This was a terrific session, thoughtful, practical, and deeply relevant. The choice to include a clear summary assisted by ChatGPT was especially smart. Many of us may not have the time to watch the full video (even though it is clearly worth it), so the write-up makes the insights more accessible and actionable. Dr. Panthagani’s approach to communication, balancing empathy, clarity, and scientific nuance, should be central to how we train the next generation. As a physician, I’ve seen firsthand how critical this is. Looking forward to more conversations like this.
I hate to use a failure at NASA to illustrate a point, but the Challenger disaster is something most of us are familiar with. That launch of the space shuttle was a particularly public one because a teacher was going up with the astronauts. Among all the experts involved with the launch was a PR expert and someone whose expertise was in, among other things, an obscure part of the massive shuttle called an O ring. The long awaited launch had already been delayed and/or rescheduled at least once, and as the next launch window approached, the forecasted temperature was too low for the safe performance of the O Ring. The expert on this stated this in unequivocal terms, i.e. "If it is too cold, the ring will fail and the shuttle will blow up." In the end, the PR person who made the case that it would not be good public relations to delay the launch again and that could reflect badly on the political administration at that time, won out and they decided to go ahead with the launch. The poor bastard whose job it was to provide expert advice on the O Ring parameters went home that night in a total state according to his wife, saying that it was going to be a disaster. Well, we all know what happened. The damn thing blew up on live television. I would submit that this was a golden opportunity to educate the public on the complexities of such a mission so that they would understand why the launch had to be delayed. Instead, the decision was made to "chance it" so the public would not think poorly of the program and the politicians currently in office. I wonder to this day what ever happened to that guy who worked his entire life to be an expert on that issue at that moment and who wasn't listened to when the moment came. Similar issues arose with COVID, and in the end, as a country, we failed miserably in the handling of that situation when we had all the experts and tools we needed to handle it better than any other country in the world. Once again, we had the best experts in the world to advise us, but had either no trust in what they had to say or saw little value in allowing them to freely communicate the reality of the situation to the American people.
I wanted to add a point on why people likely turned to media to get health advice in the first place. For example I’m a very healthy person and deeply interested in health and wellbeing, so when something feels off about me I expect my Dr to do the research and find out what’s wrong with me—but sadly through the years my experience has been poor in that regard. Drs would dismiss me or tell me that kind of bloodwork or test isn’t covered by insurance. And that’s the problem to begin with: insurance. We know that it’s a greedy money hungry business which likely puts limitations on what Dra can and can’t do (I’d love to get your thoughts on that one) but anyway this is exactly what would leave me looking for answers myself—AKA google and social media.
Another lost opportunity during the pandemic to bring the people of the world together on a communal achievement as squandered when the James Webb Telescope was ready to unfold it's mirrors. Yes, it was broadcast of some obscure channel, but that SHOULD have been broadcast on every station in every country around the world. It was a collaborative effort between many nations of the world and scientists at the top of their game who had spent decades working towards that moment. I forget the exact number, but there were something like 361 separate points of failure that had to work exactly correctly for that telescope to open correctly and begin working. And there was no way to fix it after the fact. I'll never forget watching the control room headquarters with these scientists from so many different countries sitting there twisting their hands as each of those points of failure worked as intended. What an incredible opportunity to put in front of people the complexities of science, replete with the things we know, the things we don't know or aren't sure of. We could have educated people about something other than COVID. God knows people needed the distraction. Opportunities like that CANNOT continue to be missed.
I am an NP, have been for many years. Nurses can teach how to communicate. We do it all the time at the bedside, and in the clinic. We teach patients how to take their medications, prepare them for surgery, get them ready for discharge, and so on. We teach everyone regardless of age, reading level, ethnicity, and politics. How we do this has been ingrained in our education for years!
Great discussion. I am grateful this discussion is occurring and is so needed in healthcare and across the entire spectrum of our society. One doesn’t need to look far to see the messaging and communication problems occurring in governance, in public safety, law-enforcement, social services, environmental protection, and on and on. We need folks skilled in communicating and I agree this is an aspect of education in all disciplines needing additional attention. I make one observation about healthcare communication. There are many healthcare professionals out there that are often overlooked. I agree with the comments of the nurse practitioner. Another healthcare professional communicator, often overlooked, is the pharmacist. As access to healthcare decreases as a consequence of expected funding cuts folks will seek alternative sources of information and care. Let’s get the team in healthcare together and provide a proactive approach to communication. All of us are on the same team and can learn from one another; however, we need to know who all the team players are.
Lucid interview. Dr. Faust you might be interested in the work Cory Clark, PhD. She runs the Adversarial Collaboration Project at U. Penn. Some of her research has focused on having researchers with widely differing viewpoints collaborate. The outcome was not what one would expect.
A patient who reveals directly or by the nature of a question that the patient has read about the condition or disease on the Internet, many doctors respond by criticizing the Internet and instructing the patient never to use it for medical searches. Patients who are chastised and often humiliated in this manner routinely respond by concealing their continuing use of the Internet. Doctors need to respond by teaching their patients how to research medical concerns on the Internet and welcoming questions and the opportunity to explain their diagnosis, the scope of their investigation to date, any further investigation to be done, the variety of options reasonably available to the patient, and other relevant information the patient needs and wants. The dialogue can reveal additional diagnostic facts the patient had not yet mentioned because they did not seem relevant or were embarrassing or whatever. The dialogue can also foster trust in the doctor and the diagnosis or inability to diagnose. Open communication is key to successful doctor-patient relationships.
Doctors can explain which reports on the Internet are credible and how to recognize them and perhaps provide a explanatory handout in about the same time required to chastise and criticize the patient for seking information on the Internet. Failure to give good information and encourage open communication only diminishes the quality of care and likelihood that curable problems become worse.
Insurance companies are reimbursing for the time wasted on criticizing patients for looking for answers (although I recognize that doctors do not describe the time that way when seeking reimbursement).
As I watch the recording of this, I will comment as I go. When I was attending UMBC, one of the big selling points for the university was that they have actual researchers in a given field teaching classes. My understanding was that in order for the researcher to be given the space and funds to do his or her research, they had to teach a course in that area. I remember well taking some of these classes, and it was clear that the researcher didn't want to be teaching and wasn't interested in learning how to get what was in his head into mine. As a student who attended a number of different colleges and universities over my years of education, I had good teachers and bad teachers, and the fact is, the best teachers were those who wanted to teach. Teaching, like management, is a skill in and of itself regardless of what the field is. The way our society is set up is that in order to advance in one's field, the path is through management. But, and here's the problem, people are not taught how to manage very well and therefore all of us know all too well what it's like to suffer under a poor manager. The same is true for teaching. It is a skill to explain what you know to someone else. If you want someone to understand and by-in to what you're prescribing for them, it's not enough to just know why you're recommending this. You have to be able to explain that to the patient.
Thank you both for the informative conversation yesterday. It occurred to me that a collaboration with a team of experienced health educators through one of the teacher's unions might help clarify "reading levels", vocabulary, etc.
Please define "misinformation". It is only "information" that is deemed to be incorrect by someone. It is their opinion. There is no absolute truth-meter, as we found out much of what was deemed "misinformation" during COVID was actually true, but not in the interests of some party due to economic or political biases. Whenever I hear someone using the Appeal to Authority tactic and invoking that term, I tune out what they have to say. Use logic to explain your position and realize that there may be legitimate, or even superior, alternative views when the topic is "truly complex" and not "merely complicated". The difference is huge. We physicians used to be morally and legally required to give Informed Consent--explain the risks, benefits and alternatives and let the patient decide. That all went out the window with COVID and now people question everything we physicians tell them, and rightly so. This is one of the reasons trust in physicians and hospitals has plummeted. People aren't stupid.
Not making an attempt at actively combatting misinformation & disinformation might be a mistake. Disinformation networks, both foreign state funded (Russia, China, etc) and local grifters (Alex Jones, the GOP, etc) are actively exploiting human psychology directly via social media, comment sections, and so forth with advanced techniques. It's a national security issue. They are extremely effective. Their primary goals are creating dissent and conflict within democratic countries. A country at war with itself cannot focus on external threats. They target sources of authority (medical, etc) directly with a fire hose of disinformation and other known tactics. The rise of the Internet and smartphones has made this incredibly easy. Readers and the public should be made aware of these intense psyop campaigns. There's plenty of investigative journalism proving their existence and effects.
They use one 1️⃣ Dr Josh Morgan out of ( Texas) . I was feeling awful 😞. Yesterday the rooms were all spinning around. They gave me decongested, medication. And cough syrup to ease , my body aches.
Nice interview with lots of excellent suggestions! I agree that education about communication is important for all health care professionals. There are so many competing areas to integrate into the curriculum of health professionals that I find one of the challenges is sorting out what can be removed! We had a decent amount of communication training in our pharmacy program. I think the point of care interaction is still the most effective in communicating information to patients.
Thank you for the many insights into the importance of communication. As a patient/advocate for myalgic encephalomyelitis, I have spent a lot of time talking with other advocates about how to better communicate the reality of living with this debilitating disease and the science that we now know. To say it is challenging to succinctly explain this complex neuroimmune disease is an understatement. Especially since we often have to explain the prior misinformation that most doctors base their treatment protocols on.
It's hard when the scientific explanation is succinct, but ends up not being understood. But trying to put together accurate information at a lower reading level has too often missed the mark.
What happened decades ago (1994) was the CDC created a broad vague criteria that lumped ME patients under the chronic fatigue syndrome umbrella. To say that the label CFS (which apparently was to make it easier to understand) led to total misunderstanding about what ME is and that led to patients being mistreated. CFS became known as a psychologically based disease and I think it is accurate to say that those of us with ME have had some of the worst interactions with doctors of any patient group. There is a LOT of misinformation about this disease - which puts us at odds with many doctors and the general public.
Your talk brought up so many important points that advocates in our community have worked hard to implement.
1. Know your audience
2. Update methods to communicate
3. Headlines matter
This topic of communicating using Substack brings up something that has recently happened to my Substack. (View from the Trenches of Myalgic Encephalomyelitis). The word "misinformation" is one of many terms that seem to be getting flagged by Substack's bot (?). Recently, when writing articles that explain about the challenges people with ME face when going to the doctor or talking with friends and family, Substack gave me a "suspicious content" warning before I publish. In order to prevent that warning "misinformation" was one of the words that I needed to remove.
Maybe you can find out what is going on with Substack cracking down on medical information... (FYI - I have used chatGPT to help me edit my last two articles in order to prevent triggering the "suspicious content" warning.) That has led to watering down my comments - which means I am unable to fully communicate about ME.
Here's a lesson that really resonated with me: Stanley McCrystal wrote a book called, "Risk" about understanding the nature of risk and how to handle it. When Carter was huddled with his advisors planning the rescue of the Iran hostages, there were something like 8 or 9 things that HAD to go absolutely correctly for it to be a success. In each of these areas, the expert on that aspect of the mission expressed a 90% or higher degree of certainty that that part of the operation would be a success. So, incorrectly, the conclusion was the probability of a successful rescue of the hostages was high. In actuality, the chances were .9 x .9 x .9....etc. for a total probability of success of less than 33%. Puts a whole different twist on the situation, doesn't it. Basic math that wasn't recognized by any of the experts in the room and was never communicated to the public so far as I know. Hugely impactful event that tanked Carter's re-election chances that was not admitted to, which I would argue could have been used to assure his victory but instead ushered in the Reagan years, which changed the entire trajectory of the country.
This was a terrific session, thoughtful, practical, and deeply relevant. The choice to include a clear summary assisted by ChatGPT was especially smart. Many of us may not have the time to watch the full video (even though it is clearly worth it), so the write-up makes the insights more accessible and actionable. Dr. Panthagani’s approach to communication, balancing empathy, clarity, and scientific nuance, should be central to how we train the next generation. As a physician, I’ve seen firsthand how critical this is. Looking forward to more conversations like this.
I hate to use a failure at NASA to illustrate a point, but the Challenger disaster is something most of us are familiar with. That launch of the space shuttle was a particularly public one because a teacher was going up with the astronauts. Among all the experts involved with the launch was a PR expert and someone whose expertise was in, among other things, an obscure part of the massive shuttle called an O ring. The long awaited launch had already been delayed and/or rescheduled at least once, and as the next launch window approached, the forecasted temperature was too low for the safe performance of the O Ring. The expert on this stated this in unequivocal terms, i.e. "If it is too cold, the ring will fail and the shuttle will blow up." In the end, the PR person who made the case that it would not be good public relations to delay the launch again and that could reflect badly on the political administration at that time, won out and they decided to go ahead with the launch. The poor bastard whose job it was to provide expert advice on the O Ring parameters went home that night in a total state according to his wife, saying that it was going to be a disaster. Well, we all know what happened. The damn thing blew up on live television. I would submit that this was a golden opportunity to educate the public on the complexities of such a mission so that they would understand why the launch had to be delayed. Instead, the decision was made to "chance it" so the public would not think poorly of the program and the politicians currently in office. I wonder to this day what ever happened to that guy who worked his entire life to be an expert on that issue at that moment and who wasn't listened to when the moment came. Similar issues arose with COVID, and in the end, as a country, we failed miserably in the handling of that situation when we had all the experts and tools we needed to handle it better than any other country in the world. Once again, we had the best experts in the world to advise us, but had either no trust in what they had to say or saw little value in allowing them to freely communicate the reality of the situation to the American people.
I wanted to add a point on why people likely turned to media to get health advice in the first place. For example I’m a very healthy person and deeply interested in health and wellbeing, so when something feels off about me I expect my Dr to do the research and find out what’s wrong with me—but sadly through the years my experience has been poor in that regard. Drs would dismiss me or tell me that kind of bloodwork or test isn’t covered by insurance. And that’s the problem to begin with: insurance. We know that it’s a greedy money hungry business which likely puts limitations on what Dra can and can’t do (I’d love to get your thoughts on that one) but anyway this is exactly what would leave me looking for answers myself—AKA google and social media.
Burn insurance companies down is my opinion.
Another lost opportunity during the pandemic to bring the people of the world together on a communal achievement as squandered when the James Webb Telescope was ready to unfold it's mirrors. Yes, it was broadcast of some obscure channel, but that SHOULD have been broadcast on every station in every country around the world. It was a collaborative effort between many nations of the world and scientists at the top of their game who had spent decades working towards that moment. I forget the exact number, but there were something like 361 separate points of failure that had to work exactly correctly for that telescope to open correctly and begin working. And there was no way to fix it after the fact. I'll never forget watching the control room headquarters with these scientists from so many different countries sitting there twisting their hands as each of those points of failure worked as intended. What an incredible opportunity to put in front of people the complexities of science, replete with the things we know, the things we don't know or aren't sure of. We could have educated people about something other than COVID. God knows people needed the distraction. Opportunities like that CANNOT continue to be missed.
I am an NP, have been for many years. Nurses can teach how to communicate. We do it all the time at the bedside, and in the clinic. We teach patients how to take their medications, prepare them for surgery, get them ready for discharge, and so on. We teach everyone regardless of age, reading level, ethnicity, and politics. How we do this has been ingrained in our education for years!
Great discussion. I am grateful this discussion is occurring and is so needed in healthcare and across the entire spectrum of our society. One doesn’t need to look far to see the messaging and communication problems occurring in governance, in public safety, law-enforcement, social services, environmental protection, and on and on. We need folks skilled in communicating and I agree this is an aspect of education in all disciplines needing additional attention. I make one observation about healthcare communication. There are many healthcare professionals out there that are often overlooked. I agree with the comments of the nurse practitioner. Another healthcare professional communicator, often overlooked, is the pharmacist. As access to healthcare decreases as a consequence of expected funding cuts folks will seek alternative sources of information and care. Let’s get the team in healthcare together and provide a proactive approach to communication. All of us are on the same team and can learn from one another; however, we need to know who all the team players are.
Lucid interview. Dr. Faust you might be interested in the work Cory Clark, PhD. She runs the Adversarial Collaboration Project at U. Penn. Some of her research has focused on having researchers with widely differing viewpoints collaborate. The outcome was not what one would expect.
A patient who reveals directly or by the nature of a question that the patient has read about the condition or disease on the Internet, many doctors respond by criticizing the Internet and instructing the patient never to use it for medical searches. Patients who are chastised and often humiliated in this manner routinely respond by concealing their continuing use of the Internet. Doctors need to respond by teaching their patients how to research medical concerns on the Internet and welcoming questions and the opportunity to explain their diagnosis, the scope of their investigation to date, any further investigation to be done, the variety of options reasonably available to the patient, and other relevant information the patient needs and wants. The dialogue can reveal additional diagnostic facts the patient had not yet mentioned because they did not seem relevant or were embarrassing or whatever. The dialogue can also foster trust in the doctor and the diagnosis or inability to diagnose. Open communication is key to successful doctor-patient relationships.
Yes, I agree. How do we get insurance reimbursement for doctors to be able to schedule the time for this?
Doctors can explain which reports on the Internet are credible and how to recognize them and perhaps provide a explanatory handout in about the same time required to chastise and criticize the patient for seking information on the Internet. Failure to give good information and encourage open communication only diminishes the quality of care and likelihood that curable problems become worse.
Insurance companies are reimbursing for the time wasted on criticizing patients for looking for answers (although I recognize that doctors do not describe the time that way when seeking reimbursement).
As I watch the recording of this, I will comment as I go. When I was attending UMBC, one of the big selling points for the university was that they have actual researchers in a given field teaching classes. My understanding was that in order for the researcher to be given the space and funds to do his or her research, they had to teach a course in that area. I remember well taking some of these classes, and it was clear that the researcher didn't want to be teaching and wasn't interested in learning how to get what was in his head into mine. As a student who attended a number of different colleges and universities over my years of education, I had good teachers and bad teachers, and the fact is, the best teachers were those who wanted to teach. Teaching, like management, is a skill in and of itself regardless of what the field is. The way our society is set up is that in order to advance in one's field, the path is through management. But, and here's the problem, people are not taught how to manage very well and therefore all of us know all too well what it's like to suffer under a poor manager. The same is true for teaching. It is a skill to explain what you know to someone else. If you want someone to understand and by-in to what you're prescribing for them, it's not enough to just know why you're recommending this. You have to be able to explain that to the patient.
Thank you both for the informative conversation yesterday. It occurred to me that a collaboration with a team of experienced health educators through one of the teacher's unions might help clarify "reading levels", vocabulary, etc.
Please define "misinformation". It is only "information" that is deemed to be incorrect by someone. It is their opinion. There is no absolute truth-meter, as we found out much of what was deemed "misinformation" during COVID was actually true, but not in the interests of some party due to economic or political biases. Whenever I hear someone using the Appeal to Authority tactic and invoking that term, I tune out what they have to say. Use logic to explain your position and realize that there may be legitimate, or even superior, alternative views when the topic is "truly complex" and not "merely complicated". The difference is huge. We physicians used to be morally and legally required to give Informed Consent--explain the risks, benefits and alternatives and let the patient decide. That all went out the window with COVID and now people question everything we physicians tell them, and rightly so. This is one of the reasons trust in physicians and hospitals has plummeted. People aren't stupid.
This is one of the reasons I don’t like to use the word — many people interpret as you describe here, a matter of opinion.
Not making an attempt at actively combatting misinformation & disinformation might be a mistake. Disinformation networks, both foreign state funded (Russia, China, etc) and local grifters (Alex Jones, the GOP, etc) are actively exploiting human psychology directly via social media, comment sections, and so forth with advanced techniques. It's a national security issue. They are extremely effective. Their primary goals are creating dissent and conflict within democratic countries. A country at war with itself cannot focus on external threats. They target sources of authority (medical, etc) directly with a fire hose of disinformation and other known tactics. The rise of the Internet and smartphones has made this incredibly easy. Readers and the public should be made aware of these intense psyop campaigns. There's plenty of investigative journalism proving their existence and effects.
They use one 1️⃣ Dr Josh Morgan out of ( Texas) . I was feeling awful 😞. Yesterday the rooms were all spinning around. They gave me decongested, medication. And cough syrup to ease , my body aches.
Nice interview with lots of excellent suggestions! I agree that education about communication is important for all health care professionals. There are so many competing areas to integrate into the curriculum of health professionals that I find one of the challenges is sorting out what can be removed! We had a decent amount of communication training in our pharmacy program. I think the point of care interaction is still the most effective in communicating information to patients.
Thank you for the many insights into the importance of communication. As a patient/advocate for myalgic encephalomyelitis, I have spent a lot of time talking with other advocates about how to better communicate the reality of living with this debilitating disease and the science that we now know. To say it is challenging to succinctly explain this complex neuroimmune disease is an understatement. Especially since we often have to explain the prior misinformation that most doctors base their treatment protocols on.
It's hard when the scientific explanation is succinct, but ends up not being understood. But trying to put together accurate information at a lower reading level has too often missed the mark.
What happened decades ago (1994) was the CDC created a broad vague criteria that lumped ME patients under the chronic fatigue syndrome umbrella. To say that the label CFS (which apparently was to make it easier to understand) led to total misunderstanding about what ME is and that led to patients being mistreated. CFS became known as a psychologically based disease and I think it is accurate to say that those of us with ME have had some of the worst interactions with doctors of any patient group. There is a LOT of misinformation about this disease - which puts us at odds with many doctors and the general public.
Your talk brought up so many important points that advocates in our community have worked hard to implement.
1. Know your audience
2. Update methods to communicate
3. Headlines matter
This topic of communicating using Substack brings up something that has recently happened to my Substack. (View from the Trenches of Myalgic Encephalomyelitis). The word "misinformation" is one of many terms that seem to be getting flagged by Substack's bot (?). Recently, when writing articles that explain about the challenges people with ME face when going to the doctor or talking with friends and family, Substack gave me a "suspicious content" warning before I publish. In order to prevent that warning "misinformation" was one of the words that I needed to remove.
Maybe you can find out what is going on with Substack cracking down on medical information... (FYI - I have used chatGPT to help me edit my last two articles in order to prevent triggering the "suspicious content" warning.) That has led to watering down my comments - which means I am unable to fully communicate about ME.
Here's a lesson that really resonated with me: Stanley McCrystal wrote a book called, "Risk" about understanding the nature of risk and how to handle it. When Carter was huddled with his advisors planning the rescue of the Iran hostages, there were something like 8 or 9 things that HAD to go absolutely correctly for it to be a success. In each of these areas, the expert on that aspect of the mission expressed a 90% or higher degree of certainty that that part of the operation would be a success. So, incorrectly, the conclusion was the probability of a successful rescue of the hostages was high. In actuality, the chances were .9 x .9 x .9....etc. for a total probability of success of less than 33%. Puts a whole different twist on the situation, doesn't it. Basic math that wasn't recognized by any of the experts in the room and was never communicated to the public so far as I know. Hugely impactful event that tanked Carter's re-election chances that was not admitted to, which I would argue could have been used to assure his victory but instead ushered in the Reagan years, which changed the entire trajectory of the country.