Dr. Geeta Nayyar has a prescription for medical misinformation

In our new era of technology, doctors don’t just need to inform—they need to influence.

Conversations between doctors and their patients are a kind of artisanal craft. At their best, they’re private; empathetic; empowering. They’re a skill entirely outside holding a scalpel or stethoscope. But at their worst, they occur in the ultimate black box—leaving you with more questions than answers, and no pathways to reliable information outside a hospital.

Dr. Geeta Nayyar (AKA: Dr. G) wears many hats. She has served as Chief Medical Officer at several Fortune 500 companies. She is a trusted health tech advisor to many. She is a medical school professor. And she is a trained rheumatologist. Most relevant to us though, she thinks medicine’s ultimate epidemic is its communication problem in the technology age. So much so, she wrote Dead Wrong: Diagnosing and Treating Healthcare’s Misinformation Illness.

With the pacing of a thriller, Dr. G portrays the pernicious swarm of misinformation that accompanied COVID-19. But she’s not just here to evangelize the problem to a room full of believers. She comes armed with solutions—which I was lucky enough to talk to her about, and share with you here.

You completed your residency during the AIDS crisis, and then served as a medical school professor yourself during COVID-19. You wrote this, you mention, after living with perpetual public health misinformation deja vu. So what did we actually learn this time? What should we be carrying forward as clinicians and communicators? 

I think every physician has that moment where you understand that you have no influence on how to actually be an asset to your patients. I think that's really the call to action in the book. To say: we have so many folks in charge of EHR optimization, we have so many people in charge of telemedicine, and analytics, and AI, but we don't actually have a person for misinformation and disinformation. We don't have that strategy. We don't even address it. And if you think about it, every one of those pieces touches misinformation and disinformation.

There is something almost a little bit paradoxical in the way that disinformation can both touch every role in health care, and also thrive on disaggregation. How do you reckon with that? 

I think we as healthcare leaders and as physicians, frankly, just don't think of this as a priority. In other words, there's a tech aspect to it, there's a policy aspect, there's a leadership aspect, but fundamentally, there's also a marketing and communications aspect. And in health care, particularly if you're a physician, that's just seen as marketing. That's not important. We say, that's just comms. We run a hospital, we save lives, we are payers. So there's this disconnect in the academic piece of medicine, where it's like, that's just dressing. And the truth is, it's not. The salad dressing makes the whole meal.

I think one thing the consumer learned in a post pandemic world is that health is important. No one wakes up saying, how can I be misinformed today. The consumer is saying I want to be healthy, and yet they're still getting duped. Instead you have the shaman, you have the functional medicine expert selling you a vitamin for only 29.99. What's missing is the doctors out there, what's missing is the marketing and communications on the provider side. We don't need just one Surgeon General, we need a Surgeon General in every zip code. This is where healthcare happens. It's in the zip codes.

I often worry that especially in the world of women's health, we are failing to validate people in ways that some of the supplement companies are. Like perhaps they're quieting people’s fears, without following through on the science.

Fundamentally, healthcare, medicine, whatever you call it, has to be relatable and reachable to the masses. And if we're not relatable and reachable, all the misfits out there are. They're much better at captivating the consumer, they've got better dance moves, better Tik Tok videos. They know their audience, and they meet their audience where they're at. And healthcare just doesn't do that.

I talked about the Cleveland Clinic in chapter eight. They said, we have a good brand outside of our community, but we don't have a good brand within our community. What I loved is that it was a really beautiful partnership between marketing and the clinical teams. Paul Matsen, Chief Marketing Officer, went and grabbed his doctors and said, I'm gonna put you on camera, and I just need you to comb your hair, but do what you do. So in other words, he didn't ask the doctors to become marketers. And he didn't ask the marketers to become doctors. 

He's like, we're gonna partner with YouTube. We are going to make this really cool and really scalable on social media, because that's where our community is. And we're gonna have Black doctors, we're gonna have white doctors, we're gonna have female doctors, we're gonna have male doctors. They did it very intentionally to say, that's what our audience wants. This is how we relate to our audience. 

If you were in a current or future executive operating role, how would you operationalize this call to action? Would you urge Chief Population Health Officers and value based care teams to include disinformation in their scope? Or would you designate a command center? 

I'll tell you that with Salesforce, that's what we did. We actually called it CMO-squared. So it was me as the Chief Medical Officer working with the Chief Marketing Officer. I had never met her, she had never met me. COVID happened and we had to get people out of the office, vaccinated, outfitted with PPE, then back into the office. So what I would say is that it's part of the C-suite remit. And that it is a cross functional imperative, just like so many efforts. 

Many of us in health care have long predicted a boiling point for misinformation in the year to come. How do you characterize this moment as different? And what should our expectations be for the next year or two to come?

One of the primary reasons I think this particular year is going to get worse is because of political elections. We've seen science politicized in a way that it has never been before. I think that genie is not going back in the bottle. And then, look, people are making a lot of money on intentional disinformation. Also, now every other word is artificial intelligence. So there's a role for AI here, both the good and the bad. My hope is our industry uses AI to amplify the facts. 

I also hope that we start to see the power in celebrities. One of the neatest things I saw during COVID was an Instagram Live with Matthew McConaughey and Dr. Fauci. It was a conversation between the two of them where Matthew McConaughey says, I'm from Texas. There's a lot of confusion here. And I'm just an actor, Dr. Fauci. I don't understand this. Can you explain it to me? Can you tell me about the whole sunlight thing? Too often, we see celebrities out there, selling something via a supplement. Meanwhile, they have no background in that. The savvy healthcare leader is going to say, hey, you know what, here are our champions, here are our ambassadors. And we're going to work with them. You see life science companies doing this really well. We'd love to see more of that in the provider space and payer space.

All too often I hear medical professionals talk about patients needing to self-educate, as if that is the panacea to disinformation. But in fact, my patients are very curious. The people that Maven Clinic serves are very information seeking. That is precisely what makes them vulnerable. 

It's not that people want the wrong information. It's that if we don't put out the right information, no one else will put out the “right information.” It's the gap. Healthcare has left a gap for all these misfits. But if we can fill the gap, there's nowhere for them to go.

Fifty nine million Americans get their health care information from social media influencers. Not even social media. It's important to say social media influencers, meaning, these are people they follow. These are people that inspire them. 

And they're not even good dance moves. It’s very confusing to me. 

But in the absence of no dance moves, the bar is low. I have patients ask me all the time, where can I follow your work? I always have a list ready. I say, you know what, go to the Arthritis Foundation, go to the Lupus Foundation. I say these are the top three places I recommend and trust, read that, come back, and I'll be happy to answer all of your questions. Don't go anywhere else. We forget that it is so critical to say to patients: I do want you to read, here's where I want you to read. Or, I do want you to follow me, or I want you to follow our hospital, here's the handle.

That sounds like a prescription in and of itself, just to give people who and what to follow.

Correct! 

Beyond the wonderful Arthritis Foundation and Lupus Foundation, if you’re looking for health-influencing, Dr. G and I also recommend checking out:

• Jane Sarasohn Kahn, for sharp healthcare economics. 

• Dr. Eric Bricker, for everything you need to understand your hospital bill.  

• Joel Bervell, for real medicine in Tik Tok-sized bites. 

• Kimberly Seals Allers, for dispatches on the state of maternal health equity.