There's been a dizzying amount of medical misinformation in recent years, some of it coming from healthcare professionals who shouldn't be sounding off.
A major problem for the average person in understanding healthcare is understanding who is an expert and in what.
Social media has erased the role of editorial quality control – for good and… well, really bad.
This is a problem often exaggerated by the legacy news media, which will bring any “expert” on to have an opinion on any topic. Having a cardiologist or neurosurgeon on a news panel to state an opinion on vaccines or the COVID response feels like you're getting the smartest people to share their insights.
But the reality is that they only have a marginally better grasp of the topics than you do. Essentially, they already know the vocabulary that is used.
But they don't know the science, and they don't know the practice.
There's a joke that says, “If you ask a surgeon to cure anything, the recommendation will always be surgery.” So where are these areas of conflation or misguided belief in expertise?
So who should I trust to tell me what’s wrong?
Let's start with who we should respect but shouldn't take medical advice from: nurses.
Nurses are the front line of healthcare. They have seen everything and, especially if they are an ER nurse, are incredibly well-trained in high-stress situations. They are overworked and have historically not been respected as much as they should.
They should not, however, be diagnosing people or giving medical advice as an expert.
Is it fine to ask a friend who is a nurse about how to treat a sprained ankle or even a seasonal allergy? Absolutely. They have likely seen just about everything under the sun, and if it's a non-emergency, we should feel confident that they are giving us time-tested advice.
But they aren't giving us medical school advice. They have not been trained to diagnose or treat specific illnesses or diseases. They have opinions that they've formed based on the same information you get on social media and in their social circles.
So, suppose you're asking a nurse in Texas about COVID. In that case, you're more likely to get an answer corresponding to that sociopolitical bubble than you would when asking a nurse at Massachusetts General Hospital.
It can be tough not to trust your circle or the people around you, and I know that there are nurses who will talk as though they have their MD, but they don't and they shouldn't. It's no disrespect to them, but we do need to clarify that distinction.
Is my family doctor dependable?
Next, we have primary care physicians, i.e., family doctors or general practitioners. Just the fact that there are so many different names for them is an issue in and of itself.
PCPs are incredibly important. They have the same exposure to everything that a nurse has, but they also have a medical degree. They have been trained to diagnose and treat conditions – and they should be your first step in any journey to care.
However, a PCP is not a specialist, even though they may act like one.
When I was working for a major healthcare network, we were updating our “find-a-doctor” tool that had previously been based on the doctors' self-reported expertise. No matter what specialty condition you put in, the first result would end up being a PCP.
Heart Disease? A PCP self-reported as a specialist.
Endocrinology? A PCP said they've got you.
Of course, we had to go through and re-credential all of these searches based on actual specialties and education – and you see the problem. All these doctors felt that they could and should be able to treat these conditions.
However, the reality is that a PCP is not an expert in any specialty. They're a jack-of-all-trades… and specifically are a master-of-none.
Again, this is not to disparage PCPs. They are the backbone of our healthcare system and incredibly important. However, you shouldn't have a PCP be your gynecologist or your neurologist. They can recommend you to great specialists – but don't trust a PCP to diagnose you better than a specialist.
They know a lot about some things, but not everything.
Lastly, we have the specialists. The neurosurgeon, the oncologist, or the cardiologist. These are the best trained in specific disciplines. In their fields, their advice should only be compared against their peers – not outside.
Because of the amount of training and experience required, they are highly respected and highly paid. Their advice is the best you can get.
But only in what they've been trained.
If you ask a neurosurgeon their opinion on intermittent fasting or the use of GLP-1s, their answer will be no more informed than yours. There's a chance that they are good friends with a doctor of pharmacy, or PharmaD, and someone who focuses on metabolic science, but outside of “knowing a guy,” they have no more training in it than you do.
As such, their opinion is equally swayed by sociopolitical influence – or sometimes, even worse, by their ego.
It's a real problem at this level. And it's very common, though nobody likes to talk about it.
But when you're at the top of your field in a world where lives are on the line, you don't have the privilege of second-guessing yourself or not believing in your ability.
That's great in your specialty – but it's also why we had a neurosurgeon running for president who believed the pyramids were constructed to store grain.
If you see a cardiologist speaking on epidemiology (the spread of disease in populations), it's best to take their opinion with a grain of salt – or several grains. No matter how impressive their credentials are, they should not be talking about it with authority if it isn't their specialty.
These conflations of expertise have led to incredible amounts of misinformation and healthcare crises. If you want medical advice, seek an expert in the field you have the question.
Don't be fooled by credentials and confidence.
