Showing posts with label X. Show all posts
Showing posts with label X. Show all posts

Sunday, December 31, 2023

Misinformation X


I have a lot of blog posts in the works right now. That strategy works for me because my attention has always been a problem and it works better to work on many things at once rather than bogging down on one. I decided to post on this topic and the one that may be the most relevant. The content of my blog tends to go from scientific and medical topics, to social topics, to a lot of posts that address current misinformation. The Information Age has become the Misinformation Age and there is probably no better example than the platform formerly known as Twitter.

Twitter used to be an invigorating and informative place for physicians. I could count on reasonable discussions and literature references by daily participation and focusing on specific colleagues. In psychiatry – there is a chronic misinformation problem dating back to Szasz, Foucault, and others in the 1970s.  They created tropes and memes that are still repeatedly used by antipsychiatrists today to deny the reality of mental illness and the real function and value of psychiatry. In many ways this sort of criticism has generalized to the rest of medicine and that became very clear during and after the pandemic.  The takeover of Twitter by Elon Musk and his so-called “free speech” policies made that site a fountain of misinformation.  The amount of misinformation would be embarrassing to anyone concerned with the truth or reality but these days those constraints clearly do not apply.  The truth is of little value in much of what can be read on X.  I would go as far as saying the truth is actively devalued on X and you can read falsehoods about settled areas of science, medicine, and public policy.

There is a clear positive correlation between the transition in management and an increase in misinformation, hate speech, hate speech and antisemitism.  Problems also existed before that transition and some were highlighted during the pandemic. Misinformation about vaccinations, masks, and public health personnel were clear problems. Despite what happened during the pandemic that misinformation has clearly increased.  The day before I started writing this post there was a great deal of misinformation about how “jabs” (misinfospeak for COVID immunizations) cause blood clots and that there would be a tsunami of deaths from thromboembolic diseases.  Several physicians posted clearcut evidence to refute this misinformation.  Most physicians are also aware of the fact that immunization are the single most effective intervention to prevent death in large populations. That evidence, including the evidence for COVID-19 immunization effectiveness is indisputable.  Medical research on Long-COVID or chronic symptoms following infection with the virus is also clearer now. Trying to avoid that chronic state and the associated disability is another good reason to get immunized.    Practicing physicians have a healthy respect for respiratory viruses.  We have all seen healthy young people die from infections with what are considered common cold viruses.  

A great solution for physicians and scientist would be a medical or scientific Twitter.  It seems like a simple matter but I suppose maintenance and day-to-day fees would need to be covered in addition to the original programming. To prevent the vulgarians shouting in the city square behavior of X – a simple model of behavior consistent with what would be expected in a medical or scientific staff meeting should suffice. No personal attacks, gaslighting, ridiculing, etc. and active moderation.  People would certainly be able to debate the merits of climate change and other controversial topics – but the arguments would need to be based on facts and scientific merit rather than political rhetoric. People would not be allowed to post baseless claims about another person, a theory, or a piece of research. 

The defenders of name calling, gaslighting, and misinformation all tend to hide behind the First Amendment. There is plenty of evidence in the current news that there is no absolute right to say whatever you want to say about a person or a business.  Hundreds of millions of dollars have been assessed as legal penalties for those statements in several high-profile civil suits. Litigation is a crude and expensive instrument for keeping discourse focused and civil.  A specific environment is a much better approach. Instead of proclaiming a web site as having absolute free speech – it is far better to have the exchanges moderated according to specific rules. Hence the staff meeting approach.  I have certainly been in staff meetings where tempers flared, but there was no name calling or threatening behavior. There was disagreement about information but at no point was there any question about deliberately misrepresenting the information or repeatedly lying about it.  The largest professional staff I worked with was about 35 psychiatrists.  The entire time I worked there I had no doubt about the integrity or sincerity of my colleagues – even though some of the disagreements were intense. 

Who might run such a Twitter-like operation?   The American Psychiatric Association (APA) ran an email listserv that I participated in for decades.  They decided to stop this in the past year.  It had probably run its course.  The number of new participants and total participants was low.  Discussion by email tends to become too diffuse and they are difficult to reference later. There were also limitations on discussions based on the charitable status of the organization – no political discussions.  Twitter seemed like an ideal format for discussions, educational threads, and daily reviews. I doubt that the APA or AMA have the resources for a Twitter like platform but they might and it could be seen as a benefit to potential members. Doximity comes to mind.  Currently Doximity has threads that are posted as news updates presumably by their editors. They tend to be much less interesting than good Twitter threads and discussions.  A Twitter like platform would be a greater asset in attracting physicians to the site.  LinkedIn tends to have the same constraints as Doximity but it does allow member to start new threads. All of the commercial threads suffer from commercialization and overly intrusive members.  I don’t want to see an endless sequence of friend or connection requests when it is obvious that I have nothing in common with those requestors.  On Twitter – the commonalities were obvious and I knew who to follow.   

The competitors that were started based on Twitter’s obvious demise – Blue Sky, Threads, and Mastodon just don’t seem to have active physician communities at this point.  As more physicians leave Twitter – there is a clear socialization and discussion gap. It is probably obvious that I have no clear solutions for that gap – other than a hope that somebody with enough resources and insight to the value of Twitter for physicians can get a platform established.  Alternately – more networked and focused discussions on Blue Sky and Threads is still a possibility.  Either way – I think we need a functional blue bird back in one form or another….

 

Happy New Year!

 

George Dawson, MD, DFAPA