Health Communication in the Age of Platforms: Drivers of Misinformation and the Crisis of Medical Expertise

Health Communication in the Age of Platforms: Drivers of Misinformation and the Crisis of Medical Expertise: Comparison

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Please note this is a comparison between Version 2 by Abigail Zou and Version 1 by Stylianos Papathanassopoulos.

Misinformation has emerged as a significant threat to both society and public health, with social media acting as a major conduit for its dissemination. This contributes to harmful health outcomes and undermines trust in authoritative institutions. In addition, the dismantling of scientific authority seems to be a symptom of the post-truth era, where “alternative facts” are presented in the public debate as indisputable evidence of the inherent limitations of scientific infallibility. The prevalence of misinformation on social media platforms stems from multiple, interconnected factors, including individual-level influences such as cognitive biases, as well as systemic aspects of social media’s information architecture. Unlike scientific institutions that adhere to the principles of evidence-based knowledge, social media platforms operate under an attention-driven model that favors virality over factuality. Addressing these challenges effectively requires coordinated, multi-level, and multidisciplinary interventions targeting users, content creators, technology companies, health authorities, and governments to restore public trust and safeguard the credibility of medical expertise.

misinformation
health communication
scientific expertise
trust
social media
conspiracy theories
polarization
post-truth

Over the years, the use of social media for information-seeking purposes has significantly increased. Many individuals now turn to social media platforms to obtain health-related information. Social media facilitates diverse interactions, enabling communication between patients and their peers ^[1] as well as fostering interaction between patients and healthcare professionals ^[2]. In their literature review research, Househ, Borycki and Kushniruk ^[3] documented a rise in patients’ social media use across various health-related topics, noting that different activities on these platforms may produce varying levels of patient engagement and empowerment. As a result, patients increasingly expect their healthcare providers to demonstrate not only outstanding clinical skills but also proficiency in digital communication ^[4] (p. 313).

A significant advantage of social media in health communication lies in its capacity to improve accessibility and disseminate health information to diverse demographic groups, regardless of age, education, race, ethnicity, or geographic location-unlike traditional methods ^[5]. In effect, medical practitioners often use social media to enhance communication with patients, promote behavioral changes, and ultimately achieve better health outcomes, though these benefits must be weighed against risks and ethical concerns ^[6]. During the COVID-19 pandemic, for instance, users shared health articles distributed by medical professionals on social media to raise awareness of preventive measures against the virus ^[7] (p. 2).

Research on the effects of social media use on patient-provider relationships indicates that these platforms can shift traditional power dynamics, encouraging patients to take a more active role in discussions and decision-making, a process known as patient empowerment ^[8]. Van Dijck and Alinejad describe a fundamental shift from the traditional “institutional model” of science communication, characterized by linear information flows between scientists, policymakers, journalists, and the public, toward a networked model ^[9]. In this new framework, social media acts as a “centrifugal force”, enabling multidirectional exchanges among all actors and reshaping the landscape of public debate. “The concept of apomediation, introduced by Dr. Gunther Eysenbach, a leading scholar in eHealth and health policy, captures a core aspect of the Medicine 2.0 paradigm: a shift toward openness and active user participation. In this model, individuals who seek medical information online increasingly bypass traditional gatekeepers-such as primary care physicians-and instead access credible information with the help of “apomediaries” (people, tools) that guide users to relevant and credible health information. Importantly, the presence of apomediaries is not mandatory; users can still access the information independently, but these intermediaries help ensure that the information is accurate and trustworthy ^[10] (p. 6). However, the advantages of this participatory model of information exchange can be offset by the risks and challenges inherent to social media platforms. The algorithmic amplification of misinformation and the formation of echo chambers that propagate views opposing scientific authority can undermine trust in medical expertise, potentially leading to serious public health consequences. Moreover, the absence of traditional journalistic gatekeeping allows populist actors to connect directly with the public, making their messages even more difficult to challenge or dismantle.

Responding to these challenges requires a multidisciplinary approach that promotes critical thinking in the consumption of medical information while also preserving a healthy and trustworthy relationship between medical experts and the public.

The following section addresses these issues through a thematic literature review, organizing research around key concepts and debates related to the topic. Relevant studies were identified through database searches using keywords such as trust in science, medical populism, science-related populism, health mis/disinformation, and health communication. This review is structured around three major thematic areas, trust and values in science, populist and anti-expert discourse, and misinformation (including triggers and strategies to combat it in digital health contexts), to synthesize insights on the interaction between public trust, expertise, and contemporary health communication in digital spaces.

References

Frost, J.H.; Massagli, M.P. Social Uses of Personal Health Information Within PatientsLikeMe, an Online Patient Community: What Can Happen When Patients Have Access to One Another’s Data. J. Med. Internet Res. 2008, 10, e15.
Wu, T.; He, Z.; Zhang, D. Impact of Communicating with Doctors via Social Media on Consumers’ E-Health Literacy and Healthy Behaviors in China. Inquiry 2020, 57.
Househ, M.; Borycki, E.; Kushniruk, A. Empowering Patients through Social Media: The Benefits and Challenges. Health Inform. J. 2014, 20, 50–58.
Romano, R.; Baum, N. How Pediatric Surgeons Use Social Media to Attract New Patients. Eur. J. Pediatr. Surg. 2014, 24, 313–316.
Moorhead, S.A.; Hazlett, D.E.; Harrison, L.; Carroll, J.K.; Irwin, A.; Hoving, C. A New Dimension of Health Care: Systematic Review of the Uses, Benefits, and Limitations of Social Media for Health Communication. J. Med. Internet Res. 2013, 15, e85.
George, D.R.; Rovniak, L.S.; Kraschnewski, J.L. Dangers and Opportunities for Social Media in Medicine. Clin. Obstet. Gynecol. 2013, 56, 453–462.
Zhao, H.; Fu, S.; Chen, X. Promoting Users’ Intention to Share Online Health Articles on Social Media: The Role of Confirmation Bias. Inf. Process. Manag. 2020, 57, 102354.
Smailhodzic, E.; Hooijsma, W.; Boonstra, A.; Langley, D.J. Social Media Use in Healthcare: A Systematic Review of Effects on Patients and on Their Relationship with Healthcare Professionals. BMC Health Serv. Res. 2016, 16, 442.
van Dijck, J.; Alinejad, D. Social Media and Trust in Scientific Expertise: Debating the Covid-19 Pandemic in The Netherlands. Soc. Media Soc. 2020, 6.
Eysenbach, G. Medicine 2.0: Social Networking, Collaboration, Participation, Apomediation, and Openness. J. Med. Internet Res. 2008, 10, e22.