we respond to arguments has changed.

So in 2016, Oxford Dictionaries declared that we were in a post-truth era and post-truth is best understood as a way of listening to arguments and focusing more on how the arguments make us feel, rather than kind of reasoned evidence.

>> That's that is really interesting.

So how the argument makes us feel is more important than what the evidence is, correct?

>> Yes.

So I mean, the most effective arguments combine emotion and logical reasoning, but the scale seems to have tipped a little bit, and now we're more receptive.

Yeah, to those arguments that kind of help us feel that our worldview is right, that make us feel good about that.

So I think that's one thing I think that we don't want to surround ourselves with dissenting voices because it makes us feel horrible and we don't like feeling horrible.

I think the other reason is to do with I think it's something to do with the way that the internet works.

So increasingly when we're on social media, or even when you're using your kind of streaming service, we're just delivered stuff that the algorithm is guessing that we'll already like.

And it's quite hard to break out of that.

So if I could use Netflix as an as an analogy, it's difficult for me to find things on Netflix that aren't just like the things I've already been watching.

>> Oh, that's.

>> Another thing.

So I think that a lot of our informational sources are similar.

You know, even our social media feeds just deliver us things that are like things that we've already viewed.

because there is so much information out there, we can't physically go and sort through it ourselves.

That algorithm is quote, unquote helping us, but it's really just creating these spaces where we just get more of the same.

>> Oh man, that Netflix analogy is so good.

I'm thinking like, Netflix is I'm just waiting for the day that it's like, well, you've watched Naked Gun and Naked Gun two, would you would you like to try Downton Abbey?

You know, I don't.

Instead, it's going to give you everything that is like that genre.

Yeah, because it thinks that it will you will do more of that.

But what would be good for you would be maybe saying, okay, that's enough of the Adam Sandler collection today.

Let's try something a little more thoughtful.

No offense to Adam Sandler movies.

I'm sure they're great, but no, that's just not how it works.

So, and I think what you're describing, Laura, is one of the bugs or features, however you look at it, of the modern technological age, because certainly in the past we could have had arguments that appeal to emotion and arguments that appeal to information when they were trying to figure out what to do about bubonic plague.

I'm sure there were plenty of people who were like, well, at least I this guy thinks I'm right, you know?

And I like feeling right.

But it wasn't as extreme as today.

And I feel like social media and the way we communicate online versus how we do it in person maybe accelerates that.

>> Yes, I think that's true.

I think we need to find, as you put it, more elevators with five different kinds of people in it.

maybe the best place for that is offline.

but I definitely I'm very aware that when I say that, that I'm talking like a millennial and.

>> Like a.

>> Millennial, millennial and I wonder if I don't think I have the imaginative capacity to think about how to get out of that algorithmic space that's online and do that online?

>> Well, just grab a different podcast, maybe.

>> Yeah.

>> Instead of listening to the same 2 or 3 podcasts forever.

Right?

>> Yeah, I guess that's what it is.

>> You millennial, are you saying that Gen Z would be saying like, oh, that's typical millennial?

>> I think they would.

I think they would.

>> It wasn't long ago that gen that millennials were the youngest.

Yeah.

And now look at look at you guys.

Look at you I know it's amazing what happens over time before I grab some listener feedback.

Daniel Taramasco do you want to weigh in to on the challenge of this kind of modern age, where if someone gets an idea about medicine, about a topic that they obviously, again, they care about, they care about their kids, but if they pick up a piece of information that is sort of contrarian.

the algorithms will feed them more and more of that, and all of a sudden they'll have an avalanche of that.

Yeah.

And then all of a sudden you're in a half hour conversation trying to convince someone that your credentials matter.

Yeah.

so again, I guess it goes back.

You can't just hold up credentials every time, though.

Not everyone's going to respond.

>> To that.

Well, you know, it's funny.

I even from the time when I first started working you kind of have that credibility when you walk into a room and you're like, I'm going to be your doctor.

I'm taking care of you.

to now it's like, hey, I actually studied this stuff.

And like, I get paid to advise you.

You know, I once told a patient, if I make a mistake or if I advise you the wrong way and something bad happens, you can sue me, right?

The person giving you that advice online that doesn't know you hasn't examined you.

you don't even know what their motives are for the information that they're giving you.

If it's wrong and you you suffer harm from that, you can't sue them.

They have nothing.

You can't do anything, you know.

So who do you think has the the, the the stronger obligation to advise you on what to do about your health?

>> I actually think this is a really smart way of presenting.

>> Oh.

>> Does does that work?

>> So.

I think going through practicing medicine.

Now if you want to be effective as a physician, you have tried everything.

Not everything works for every patient.

Sure.

you have you have kind of a, you know, I don't want to say a Rolodex.

but in your head, you have.

>> Kind of a Gen X thing.

Yeah, that's a baby boomer.

>> Thing to say.

Yeah.

>> But you already have these pre-planned arguments because you've used them so many times for patients, and that's how common it is.

and some work for some and some work for others.

Yeah.

>> Well, on the subject of trying to convince patients to take a COVID vaccine, here's Mike in Rochester on the phone.

Hi, Mike.

Go ahead.

>> Hi.

Hi there.

Yeah.

So I was in private practice for a long time, and more recently I've gone part time.

And I actually work in an inner city clinic.

with a largely indigent population.

Now.

And as hard as it was to convince people to get the COVID vaccine before, of course, I'm finding it even more difficult now.

And what's interesting is the during the during the peak of the crisis there was a large number of people in the ICU on ventilators, and we noted right away that the people who were unvaccinated or unvaccinated, were the predominant patients in that situation.

And so these patients would come in.

I try to tell them to get their COVID shot.

And they said, oh, no, no, those things don't work.

And they have all kinds of side effects.

Is all I can tell you is the majority of people in the ICU on a ventilator are unvaccinated.

What would you conclude from that?

And it just I just had a very hard time convincing him to get the vaccine.

And today I can't even I doubt that most of the doctors who I work with as residents have gotten the COVID vaccine.

I mean, partly because we all have some immunity to it.

So everyone has had some exposure to it, but the data just was published in the Journal about a week ago, showing that hospitalization is reduced in half for people who have had the COVID vaccine.

That's true for COVID.

It's true for Flu's, true for RSV, and yet we have such a hard time convincing people to get vaccinated.

Even a very frail, vulnerable population that I'm dealing with now, most of them will not take that vaccine.

>> I'm going to try, Mike, to offer a rejoinder.

And I want to I want to ask you what you think, and I want to ask our guests in studio what they think, because I want to give you the kind of response that some of the patients that you're talking about have emailed to me frequently in the last five years.

And it sounds something like this.

You told us when the vaccines were on the horizon, that all we needed to do was get the vaccine, it would end the pandemic and we wouldn't get sick and we wouldn't spread it.

And now we got the vaccines and we still get COVID and we still spread it.

And you were wrong.

And now we don't trust you.

And right.

And Mike, what I tell them is, I mean, just from my perspective, having hosted so many shows throughout the pandemic, right here in this quiet building, when a lot of people were still staying home, was I thought the language was more nuanced.

At the time, I thought it was, hey, this is how we probably end the pandemic and the hospitalization and dying.

For the most part, there's going to be outlier cases, but this is the path there that when you get COVID, you will not be as sick, that you probably won't have symptoms as bad.

Was there some language that said like, this is it, this is you'll never get COVID.

Maybe so, but I think that that probably got amplified in some idea in the minds of some Americans that, like I was told this was the end and that I would never get it.

And you were wrong.

And now I don't want to hear it.

That's kind of where it is.

What do you think, Mike.

>> And I and I think perhaps the CDC was guilty of overemphasizing the effectiveness of the vaccine.

And it's obvious now that people can get COVID even after they get the vaccine.

But it's but it's also true that the severity of the illness is reduced.

It is a much lower risk of ending up on a ventilator if, in fact, you get vaccinated.

But again, it was probably a bit oversold.

Maybe that's how people interpreted it.

Maybe the CDC sort of pushed us in that direction.

So I agree that that is part of the problem.

>> Okay.

I really appreciate the call, Mike.

Go ahead doctor.

>> So I was I was probably a little bit more pessimistic when I was advising patients on the vaccine, and not in that it was going to be ineffective.

But what to expect?

you know, the hard part, when the vaccination came out, us physicians, you know, we didn't have any long term outcome studies, you know, that we could say, hey, this is what we saw.

This is, you know, we were kind of asking patients to, hey, trust, trust my my judgment.

Trust my opinion as your medical doctor.

and, you know, I told patients that my my expectation was that this would work similar to other vaccinations for respiratory viral illnesses, where you would be protected, you would be less likely to have severe illness.

and it was really important and that it's the best option we have at this point.

in fact, the vaccine ended up turning out to be more effective than we even anticipated in terms of reducing severity of illness and death.

and so but I did tell patients, yeah, you could probably still get it.

And yeah, you probably can still pass it, but you're far less likely to die.

and that's absolutely what we saw.

>> I thought Mike's point about look at who's on the ventilators.

Look at who's dying.

Look who's in the hospital.

The vast majority are unvaccinated.

And that is a direct line.

that's really powerful to me, having known people who've been on that ventilator.

But for some reason, it still is not enough for some.

>> And that was hard.

That was really hard.

That was very hard to because I worked on COVID floors.

I worked in an ICU.

I've had to deliver.

Bad news a lot during COVID.

and that it was very hard because all I wanted to do was go like, oh, my gosh, we have this vaccine.

This is great.

Just take it.

You know and to be met with such conspiracy theories and misinformation, disinformation that was really tough.

That was really tough.

>> Laura, you want to jump into on some of Mike's points about how to try to reach people and the kind of communication he was attempting.

>> I guess I'm thinking more widely what what would it look like for a physician to have a conversation with a patient and basically say, what can I do to help you trust me?

So rather than being.

>> Question.

>> More about this is why you should get the COVID vaccine.

Like taking a step back and asking that question.

yeah.

What would that look like?

>> Sometimes it works because I've said that before too.

>> So that's one of the many tools.

>> Yeah, of course.

>> I liked what Dr.

Tomasko said.

We've tried everything.

>> But.

>> It's interesting that.

Yeah, Dr.

Bell's idea is one that you have tried.

>> Yeah.

Oh, absolutely.

>> Trying to open that door with humility, saying, I want to earn your trust.

>> Well, and.

>> Sometimes it saves you time because if I, if you if my patient tells me no matter what you say, no matter what evidence you show me, I'm not going to do what you're recommending, and I'm not going to believe you.

Well, then we've just saved ourselves a lot of time because I, I you've you've just established.

I'm not going to convince you.

So I'm not going to waste your time.

I'm not going to waste my time.

But when they do actually tell you, you know, hey, I really want to know about this.

This is what's bothering me.

And I can pinpoint and actually have a discussion around those maybe roadblocks for that person.

then it turned out to be a very fruitful conversation.

>> on watching on YouTube, Sydney says we need to bring the teaching of thinking skills to the American educational system.

We must teach the scientific method, broadly speaking, and how to compare credible sources versus non credible ones.

That's from Sydney, Sydney.

That's one of the reasons we had physicist Adam Frank on last week with a bunch of PhD candidates who are talking about their research and the work that they they feel like they're benefiting as scientists, becoming scientists through the scientific method.

But why we all would be better thinkers if we adopted some of those principles.

So I agree with that point.

and just comparing sources credible versus non credible ones, I am not going to forget any time soon.

Dr.

Masters point when he said, I'm advising you and I can get sued if I'm.

>> Wrong and the.

>> People on Natural news online are not suitable.

I'm going to try to follow the best course of action for you because I do not want a lawsuit.

>> You're basically.

>> Going to have to edit out.

>> My entire.

>> that's compelling.

>> This shouldn't have.

>> Been live.

I didn't think we'd have to use the dump button with Dr.. >> Terry mask.

I will say this engineer, Rob Braden, would you have put this.

>> On your.

>> List of likely dump?

But not today.

But, hey after we take a brief break, we're going to come back, and Diana in Pittsford will take your phone call.

I've got a couple of other emails related to how people feel about vaccination and the way that their doctors and medical professionals are communicating, which I think is really interesting.

We are here because on Thursday night, it's the opening of a multi-part series from the Rochester Academy of Medicine.

And if this is interesting to you and you want to learn more, you want to bring someone with you, do that on Thursday night at 6 p.m., Thursday night, 6 p.m.

at the Rochester Academy of Medicine, and they have this series for the very reasons we're talking about.

They want to demystify misinformation and help the public not only understand better, but help all of us communicate more effectively.

We're talking to Dr.

Laura Whitebell, who is associate professor of writing at the University of Rochester.

Dr.

Daniel Taramasco, a hospitalist with Rochester Regional Health.

We're right back to your feedback.

Next.

Coming up in our second hour, the rise of nonalcoholic adult drinking in Rochester and the Finger Lakes region.

It is a surging market, and the people involved in the market don't think it's just a fad.

And it's not just because of Gen Z, although they are drinking a lot less than most previous generations, really, all previous generations.

We're going to talk about what zebra striping is.

We're going to talk about how our habits are changing next hour.

>> Now more than ever, your public radio station relies on support from our sustaining members.

When you start or increase your monthly donation, you are doing your part to ensure this trusted source of local, national and international news stays healthy and thriving for years to come.

>> This is Connections.

I'm Evan Dawson and this is Diana in Pittsford on the phone.

Hi, Diana.

Go ahead.

>> Hi.

I just have a question for the the medical doctor.

Do you find that my chart and my care, the programs that both of our hospitals run cause more problems for you and that they bring out more stupid questions because everybody researches these things and then knows nothing except for new numbers.

And I just find them a tremendous waste of my time.

And I imagine the doctor's time just like an opinion.

Thank you.

>> Diana, I will say this before I kick it over to the doctor.

This is a whole other hour.

I think.

I love the idea of my chart.

The execution can what Diana is saying, doctor, is that you just threw a bunch of things at me that I don't really actually understand, and I won't be able to talk to a doctor for another hour or day or two.

So now I'm on my own to research.

You didn't want me to research it, but now I've got all this info and I have to research it, and now I'm confused.

I kind of can relate to where Diana is on this.

What do you think?

>> So.

Oh, gosh, I don't know how I can even speak about this.

you know, there's a really good intention there, right?

You have the access to the information of either a recent appointment or a test result or, you know an x ray or something of that nature.

The the problem is there is so much verbiage within a report that that you would, you know, you start looking things up and you're like, wait a minute, that doesn't sound good.

Oh, God.

And then you're in a full panic.

Before long, or you see something that is an abnormal test result, which sometimes an abnormal test result is appropriate or expected for certain patients.

Right?

I mean, I work with patients that are admitted to a hospital and they will get their morning lab results before I do.

Sometimes.

And and now I'm getting messages from nurses.

This patient needs to speak to you right now for a lab that has no bearing on their outcome or whatever.

>> But they may not know that.

>> No, exactly.

And that's that's, I think what makes it so difficult because you know, once I sit down with these, you know, with patients and I explain to them, hey, you don't have to worry about this.

This is okay.

This is what this actually means.

I think that if you have a relationship with your physician, especially if it's your primary care that and you have that sense of trust with them.

you know, it's good to be aware of what is going on with you and have questions.

It's always good when a patient comes to you preemptively with bulleted questions, you know, hey, these are the concerns.

it kind of helps.

utilize that that patient physician time.

it optimizes it, but I always tell patients if there was something that you should really be panicked about and staying up at night, your doctor would be calling you.

because they get those results, too.

>> Okay.

Helpful.

But, Diana, the confusion.

I have been there, and so let me turn this around on doctor white belt.

So when you are a patient, how have you found the communication quality coming from the health care system?

Generally?

>> So I turned all the notifications from Mychart off.

>> Why is that?

>> Because they.

>> Because you realize you don't really know how to interpret it.

>> It was too much.

So I only see a test result if I physically go in.

And often I choose not to and let my physician give me that result.

>> That's an interesting.

>> So that's that's been my approach.

>> Diana, you opened a can of worms.

That's a whole other day.

But but that's a that's a really, really good set of points there.

let me get Dallas's point a little bit more about where people are.

And for example, COVID vaccines and Dallas says the COVID vaccine is all messed up.

Trump makes it.

The Dems want went out and said they wouldn't take it.

Biden gets elected and the Dems turn around and say it's great, but it's the consumer who has the problem.

Let me try to to decode a little what Dallas is saying in the vice presidential debate in October of 2000.

This is a month before the election, and this is now just, what, three, four months before vaccines start really rolling out.

So they were coming and Kamala Harris running for Vice President, Mike pence running for reelection as vice president.

We're talking about the vaccine and what Harris said.

The quote in that debate was, if doctors tell us we should take the vaccine, I'll be the first in line to take it.

Absolutely.

If Donald Trump tells us that we should take it.

I'm not taking it.

And what what that became for a lot of Donald Trump supporters was this idea that because it was the Trump administration that shepherded Operation Warp Speed that you're going to try to play politics with it, that you're not going to take it seriously.

And so I don't think to Dallas's point, the Democrats went out and said they wouldn't take it.

He's taking one comment from Kamala Harris in a debate.

So I think Dallas is not being really fair to the situation.

But I do think Dallas is not wrong to say that that communication was very clumsy.

I, I think what needed to be communicated was I don't care who the president is, I don't care who they're politics, what their politics are.

If the medical community is good with the vaccine and it's ready to go, I'm ready to take it, you know, and and it was more of a mixed message from Harris there.

And clearly it did damage.

And so as someone who teaches writing and communication, you know, do you look at that as a mistake?

>> Yes, I think so.

I think it's hard when issues become Partizan.

I think it's hard when issues that are really important to individuals and communities become sort of political.

Footballs are just get tossed about and yeah, I would like to see that avoided more.

>> Okay, doctor Tomasko.

>> Wow.

This is this would be another hour long topic.

you know, that that was an.

I said to people in private, if, you know, the COVID pandemic.

As for the sitting president at the time would have been the easiest thing to handle.

You would have just said, these are experts in their fields that the government has vetted.

They've spent their lifetime studying this.

And this is their advice, and we should listen to them because it's the best we have at this time.

And unfortunately, the COVID itself, in terms of, you know, recommendations for social distancing to treatments to vaccinations, to random medications that were totally ineffective it was very heavily politicized.

And I think what I this added a new layer when I was talking to patients because if a politician that they supported advised them on a, let's say, a drug, you know, I won't name the drug, but.

>> Does it sound like ivermectin?

>> And for me to say that, you know, based on the literature and the evidence, it was it was not it was not effective.

And and I remember a patient in particular, I, he was demanding I prescribe this medication and I'm like, well, one that's not the medication is not going to work for what you want it to.

Number two, you have contraindications because of your, your health that you wouldn't be able to take the drug even if it did work.

And the patient fired me and okay.

And you know, and I said, which is fine.

but I was like, it's not going to change my advice to you, right?

Yeah.

because if I gave that advice and it was wrong, which it is and you get harmed, I'm liable.

I'm responsible.

not just legally, but morally.

Ethically.

so that was a very difficult thing.

And I think what what happened is patients got to this point.

Well, if, if he's wrong about this, what else might be wrong?

>> Yeah.

>> And you really and it's like and you try to just stay on topic.

and that was sometimes not easy to do.

>> And all of a sudden the trust in an entire system starts to erode.

So as frustrated as physicians can still be today, hearing patients say, well, how about just ivermectin?

How about hydroxychloroquine?

I mean, that's still happens.

And I know that's frustrating.

At the same time, I was in an establishment recently and I saw a keep six feet away thing on the floor.

And I'm like, I don't think that was ever scientific.

It was a guess for a little while.

I mean, I thought it was a useful idea to just in our head say, let's do our best until we get more information about how this spreads to kind of.

But this is like an outdoor establishment out in the patio in 2025.

And I'm like, what are we doing here?

That felt very strange to me, too.

>> Did they forget to take it off the ground or.

>> I don't know.

So maybe so, but.

>> Was it faded?

>> No.

>> Okay.

>> I wanted to take it off the ground.

So.

And I'm not trying to both sides this.

I'm just saying, like, I'm trying to understand where people start to feel like they're not getting good information.

So let me let me squeeze in as much listener feedback.

Both of you have sparked so much great conversation.

This is from Daniel, who says language is being used to confuse being college educated.

I don't know what disinformation even means.

Just call it what it is, call it lies.

Perhaps people will understand a more simple definition of disinformation.

All right, Laura, what do you think?

>> Yeah, this is where I'm going with trying out this term.

False information or even wrong information.

I agree with you.

I think the.

Yeah, the confusion between all these myths, dis mal informations is confusing.

And.

Yeah, so I think false information.

Yeah.

If you know it to be a lie, go ahead and call it a lie.

Yeah.

Calling things what they are I think is always a good move.

>> disinformation.

Correct me if I'm wrong here, but disinformation can lead to misinformation.

>> Definitely.

>> Okay, so one flows kind of downstream from the other.

Fair, correct?

Yes.

Okay.

useful there.

And let me just try to grab John on the phone and I'll get two more emails here.

This is John in Rochester.

Hey, John, go ahead.

>> What are time saving websites for both doctors and patients to use?

>> Time saving websites with just better information than others?

>> Well, with a return visit with a follow on visit after having done some online research, the patient would be able to go deeper into a subject.

>> Yeah, yeah.

So, John, I don't think there's anything wrong with trying to educate yourself and learn more.

I don't know if there's a single clearinghouse of information that said, understanding the source is important.

>> Yeah, yeah.

And, you know, sometimes what I'll so it's different.

Right.

So depending on the illness or the question will determine what I would advise you to go use as a reference.

And so what I often advise patients to do is talk to your when you receive a diagnosis or a new medication.

This is when you might want to ask your physician, what would you recommend I read?

What would you recommend?

What sources to go, you know, to, to to use to help me decide on X, Y and z. Because depending on the illness, the drug, the disorder, the surgery, the procedure, it's going to be a different source.

>> Okay, John, I hope that helps.

Let me squeeze two more in here.

Alex emailed to ask, are there commonalities to house conspiracy theories?

basically are formed or what they say?

Any commonalities when it comes to the world of conspiracy theories that you see?

Dr.

White Bell?

>> Yes.

The big commonality is they usually tend to form in places where there is doubt or question.

so I guess the COVID vaccine is a good example, you know, do we know 150% that it works?

No, we can't possibly.

So this is a space where we might have questions.

about, you know, about its effectiveness.

So that's what I would say.

The biggest commonality is these spaces where we do have questions and questions we should ask questions we should wonder about.

but yes, that's where a conspiracy theory might form.

>> But can we realistically say there should be doubts about the moon landing?

I mean, that's when I felt pretty good about.

>> I mean, I wasn't there, I guess.

>> Oh, no, we have a conspiracy theory in the room.

>> No, I'm joking, but yes, there were there were doubts.

And here, I mean, this is an example of doubt because it must have.

It would have seemed so magical.

People standing on the moon, walking around.

There is something.

>> No, no, that's a fair.

That's a that's fair.

I'm not thinking fairly there.

>> Yeah.

That's where the doubt.

>> The first time you see somebody do it, it does look like the first time you see an airplane in the sky.

It looks magical.

>> Exactly what helped me kind of conceptualize conspiracy theories, especially during COVID because I was getting, you know, you get your emotionally involved as a physician.

and so I think most conspiracy theories originate out of fear.

And the to accept that there was a global pandemic that could kill people, that was unpredictable, was really scary.

And it was easier, I think, or a defense mechanism for people to assume that this is made up.

This is a hoax.

This is all made.

You know, this isn't real.

That was easier to digest and process it than accepting the reality.

>> So as we conclude here, I had a couple of emails about RFK and the kind of the the possible damage.

And I always got back to, I think about the idea of guardrails like, you know, what are the guardrails that will still make sure that we're moving in a direction that is toward more public health and good information.

How do you see the current state of guardrails in the system?

Got about a minute left here, doctor.

>> Oh, God.

it's tough.

It's tough.

I that's a that's a very long conversation.

It's very scary right now.

It's very tough.

The guardrails.

I think many of the guardrails have been removed or are very compromised.

>> That's an example.

>> Right now we have a secretary, a director of the HHS that is one of the most prolific anti-vaxxers in modern time.

That that that's scary.

>> It's doing a lot of damage.

>> It is.

It is.

>> I thought you were going to swear again.

So.

>> So that's why I paused.

I edited myself.

>> There you go.

>> if you want to, listeners, if you want to hear more, if you want to take part in the ongoing series that starts on Thursday with the Rochester Academy of Medicine on demystifying misinformation.

Thursday, 6 p.m.

at the Academy of Medicine.

They would love to see you there.

Our guests will be there for that.

There's going to be more in the series to come, and I'm really grateful for the time.

Dr.

Daniel Taramasco, hospitalist with Rochester Regional Health.

Thank you for being here today.

>> Absolutely.

>> And our thanks to Dr.

Laura Whitebell.

Laura is associate professor of writing at the University of Rochester, focusing on things like conspiracy theory and communication and more.

Thank you for your expertise as well.

>> Thank you.

>> We've got more Connections coming up in just a moment.

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