“I don’t need meds;” “A natural cure for diabetes;” “They will sell my teeth to the government”

Future physicians share first-hand accounts of medical misinformation’s reach and durability as winners of the 2023 Building Trust Essay Contest

The worst of the COVID-19 pandemic might be over, but the medical misinformation it exacerbated has caused harmful and long-lasting societal effects, from vaccine reluctance to the distrust of, and threats of violence against, health care workers.

The medical student essayists who have won the second Building Trust Essay Contest, sponsored by the American Medical Student Association (AMSA) and the ABIM Foundation, are being honored for their portrayals of misinformation that continues even after the Public Health Emergency has been lifted. Medical students from 20 schools across the country submitted essays about their experiences with misinformation in a health care setting. The six winners – along with brief excerpts from their essays – are as follows:

• Molly Fessler, University of Michigan Medical School “Can we get you a COVID test today?” Our patient looked up sharply. I was aware of him taking in my N-95, the pro-vaccination pin on my lanyard. “Nah,” he said, “that COVID thing is a hoax.” Immediately, my heart began to beat with agitation. I couldn’t ignore his provocation: the presentation of false facts, my own knowledge questioned, and, of course, the public health ramifications of his belief.

• Isra Hasnain, The University of Chicago Pritzker School of Medicine “It sounds like you’ve been struggling. There are options we can talk about,” said the physician. “Therapy, medication…” “No. I don’t want medication,” she interrupted. Her response was firm and immediate, and I saw the attending’s head tilt in concern. “Why don’t you want medication?” “I read on Facebook that it changes your personality,” the patient replied. Her hands trembled in her lap. My attending gently reached over to pry the patient’s hands apart and hold them in her own. “And makes you crazy. I don’t want to mess with anything. I’m not weak. I can handle it. I don’t need meds.”

• Ian Jaffe, NYU Grossman School of Medicine The website was slick, with high-quality, scientific-appearing diagrams and links to real scientific studies. It said that the blend of “earth-grown herbs and natural compounds work together to restore healthy blood sugar levels.” A natural cure for diabetes had to be better than taking Metformin forever, right? Reviews on the website near-universally said that GlucoBal had balanced people’s blood sugar. He even clicked on one of the linked studies. It seemed to support what the website was claiming. There wasn’t any need to pick up the Metformin from the pharmacy.

• Meher Kalkat, The Johns Hopkins University School of Medicine (winner of the 2022 Building Trust Essay Contest) “David, you need a root canal due to the deterioration of your teeth.” I explain the procedure to him and its importance to his health, but he shakes his head vigorously to make me understand. “They will sell my teeth to the government. They will use it to track me down or frame me for a crime.” David’s fears are far from unfounded. His deep mistrust of the medical system is borne from experiences in his home country, where the government arrested people for crimes they did not commit, and health care providers turned over patients to the police. His belief of misinformation is rooted in conversations with other refugees that have warned him that people may pretend to help him only to send him back to his home country.

• Elina Kurkurina, Frank H. Netter MD School of Medicine at Quinnipiac University The issue with online information is that it’s often out of context. Internet searches tend to identify rare or worst-case outcomes. Misinformation and misinterpretation often go hand-in-hand, and it’s hard to navigate this space alone. Caring for vulnerable patients requires trust, comfort, and thoughtful communication to help alleviate the anxiety often experienced by patients in these settings. Teachable moments in the clinic are an opportunity for these values to shine.

• Christopher Montgomery, UCSF School of Medicine Teddy, a Harlem native, was supported, loved, and grew up in the surrounding community, and he now returns the favor every day, taking care of his community in a space meant to be safe. As the needle pierced his skin, its protective contents pushed into his body, he immediately looked at me. Teddy asked me to be with him for his first COVID-19 vaccination. Seeing doubt and fear in his eyes, questioning what he had just done, was, for lack of a better word, painful. However, Teddy receiving that life-saving (for many) vaccine, trusting what he was taught, and relying on the information he learned, was motivating.

“We should all be seriously concerned when our future doctors have to meet head-on the sort of profound medical misinformation that has warped the view of science, reduced trust in the reliability of clinicians, and forced so many out of medicine,” said Richard J. Baron, MD, President and CEO of the American Board of Internal Medicine and the ABIM Foundation. “I’m inspired by these students for fearlessly sharing their experiences about discrimination, medical conspiracies, vaccine hesitancy, and the pervasive stigma surrounding mental health.”

“I was deeply impressed by the insights shared by medical students, highlighting the crucial role trust plays in their relationships with faculty, peers, and most importantly with their patients and communities,” said Rohini Kousalya Siva, MD, MPH, MS, AMSA’s National President. “Their perspectives not only underscore the importance of fostering trust as a foundation for effective health care delivery, and for forming meaningful connections, but also emphasize the importance of addressing medical misinformation.”

Essays were reviewed and scored on the (1) connection to the topic of trust, (2) quality of writing, (3) novelty of the message, and (4) opportunity for others to learn by an esteemed panel of judges:

• Maria L. Belalcazar, MD, Vice Chair for Equity, Diversity, and Inclusion at the University of Texas Medical Branch
• Marianne M. Green, MD, FACP, Vice Dean for Education, Raymond H. Curry MD Professor of Medical Education, and Professor of Medicine at Northwestern University, Feinberg School of Medicine
• Lorna A. Lynn, MD, Vice President of Medical Education Research at the American Board of Internal Medicine
• Furman S. McDonald, MD, MPH, Senior Vice President for Academic and Medical Affairs at the American Board of Internal Medicine
• David Reuben, MD, Director, Multicampus Program in Geriatrics Medicine and Gerontology and Chief, Division of Geriatrics at UCLA
• Annelise Silva, AMSA National President-elect, medical student at Wright State Boonshoft School of Medicine
• Rohini Siva, AMSA National President, 4th year medical student at Eastern Virginia Medical School
• Daniel Wolfson, MHSA, Executive Vice President and COO of the ABIM Foundation

Full essays can be read here.

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About the ABIM Foundation The ABIM Foundation’s mission is to advance medical professionalism to improve the health care system by collaborating with physicians and physician leaders, medical trainees, health care delivery systems, payers, policymakers, consumer organizations and patients to foster a shared understanding of professionalism and how they can adopt the tenets of professionalism in practice. To learn more about the ABIM Foundation, visit www.abimfoundation.org, connect on LinkedIn or follow on Twitter.   About the American Medical Student Association AMSA is the oldest and largest independent association of physicians-in-training in the United States. Founded in 1950, AMSA is a student-governed, non-profit organization committed to representing physicians-in-training, advocating for quality and affordable health care for all, and building the next generation of physician leaders. To join our community, visit amsa.org.

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