How physicians can share health information and manage dissent online [PODCAST]

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“In the time of the COVID-19 pandemic, I am both hopeful and inspired as well as disappointed. I see those angry that their ideas or opinions conflict with science. Instead of the steady path and hard work of building bridges, they create division. I see many capitalizing on fear and uncertainty, weaving a compelling story and drawing in the desperate ones who need a scapegoat, an explanation, or some form of certainty.

It’s OK to be a dissenter.

It’s OK to challenge what seems to be the status quo.

It’s OK to ask questions about why we do things the way we do them.

But if you really want to see a meaningful conversation, you must go about it in the right way. The right way is usually slow and painful but full of the promise of refinement that only comes through allowing our work and our perspectives to pass through the filters of those who see the world differently. Only then can the purest form of our questions be answered, and our message be heard.”

Jaclyn Lewis Albin is an internal medicine-pediatrics physician.

She shares her story and discusses her KevinMD article, “Dissent in the time of COVID-19.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Jaclyn Albin. She’s an internal medicine-pediatrics physician, and she wrote the KevinMD article “Dissent in the time of COVID-19.” Jaclyn, welcome to the show.

Jaclyn Lewis Albin: Thank you. Glad to be here today.

Kevin Pho: So before we get into your article, I was wondering if you could share your story and your journey to where you are today.

Jaclyn Lewis Albin: I think my journey probably began at the age of three, when I knew I wanted to become a doctor, and I would scrounge around all the empty drawers looking for Band-Aids to make various medical kits as a kid. And no one in my extended family on either side is a health professional, so it was a unique passion, but I always felt supported by my parents to pursue medicine.

And I lived in Texas, where sometimes women are still discouraged from pursuing a career path that can be demanding, but I pressed through that and got my dream medical school experience at George Washington University in D.C., and then came back to Texas for residency in Houston. And then I’ve been back in the Dallas-Fort Worth area for almost six years.

Kevin Pho: All right. So you were doing primary care, internal medicine-pediatrics, and in Texas, there’s a flare-up of COVID-19. How has the pandemic affected you and your practice so far?

Jaclyn Lewis Albin: Well, as a pediatrician and an internist, we had to make a lot of decisions about how we protect part of our population while ensuring that we still deliver good care. So for example, newborns, children that need a lot of vaccinations in the early years, we still bring them into clinic. And we’ve really transitioned to a model where we bring in patients who are well into the clinic, and then we try to keep everyone who’s feeling sick on telehealth, and also our really vulnerable patients on telehealth.

So one positive that I think will carry forward is incorporation of virtual medicine and how much that’s beneficial to our patients. It increases convenience for them, and it diversifies how we take care of them.

Kevin Pho: Now, is there something that you’ve learned over the past few months, something that you know now that you wish you knew back before the pandemic started?

Jaclyn Lewis Albin: Sometimes in medicine, we get really comfortable in the ways that we’ve always done things. And I’ve always been one of those people that looks at the way we do things and wonders, “Why do we do it that way? Is there a different way? Is there a better way?” And honestly, that’s not always a comfortable question to ask when people feel settled and they feel like things are working.

And I think the pandemic has forced us to get really creative and innovative, which really is part of what my post was about: How do we embrace scientific inquiry and innovation in a way that is well received by the medical community? So I’ve learned a lot about that in the past few months.

Kevin Pho: So let’s talk about your article, “Dissent in the time of COVID-19.” Can you walk my audience through that article and the story of why you decided to write it?

Jaclyn Lewis Albin: Sure. So I think, like most physicians during this time, we feel compelled to be a voice in our social media circles, among friends and family who are not in medicine, helping them understand the science that’s coming out. I don’t think the lay public has ever really seen the scientific process unfold in very raw and open ways like they have during the pandemic. And I think it’s been hard for people. They struggle to see how sometimes we get it wrong, and then we shift, and then we learn something new, and then we shift, and we ask hard questions, and we challenge one another. That’s how science works.

But I became really frustrated about a month in, when I began to see that people were not trusting scientific voices and public health experts and epidemiologists who are trying to guide us with the years of knowledge they built, and began to see increasing numbers of conspiracy theories on YouTube and many other examples in the media where people are desperately seeking for a message of truth.

And I think it was after I had gone for a walk-jog, because I’m not in quite good enough shape to jog the whole time, and I was trying to burn off some steam, because I’d been frustrated by some of those posts that I’d seen from people that I care about and respect. And the piece for me was my story, weaved into my strong belief that dissenting against the way we’ve always done things has to be done in the scientific process, which is going to make it slower and more meticulous and harder than we wanted it to be. We can’t just say, “That’s wrong. Here’s what I believe instead.” You have to actually build the science for everything that you do if you want it to actually help people and be based in evidence.

Kevin Pho: Even before the pandemic, a lot of patients would go on social media, like Facebook, for medical information, and as we both know, there’s a lot of misinformation online, especially with Facebook. Now, what are some ways that physicians and public health officials can go on social media to help correct that misinformation or help guide patients to better sources of health information?

Jaclyn Lewis Albin: Absolutely. I think social media is a wonderful resource for health information, and we as physicians need to be there. In fact, that was why I actually started putting some content that was important to me on Instagram specifically, because my passion is really the role that food plays in health outcomes and how we can change people’s health and life with food and how we can teach them to take ownership and be empowered to eat better.

So I just started sharing: What do I make as a mom? How do I get my young children to eat nutritious food? How do I cook dinner quickly on a busy work night? And sharing ideas and beginning to put content out there. And then I started to get engaged as well on Twitter, and I use Facebook as well, and I found there’s a really wonderful community who share evidence-based resources.

I think when we put our stuff on social media, though, we need to say what our credentials are. We need to identify ourselves by our training. I’m not a pandemic expert, for example. I’m a primary care doctor, so I have different advice and expertise than someone who’s trained in that. So we need to put that there, so everyone knows who they’re listening to. And then it’s key that you use resources that are rooted in the evidence.

So those two pieces: I think when someone is looking for whether or not they can trust something on social media, they need to look at the credentials of the person speaking, and then they need to look at the evidence that they’re citing. And that really is the full check.

Kevin Pho: Now, whenever you share content on social media, or whenever you create content on social media, physicians can sometimes get attacked by those who don’t believe the science, who believe in conspiracy theories. So when you encounter people who push back against what you write, what is your approach in handling that situation?

Jaclyn Lewis Albin: I think you have to be careful not to respond in emotion, because as a pediatrician, I think I learned early on that almost every parent universally wants what’s best for their child, and they will sometimes be motivated by anger because of fear. And when people are afraid. Could we identify a time in our society, in my lifetime, where we’ve been more afraid? I don’t think so. So people are afraid, and it causes them to behave in strange ways. So I think part of the goal for anyone who wants to be a leader, who wants to be a voice when people are afraid, is to try to remain calm and not take it personally.

And sometimes that means I’m calling up a friend and I’m processing my thoughts before I respond. And sometimes it means choosing not to respond, if you think it’s not going to be fruitful, because conversations on social media can be wonderful and enriching, but there are times when there’s nothing that replaces a one-on-one conversation. So you have to choose your battles and be careful that you put your resources out in a space where people try to engage with an open mind.

Kevin Pho: So let’s take that question one step further. In your practice, I’m sure that you may be meeting people who may not believe in wearing masks, who believe that COVID is a conspiracy. From a pediatric standpoint, you may meet people who are vaccine hesitant or certainly don’t believe in the value of vaccines or believe in a false connection between vaccines and autism. Now, what is your approach in dealing with situations like these?

Jaclyn Lewis Albin: Well, so when it comes to things like vaccines, the beauty of primary care is a longitudinal relationship. And I always say to my patients, “If you don’t trust me about something big, I don’t know how you can trust me about all the little things that I do to guide your child’s health and future.” So I really try to build that relationship and hopefully come to a place of trust with my patients, where they believe that the things that I offer for their child are the same that I’m doing for my own children, and we’re able to get to the same root goals, which are to make a healthy and minimal-risk situation for their child to live a full life.

And when it comes to things like masks, I think what bothers me is how something that’s rooted in science and based in public health principles has become politicized. And I think that’s where we have to be careful who we engage with, because if someone wants to make the conversation political, it’s not very productive. And in our clinic, we require masking. If someone doesn’t want to comply with that, to protect the other patients around them and to protect us as health care professionals, then we ask them to not seek care in our building right now. We can serve them over telehealth.

Kevin Pho: We’re talking to Jaclyn Albin. She’s an internal medicine-pediatrics physician, and she wrote the KevinMD article “Dissent in the time of COVID-19.” Jaclyn, what is your number-one tip for physicians who want to go online and perhaps educate patients and share reputable sources of health information?

Jaclyn Lewis Albin: I think you want to stick to a relatively narrow spectrum, because we cannot all be experts about everything. And in my passion, culinary medicine, lifestyle medicine, I share a lot of information online, and that’s become a brand for me, really. And I think each physician needs to find something that they’re passionate about, that they can sort of wade through all the evidence, and also be willing to go through the challenging conversations to advance knowledge in that space.

And if you want to share something that’s pertinent to the times that’s really important, sometimes amplifying the voice of a colleague who’s an expert is a better choice than putting out your own content, because you want to keep it to a specific niche area that you feel really proud about promoting and really equipped to help engage with the public and with your colleagues.

Kevin Pho: And my final question: What is your take-home message for the KevinMD audience?

Jaclyn Lewis Albin: I would say that everything that matters usually takes longer and is harder than we wanted it to be. So when we choose the things that we want to champion as physicians, as advocates, as friends, and educators, we have to choose things that we feel excited and passionate about, that we believe are really important. And that carries us through the hard blood, sweat, and tears process of getting innovative things accomplished.

Kevin Pho: Well, thank you so much for sharing your insight. Thank you for your time and for being on the show.

Jaclyn Lewis Albin: Thanks so much. Take care.

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