Generative AI in the Face of Health Misinformation: A Friend or Foe as a Tool for Public Health Communications with Dr. Geeta Nayyar

[00:00:02] Hey everyone, welcome back to this Outcomes Rocket and Healthline Media series on the future of AI in healthcare.

[00:00:09] I'm your co-host Dr. Jenny Yu, Chief Health Officer for Healthline Media here with Saul Marquez.

[00:00:16] Saul, it's great to be with you here again.

[00:00:18] Yeah, great to be with you Jenny. Excited for today's episode.

[00:00:21] Well, let's get to our intro right away. We have Dr. G who really does not need an introduction, a physician and a health care tech leader

[00:00:29] who's written a book recently called Dead Wrong. So happy to have you on this episode with us today.

[00:00:35] Thanks for having me. Thanks for having me guys.

[00:00:37] Let's get to our first question. What is the impact of misinformation and communication on public health?

[00:00:43] Do you think we've underinvested in communicating and supporting a public health voice?

[00:00:50] Jenny, I think first of all, thank you so much for having me.

[00:00:53] And I think in a post pandemic world, it's a very astounding and resounding yes.

[00:00:58] Right. For the first time ever during the pandemic, the surgeon general actually put out a mis and disinformation warming.

[00:01:05] So I think that tells you where we are in history.

[00:01:08] That said, misinformation are not new.

[00:01:11] It's these issues have been with us since the plague.

[00:01:14] What has changed is the technology.

[00:01:17] We're in a space now when we think about social media, if we think about what we're learning about artificial intelligence,

[00:01:23] we're living in an era where misinformation travels six times faster than the facts.

[00:01:28] So there is a resounding effect on public health.

[00:01:31] And we really saw it firsthand during the pandemic and the stakes just couldn't be higher, right?

[00:01:36] We are talking about people's lives.

[00:01:38] Yeah, that's so true.

[00:01:40] And sometimes this information kind of catches on wildfire and you're right with technology.

[00:01:46] We need better sort of channels for how this information gets out.

[00:01:50] Yeah, totally agree with you guys there.

[00:01:52] And from the angle of digital transformation strategies that leaders could use,

[00:01:58] particularly health leaders listening to us through AI, social media partnerships and influencers.

[00:02:05] How can we make it more digestible for consumers?

[00:02:08] First of all, I think as healthcare leaders, really if you look at my book,

[00:02:12] the call to action in the book is to say that this is healthcare's problem to solve.

[00:02:17] And too often, I go around speaking around the country or in the world.

[00:02:20] And when I ask who's in charge of patient engagement, consumer experience, value based care,

[00:02:26] tens of people's hands go up from the chief marketing officer to the chief medical officer

[00:02:31] to the chief information officer.

[00:02:33] But when I ask who is in charge of the organization's mis and disinformation strategy,

[00:02:38] no one's hand goes up, right?

[00:02:41] And one of the best quotes I think from the book is this idea that

[00:02:44] mis and disinformation grow in the dark.

[00:02:47] In other words, healthcare has kind of accepted it as part of the environment that we practice within.

[00:02:51] But we've never really said, man, we should handle this, right?

[00:02:55] This is our issue to lead in.

[00:02:57] And so really the call to action is to say that living in an era where every other word

[00:03:02] is consumer experience, patient engagement, how are you going to utilize AI?

[00:03:06] The same technologies that are using to spread this information

[00:03:10] and to spread the use of all kinds of tricks and trades can be used for the facts, right?

[00:03:15] It can be used to inspire people to get their mammogram.

[00:03:18] And as a business leader and a healthcare leader, it can drive revenue into your organization, right?

[00:03:23] Ultimately, it can lead to patient acquisition, retention, brand loyalty.

[00:03:29] So it's really the same technologies, but it's taking a position on it, owning the issue.

[00:03:34] But using the same technologies for good and now for evil to simplify it.

[00:03:39] Totally.

[00:03:40] Totally.

[00:03:40] I love that.

[00:03:41] And by the way, great to see you again.

[00:03:43] And we had an opportunity to connect with you and actually Dr.

[00:03:47] You as well at Hymns and a lot of the themes that came up during that conference

[00:03:52] are sort of resonating here again.

[00:03:54] So love that angle that you have on using AI for good rather than bad.

[00:03:59] Definitely.

[00:03:59] And there's a whole chapter in the book actually going through a use case at the Cleveland Clinic

[00:04:04] where the Cleveland Clinic actually partners with YouTube,

[00:04:08] partners with their clinicians from all walks, from all races, from all genders

[00:04:13] really highlights those voices to relate to those communities, particularly in the

[00:04:17] underserved black and brown communities, but really takes the bull by the horns

[00:04:21] and says, not only are we going to get the facts out there,

[00:04:24] but we're going to showcase our talent.

[00:04:26] And we're also accountable.

[00:04:28] So if we tell you this is what you should do with your calcium,

[00:04:30] this is what you should do about your hemoglobin,

[00:04:32] if something doesn't pan out, something doesn't work out, come see us.

[00:04:35] Come see us.

[00:04:36] And you might like us and find that we're actually relatable because we have the

[00:04:40] same color here or the same gender, right?

[00:04:43] Ultimately, what we always forget in healthcare, what we always forget in

[00:04:45] technology is that health is human.

[00:04:49] It is always going to be the human factor that inspires or motivates

[00:04:53] someone to do something with their care because they find the trust

[00:04:56] that wherever the trust is found, which is why so many people have

[00:05:00] been so successful at disinformation, which is the intentional manipulation

[00:05:04] of the masses for some sort of gain or profit.

[00:05:07] It is inspiring when you watch some of these influencers on TikToks

[00:05:11] with amazing dance moves who are only selling you a supplement for 10.99.

[00:05:16] But they're so inspiring and healthcare is so not inspiring.

[00:05:20] Right?

[00:05:21] And it's so confusing if we think about the price points.

[00:05:23] And when we think about just even doctors thinking about social media,

[00:05:26] Jenny, like there's kind of a taboo to marketing.

[00:05:28] We've traditionally thought of marketing as just a nice to have, not a must have.

[00:05:33] The reality is marketing is patient education.

[00:05:35] It is actually health literacy.

[00:05:37] And that is where the consumer is at.

[00:05:40] So it is healthcare's miss not to meet the consumer where they're at.

[00:05:43] But more than this, people are profiting off of our patients.

[00:05:47] People are profiting off of our patients and where their

[00:05:50] co-pay might get them a mammogram for 30 bucks.

[00:05:52] They're instead spending that 30 bucks on a supplement or some

[00:05:56] other snake oil that they think is keeping them healthy.

[00:06:01] When in fact, it could be doing nothing or worse, actually setting them back.

[00:06:04] And so that's really the biggest myth is that we as healthcare leaders

[00:06:07] are not actually taking the lead on this and instead are in this passive mode

[00:06:12] where we're watching this happen right in front of us.

[00:06:15] Yeah.

[00:06:15] And you're so right in which you talk about consumerism in the healthcare space.

[00:06:20] And when I watch these TikTok or Instagram influencers, I mean, hey,

[00:06:25] they get me also.

[00:06:26] And so easy to think about how I can lose weight with a compounded GLP one

[00:06:32] for $99, and it just seems everything just seems so easy and relatable.

[00:06:37] Like you mentioned, and we talk about that patient experience

[00:06:40] and that consumer experience.

[00:06:42] And people want to know what is the truth in healthcare?

[00:06:45] What where do I find the facts?

[00:06:48] And how do we help then those patients who are in those channels,

[00:06:52] whether they're in social or elsewhere, to really then separate from the myths

[00:06:57] and the facts in this day and age?

[00:06:59] Sure.

[00:07:00] Number one, if you are a healthcare leader, put your hat in the ring, right?

[00:07:03] Create some of those apertures own that narrative.

[00:07:07] But number two for consumers, yes, this has to be a conversation

[00:07:10] you're having in the examining room or the virtual examining room

[00:07:13] to say, well, check the source cross reference.

[00:07:16] The source is this the only person in the world saying that X, Y

[00:07:20] and Z leads to B being mindful of that.

[00:07:23] I call it the spidey sense if something feels like the headlines

[00:07:26] are a little bit too provocative and somebody's selling you something

[00:07:30] at the end of this video, there are just those intangibles where it's

[00:07:34] like, I'm not sure.

[00:07:36] And also ideally the conversation to under rheumatologists

[00:07:39] I have with patients all the time where we give some pretty scary

[00:07:41] medications is I say, look, these are the sources I follow.

[00:07:45] These are the influencers I follow, legitimate accountable rheumatologists

[00:07:49] breakdown studies for me.

[00:07:50] This is what doctors are following.

[00:07:52] And then this is what I recommend to you with my patient, the lupus

[00:07:54] foundation, the arthritis foundation.

[00:07:56] They are a world of patient advocacy out groups out there

[00:08:00] that have all of these types of apertures online resources.

[00:08:04] And I would even say to take it a step further, I just spoke

[00:08:07] at one of these patient advocacy groups and I said, you are

[00:08:10] in a position to come up with that list.

[00:08:12] This is not the last patient that's going to ask you where should

[00:08:14] I get this information?

[00:08:15] Why not give a purple star to the doctors that are actually

[00:08:20] real support patient advocacy are accountable to these things?

[00:08:24] So I think there's room and space for us to also own the narrative.

[00:08:28] Jenny, right?

[00:08:29] But really, these are the simple things.

[00:08:31] And then lastly, having a doctor before you're sick is

[00:08:34] perhaps one of the best things you can do.

[00:08:35] And having that conversation, which is to say, I want to be

[00:08:39] a part of shared decision making.

[00:08:40] And we as doctors, I know a lot of consumers don't believe

[00:08:42] this, we want you to write.

[00:08:44] Jenny, we want you to actually know about your diabetes because

[00:08:47] data tells us if you know about your diabetes, you will

[00:08:49] actually take your medications, watch your diet, because you

[00:08:52] understand the process.

[00:08:53] So doctors are the best people to ask what I should read and

[00:08:57] who I should follow.

[00:08:58] And ideally, if you can ask your doctor, can I follow you?

[00:09:01] Do you have a presence with something you do or your

[00:09:04] organization does?

[00:09:06] Because ideally, the person you're following is actually

[00:09:08] someone who is accountable for your health.

[00:09:11] That should be the only incentive, not a supplement,

[00:09:15] not snake oil, not a skin care routine.

[00:09:17] Jenny, there's one where you could just lose like 20 years off

[00:09:20] your face with this.

[00:09:21] I'm not spending too much.

[00:09:22] I'm just trying to get my...

[00:09:24] Well, this is the advice of a digital publisher working

[00:09:27] with doctors and other kind of experts in the space.

[00:09:30] We tend to aggregate the information for our readers

[00:09:33] and users and so important.

[00:09:34] And you're right.

[00:09:35] Everyone needs to throw their hat in the ring in terms

[00:09:38] of that list that you share with your patients as to

[00:09:40] trusted sources, trusted products.

[00:09:43] We're doing as a digital publisher, but those lists need

[00:09:45] to be shared widely so that people can have the

[00:09:49] information and know that's the experience to combat

[00:09:51] some of the other influencers out there just

[00:09:54] sell in snake oil, as you mentioned.

[00:09:55] Definitely.

[00:09:56] And I also want to be clear that we're not asking

[00:09:59] physicians to become marketers.

[00:10:01] Right?

[00:10:01] We've given physicians enough to do.

[00:10:03] We've seen that right in this era of burnout

[00:10:05] and shortages.

[00:10:06] What I think we're saying is let the marketers

[00:10:09] do the marketing and let the doctors do the doctoring

[00:10:12] and let the tech people do the technology stuff.

[00:10:14] Right?

[00:10:15] And ideally they're working together.

[00:10:17] And that's why I use the example of the Cleveland

[00:10:18] Clinic because they did this really beautifully where

[00:10:20] they had the chief marketing officer say, look,

[00:10:23] I'm going to make sure you look good.

[00:10:25] I'm going to make sure your hair is combed.

[00:10:27] I'm going to make sure you understand that you've got

[00:10:29] 30 to 60 seconds to make this video or whatever it

[00:10:32] might be.

[00:10:33] But doc, just talk about a colonoscopy like you do every day.

[00:10:36] That's what you do every day.

[00:10:37] I just want to highlight and amplify your voice.

[00:10:40] Leave the marketing to me.

[00:10:41] That's my role.

[00:10:42] But the science is for you to solve, right?

[00:10:45] And the technology piece to say, how do we connect

[00:10:47] all those diamonds so that whatever is on social

[00:10:49] is also what people are seeing when they check in

[00:10:52] or when they have a question at the point of care

[00:10:54] and so on and so forth.

[00:10:55] So I think the bottom line is it's a team sport.

[00:10:58] But we're always better when we let everyone

[00:11:00] lead into their own individual strengths.

[00:11:02] And we are by no means asking doctors to do this

[00:11:06] for no reimbursement.

[00:11:07] And neither are we asking them to now be marketers

[00:11:11] because this is just not a realistic ask, right?

[00:11:13] But the team sport and really the only time I at least

[00:11:16] ever saw this, Jenny, I don't know about you,

[00:11:18] so Jenny, but the only time I saw this happen

[00:11:20] was during COVID.

[00:11:21] It was the first time I personally met the chief

[00:11:22] marketing officer at Salesforce because she was

[00:11:26] responsible for communicating.

[00:11:28] Get in the office, get out of the office,

[00:11:30] get masked, don't get masked, get tested, what test.

[00:11:33] And so she knocked on my door and said, hey,

[00:11:35] Dr. G, what the heck am I saying?

[00:11:37] Why do I say this?

[00:11:37] Am I great because everyone's asking me this.

[00:11:39] Thank God if you would help me get this message out at scale,

[00:11:42] that would be great.

[00:11:43] So every day is a crisis in health care,

[00:11:46] not just during a pandemic as you guys know.

[00:11:48] So I think that team sport piece is really critical.

[00:11:51] And I think that's just it.

[00:11:52] Health care has communication problem in which

[00:11:54] it takes 17 years for studies to become guidelines.

[00:11:57] It takes guidelines then to really be known by

[00:12:00] patients and physicians all across the different

[00:12:02] specialties to really then become best practices.

[00:12:05] So you're exactly right.

[00:12:07] Let's use the marketers to get that communication.

[00:12:09] Yeah, that communication piece is so key, Jenny.

[00:12:12] And Dr. G, you always talk about this post-pandemic world,

[00:12:16] right? That's like the chalk line gets snapped there.

[00:12:19] And then we look forward because it did change a lot of things

[00:12:21] and we have lost trust.

[00:12:23] And you've given us some good examples about

[00:12:26] owning our influencers and sharing those.

[00:12:28] I'm not a physician, but for the physicians listening,

[00:12:31] who are your influencers?

[00:12:32] And are you telling your patients about them?

[00:12:34] I think this is a great example.

[00:12:36] What other things can health care leaders do

[00:12:40] to really help with this infodemic

[00:12:42] that we currently have out there?

[00:12:44] Well, we talk a lot on health equity in the industry.

[00:12:46] We talk a lot about health equity, whether you're in health care or not,

[00:12:49] I think every employer out there has deals with this, right?

[00:12:53] And so much of employer health is public health.

[00:12:55] And so one of the biggest issues in health equity is actually this, right?

[00:12:59] Because we know that the underserved populations,

[00:13:01] the black and brown communities are more susceptible to mis and disinformation,

[00:13:05] often because they don't trust the establishment of science, right?

[00:13:10] Fun fact, 92% of all Americans trust their doctor.

[00:13:14] But 52% of Americans don't trust the system.

[00:13:17] Their doctor is operating it, right?

[00:13:20] And that's something that we as an institution have to win back.

[00:13:24] Science needs a PR help and we've got to win the trust back

[00:13:29] because this all comes down to trust.

[00:13:31] And in a post-pandemic world, the consumer has gotten the message

[00:13:35] that health is wealth, a reminder rather than health is wealth.

[00:13:38] And they're willing to spend disposable income on it.

[00:13:42] Everyone's got one of these, a ring, something to track your sleep,

[00:13:47] your mood, your steps, whether or not it makes a difference,

[00:13:51] whether or not you can interpret it as a different question, right?

[00:13:53] But the consumer feels like they're taking control of their health with these things

[00:13:58] and they've gotten the wake-up call that I better remember

[00:14:01] that my health is important in a post-pandemic world.

[00:14:03] So truly healthcare's opportunity to win that trust back,

[00:14:07] to gain the patient's trust.

[00:14:10] But half of that is meeting them where they're at

[00:14:13] and understanding that disconnect.

[00:14:15] We have to be more relatable and reachable in science.

[00:14:19] It's really the pandemic is full of so many use cases.

[00:14:22] But I think the biggest one for me was the fact

[00:14:25] that we developed a world-class mRNA vaccine in nine months flat

[00:14:29] and it's 2024 and we can't get anyone to take it.

[00:14:33] It's the classic example of innovating in a lab, but not in reality.

[00:14:37] And why is that?

[00:14:38] And it's that last piece that health is human

[00:14:41] and we miss the human factor.

[00:14:42] We botched the communication.

[00:14:44] We never thought about the relatability.

[00:14:46] We never thought about trust.

[00:14:48] We never acknowledged the many reasons people don't trust.

[00:14:52] The institution of medicine, Tuskegee, Henrietta Lacks.

[00:14:57] There are things in the history of medicine we need to acknowledge.

[00:15:00] We need to acknowledge and we have to understand

[00:15:02] why those communities don't trust us.

[00:15:03] It's not that they don't want to trust us.

[00:15:06] They have very good reasons not to trust us.

[00:15:09] So we have to give them a reason to in today's world.

[00:15:12] But part of that is acknowledging our past and the transparency of that.

[00:15:15] So those are really the things that we have to walk away from.

[00:15:17] But if you want to innovate in the real world,

[00:15:20] the last mile is the human mile.

[00:15:23] And all of these technologies are terrific,

[00:15:26] but they don't actually make a difference if you're not able to reach people

[00:15:31] and understand the people factor, which is that intangible factor, right?

[00:15:35] But it's the number one question.

[00:15:37] I'm sure you get this, Jenny, when I dropped my daughter off at school,

[00:15:39] inevitably there's someone trying to get the heck out of there

[00:15:42] and someone's, Dr. G, do you know a female cardiologist?

[00:15:47] Do you know a female gastroenterologist?

[00:15:50] Why is that?

[00:15:51] Because there is an assumption that if I see a woman, I'm a woman

[00:15:54] and I would like to see a woman because there's an assumption

[00:15:57] that I could trust that person.

[00:15:58] I could relate to that person.

[00:16:00] Right? So we forget that in medicine, though.

[00:16:03] We're like, well, this is black and white.

[00:16:05] It's not health is human.

[00:16:08] Medicine is all about humanity.

[00:16:09] When we forget that it's when we always screw up.

[00:16:12] And the vaccine is a great example of that.

[00:16:14] We got the science down, we got the innovation down, we nerded out.

[00:16:17] It was super cool.

[00:16:19] But guess what?

[00:16:21] We're not serving MDs and PhDs.

[00:16:23] We're serving everyday people and we forgot the human factor.

[00:16:28] Love that, Dr. G, thank you for that.

[00:16:30] And I guess the message to everybody listening to this is

[00:16:34] put on the shoes and walk that last mile.

[00:16:36] And what would they do?

[00:16:38] And that's something you should do.

[00:16:39] So I love that response to that question.

[00:16:42] Thank you so much for that, Dr. G.

[00:16:44] Yeah, and I would just like to close out by asking one last question.

[00:16:47] You mentioned about trust and transparency and the human factor.

[00:16:51] And in this age of AI now, where expert likeness could potentially be

[00:16:55] generated by technology and voice and an image.

[00:16:59] What do you think that guard rails need to be so that we are setting

[00:17:02] and committing to an industry standard in this time now?

[00:17:05] This is tough for all of us who are big believers in innovation

[00:17:09] and that lives through so much innovation and science.

[00:17:11] It's tough because innovation and regulation often have a

[00:17:14] tension relationship, right?

[00:17:16] But I think we don't actually have to look that far.

[00:17:18] If we look at the way we've handled social media regulation,

[00:17:22] if we look at some of the missteps made with the electronic health record rollout,

[00:17:26] there are a lot of lessons to be learned, which is one with electronic health records.

[00:17:31] We have to understand we need to do things with the workforce, not to the workforce.

[00:17:35] With social media, we are understanding all of the harm now

[00:17:39] that continues to be found in research and studies.

[00:17:42] And the way we've regulated that industry is largely at itself regulated

[00:17:46] by social media companies.

[00:17:48] This is not the things we can do with artificial intelligence.

[00:17:52] We have to be more mindful.

[00:17:53] We have to understand both the good, the bad and the ugly.

[00:17:56] And we have to have the appetite and willingness

[00:18:00] to understand that regulation is going to be a part of doing this innovation right.

[00:18:04] And I think social media perhaps has some of the biggest parallels

[00:18:08] to and the good things it can do, but also the bad.

[00:18:11] So I think it's very important that we continue to learn, study it.

[00:18:15] And I also think it's very important that health care leaders

[00:18:19] are weighing in every day health care leaders are weighing into how

[00:18:23] this technology is used so that we are using it in the right places at the right time.

[00:18:27] And as you mentioned to that, this is it's like science.

[00:18:30] It's dynamic. There's no black and white.

[00:18:32] And so I have to acknowledge and learn along the way

[00:18:34] and then be able to own up to the mistakes

[00:18:36] and really then hold each other accountable so that we can better stand.

[00:18:41] Absolutely. And we cannot leave it up to the companies themselves to regulate.

[00:18:45] Right. It has to be a multi stakeholder approach.

[00:18:48] And we need to do the same with social media.

[00:18:50] We're getting to that point and we're seeing other countries taking the lead

[00:18:53] in that regard. Totally agree, guys.

[00:18:55] This has been great.

[00:18:56] Dr. G, thank you for the opportunity to really spend some time with you.

[00:19:00] I've really enjoyed it. Jenny, what do our listeners?

[00:19:02] Thanks for being with us today.

[00:19:03] Thanks all and Dr. G.

[00:19:05] Remember to check the show notes for key takeaways and links to resources

[00:19:09] my intervention today on today's podcast.

[00:19:11] Thanks, Dr. G again for taking the time to be with us.

[00:19:14] And we'll see you all soon in our next episode.

[00:19:16] Thanks, everyone.