The physician social community is filled with vaccine disinformation

Nurse Darryl Hana prepares a dose of the Pfizer COVID-19 vaccine at a three-day vaccination clinic at the Providence Wilmington Wellness and Activity Center on July 29, 2021 in Wilmington, California.

Mario Tama | Getty Images

Dr. Paul Malarik, a retired psychiatrist, now spends about 50 hours a month administering Covid-19 vaccines at pop-up clinics near his home in San Luis Obispo, Calif. As a result, he is particularly concerned when he logs on to Doximity, a website used by doctors, and reads comments against vaccinations.

“You rarely get to the level of microchips in vaccines, but a lot of those things come pretty close,” said Malarik, who volunteers his time mixing vaccines, planting shots and educating the public. “You are actively working against us.”

Long known as LinkedIn for Doctors, Doximity made its stock market debut in June and shot to a market cap of $ 10 billion. In its listing prospectus, the company said it had 1.8 million members, including 80% of doctors in the United States.

Malarik, who worked in psychiatry for over two decades, said it was amazing to search Doximity’s website and find the kind of misinformation he was expecting on Facebook and YouTube, where conspiracy theories are rampant.

Malarik read straight from several comments made by people with the initials MD or DO (doctor for osteopathy) after their names. There is no anonymity on the website so everyone is identified. In the posts they refer to the vaccines as experimental, unproven or fatal and occasionally write “fauxi” when they talk about Dr. Anthony Fauci, Senior Medical Advisor to the White House, will speak.

Some commentators say that antibodies that become infected with Covid are more effective than the messenger RNA (mRNA) vaccines, which direct human cells to produce specific proteins that create an immune response to the disease.

While the mRNA vaccines against Covid-19 are currently on the US market under emergency approvals from the Food and Drug Administration, clinical studies have shown that they are highly effective against Covid-19. The FDA and Centers for Disease Control said they were safe, effective, and recommended for anyone ages 12 and older, including those who had the virus. President Joe Biden and CDC Chief Executive Dr. Rochelle Walensky have described the current situation as a “pandemic of the unvaccinated”.

As Malarik scrolls down the Doximity newsfeed, he stops at a New York Times story from June that is still featured prominently on his page. The headline reads, “A judge dismisses a Houston hospital employee’s lawsuit over vaccination mandates.”

Hundreds of Doximity users posted comments below the article. This is what one surgeon wrote:

“Covid-19 vaccines have already killed over 4,000 adults who received the vaccine,” the post reads and appears to be emulating a debunked claim by Fox News host Tucker Carlson. “Prescribing a vaccine that has killed over 4,000 people is like murder.”

It’s not an outlier. Dozens of screenshots and descriptions of posts shared with CNBC by other doctors were consistent with Malarik’s experience. Articles about vaccines or masks have hundreds of comments, many of which are factually imprecise and often based on conspiracy theories, while stories on less politically divisive subjects contain few, if any, comments.

“Everyone jumps in on the articles they can argue about,” Malarik said.

Doximity stocks were down more than 5% on Friday morning.

The puzzle of content moderation

Medical misinformation is a particular challenge for Doximity, which remained largely under the radar prior to its IPO, as the San Francisco-based company seeks to grow its user base and remain a source of high-quality, reliable data while getting through navigated the tricky waters of the content. Moderation.

Doximity will be releasing quarterly results next week for the first time since going public, after a year of revenue growth of 77%. The company has been profitable every year for the past three years by keeping operating costs down.

Jeff Tangney, CEO of Doximity on the New York Stock Exchange for its IPO on June 24, 2021.

Source: NYSE

Doximity is not an open social network: to join, users must be practicing U.S. health professionals. The company verifies members with a photo ID from a medical license, a hospital ID card, emails from medical institutions and challenge questions, among other things.

Like LinkedIn, the company makes money from sponsored content and from recruiters who use the site to find talent. Because Doximity focuses solely on healthcare professionals, most of the marketing money comes from pharmaceutical companies and hospitals who reach relevant users with treatments and services, including through sponsored articles and animated videos in the news feed. More than 80% of Doximity’s sales in the last fiscal year came from its marketing products.

Unlike LinkedIn, Facebook, Twitter, and other popular social media platforms, Doximity doesn’t allow users to post stories. The company publishes articles from mainstream news outlets and medical and scientific publications, and each user’s feed is customized based on the field of medical practice and other personal information.

“Our platform uses both algorithms and clinical editors to select content from a variety of sources based on a member’s profile and reading interests,” states its prospectus. “We are able to aggregate links to relevant content from a variety of different sources, such as medical journals and specialist websites that a member might otherwise have to search for separately.”

An additional benefit is that users can earn so-called advanced training credits (CME) by reading certain eligible articles. Some states require doctors to receive a certain number of credits each year in order to keep their licenses.

However, users are allowed to comment on these stories – and this is where medical misinformation can spread. In the same news feed as these articles, users will find a wealth of comments that are far from educational.

For example, a recent article on masking requirements for children has drawn the ire of some of the same doctors who oppose the vaccines. One general surgeon commented that “masking children is utterly ridiculous and a form of child abuse”. Another said that “50 years of data collected by the CDC and [World Health Organization] proved that these masks made no difference. None. “

Scientists and health organizations have repeatedly said that masks can help slow the spread of Covid-19. The rise in the delta variant and the resurgence of hospital admissions in parts of the country led several states to reintroduce mask requirements.

Doximity has rules designed to curb misinformation. In its Community Guidelines, the company lists 11 things that can lead to content removal, including “spreading false or misleading information”.

The policy page has a separate section that deals with “Content that violates generally accepted public health guidelines”. Seven bullet points cover the types of posts that will be removed. This includes content that “makes unsubstantiated claims about the effectiveness, side effects, or effects of vaccination with FDA-approved vaccines” and that “spreads false data on deaths, hospitalizations and rates of infection related to infectious diseases.”

Doximity said in a statement emailed that while it supports the sharing of ideas “about new science and the latest medical news” among its users, it is expressly prohibited from posting medical misinformation.

“Like most virtual communities, we have community guidelines to ensure that Doximity remains a safe and respectful environment,” the company said. “We use a rigorous clinical review process with clinicians to evaluate member comments that are flagged as potential misinformation.”

Doctors have a “powerful platform in society”

The risk for doctors goes far beyond the possible measures of Doximity. Last week the Federation of State Medical Boards, a nonprofit that represents medical boards across the country, released a statement notifying doctors that they could lose their license to engage in such activities.

“Doctors who generate and disseminate misinformation or disinformation about COVID-19 vaccines risk disciplinary action by state medical associations, including suspending or revoking their medical license,” the FSMB said. “Doctors with a license to practice medicine have a high level of public trust due to their specialist knowledge and training and thus – whether they recognize it or not – have a strong platform in society.”

The FSMB said it was responding to a “dramatic increase” in the spread of false information by doctors on social media and elsewhere. But the group does not actively search websites for abusers.

Joe Knickrehm, a spokesman for FSMB, told CNBC in an email that state medical associations operate on a “complaints-managed” system and usually take action when advised by patients, health systems, other doctors, or the public. He said the group runs a free tool called Docinfo.org that anyone can use to get information about a doctor and file a complaint.

As a company, Doximity has tried to be a good force in keeping users updated on the developments, treatments and vaccines from Covid-19. At the start of the pandemic, Doximity set up a private Covid-19 newsroom for clinicians to find updates, recommendations, and discuss best practices. It also offered its new video telehealth service for free until early 2021 to allow doctors to work with patients remotely.

Doximity even has a site called Op-Med, where members post opinion pieces and their personal stories. Numerous doctors have written articles for the vaccines with headlines such as “How the COVID-19 Vaccine Changed My Life (So Far)” and “How Vaccinating Has Rekindled My Love for Medicine”.

But determining where to draw the line between providing a valve for healthy online debate and spreading harmful misinformation is a problem that has messed up social networks for years. It’s especially important when it comes to life and death.

As it is, some anti-vaxxers are already thinking that Doximity will silence them. In a recent comment on a vaccine story, an anesthetist said he was offered the opportunity to invest in Doximity’s initial public offering, which included an allocation of up to 15% to doctors on the platform.

He wrote that Doximity censored an earlier post because it did not fit into the company’s “position on vaccination.” So he had no interest in IPO shares.

“I’m not going to invest in your targeted information highway with your mind control cops,” he wrote in the comment. “Have a good day.”

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