A year in the life of a clinical fact checker

12 December 2023 | Dr Fergus Brown

I applied for the Clinical Fact Checker role at Full Fact as I neared the end of my Foundation Program in medicine. I had planned to locum for a year, but was drawn to this role and ended up starting a few months into my ‘FY3’. 

Part of my interest in fact checking comes from seeing the result of medical misinformation in practice—like anyone working in healthcare over the pandemic, the potential harm of vaccine misinformation was clear to me when people who had chosen not to have the vaccine became ill and hospitalised with Covid-19. 

Some may have chosen differently had they had better information. 

But the impact of medical misinformation goes further than this. People’s understanding of how their body works and how external factors influence their health can impact their choices when it comes to lifestyle and diet, and their likelihood to seek appropriate medical care when they need it. We also know that high quality communication from healthcare staff can improve adherence to medications, and that this can lead to better outcomes.

I worked in a public health Health Protection Team in the summer of 2022, during which time there was an mpox (monkeypox) outbreak. The job involved phoning cases and contacts to assess the spread of the outbreak, as well as provide advice to people aimed at minimising onward infections. 

These calls often revealed that people had been exposed to misinformation, with people believing the disease to be just like chickenpox, or having severe vaccine hesitancy about the smallpox vaccine used to prevent infection after exposure. The importance of high quality health information was clearer than ever to me after this.

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What’s out there?

I felt I had a decent grasp on the scale and content of medical misinformation before I joined Full Fact, but I’ve learned that what I was seeing was the tip of the iceberg. 

Social media is awash with false information on health, from exaggerated promotion of the health effects of fruits and vegetables to false cancer cures by the boatload

Bad information about how the body works normally and in illness undermines public understanding, and creates the basis for misinformation to take root. 

Unsubstantiated claims of harm from common consumer or health products can also create unnecessary anxiety and sow distrust of public health authorities.

This stuff is everywhere—on every major social media platform, on public accounts and in community groups. From individual members of the public to politicians and major media outlets, bad information on health is pervasive across the media landscape. 

Alarmingly, we’ve even had to fact check health claims from UK registered doctors.

Misinformation about that very same smallpox vaccine, important during the mpox outbreak, has cropped up in my work at Full Fact. Misinformation about Covid being a fake virus and on the safety and effectiveness of the Covid vaccines persists.

I’ve had the opportunity to research and write about a huge variety of health claims. From unusual misconceptions (worm pee isn’t causing your headaches and protein does in fact exist) to the downright dangerous (debunking claims about seeds that don’t cure cancer but which are converted to cyanide in the body and making clear that drinking borax is in fact dangerous). 

I’ve also had the chance to do more analytical pieces, such as on the amount of excess deaths caused by A&E delays, or the way tap water is regulated in the UK.

Nutrition and food claims also make up a chunk of the misinformation we see and check. A lot of these claims can cause unnecessary worry about food, or can encourage consuming dangerous products, and may distract from basic (and much more achievable) guidance on healthy diet.

As well as social media claims, a decent amount of the job involves fact checking newspapers and media outlets—on misreported studies, incorrect reporting on health policy issues, or articles that explain health and disease incorrectly. This is important work. A recent poll of adults in Great Britain over the age of 16 reported that 73% of people typically get information about science from news media outlets, and a majority trusted these sources. Journalists need to get this stuff right.

Spotting misinformation can be tricky, but checking the source and reading other reporting on the issue is a good place to start. Often people may try to come across as experts by using slick presentation skills, or flashing scientific looking references across the screen. 

General scepticism of people blaming all health issues on one thing, or suggesting one thing can solve all your problems, is probably a good idea. If it looks too good to be true, it probably is. 

Science is a lot more complicated and dynamic than we’re generally led to believe. Things change, views are updated and consensus opinion can get things wrong. But if someone is telling you something that most experts don’t seem to believe, be careful about taking their word for it.

What I'll take back to medicine

Writing is an essential part of communicating in medicine, and I’ve previously helped lead a project to improve written communications with patients. But as doctors we all too often rely on jargon, acronyms and minimal explanations to get letters done quickly while other tasks pile up. 

Writing clearly in a way that anyone can understand is a key component of my role at Full Fact, and I feel my skills have definitely improved, which should directly benefit my patients. 

Fact checking is a very different mode of working compared to clinical practice. The pace is different, and the focus is on slightly longer term work—i.e. researching and writing a piece might take a couple of days, it then has to be reviewed thoroughly or it might take weeks while you gather expert comment. This has been refreshing. Having time to think and consider the bigger picture can be satisfying in a way that ward work can sometimes lack with the emphasis on what needs done today overruling the long or even medium term.

Part of the challenge with combating misinformation is that sometimes, the right information isn’t easily available. If it takes me hours of work to find reputable sources for some of the more complex claims we’ve checked, with my background and training, what hope do people without a medical background have? 

Though we are a UK based charity, we often rely on official information from other countries in our fact checking. It’s important that authoritative information is available from UK organisations like the NHS, or other government bodies, so the public can rely on them rather than influencers who may not be qualified to advise on the matters.

Now that I’ve seen how widespread clinical misinformation is, I’ll aim to be more aware of its impact on my patients. Some effort to find out why someone doesn’t take a prescribed medication, uses a certain supplement or is eating a particular diet would be a normal part of a medical consultation, but I feel now I can ask focussed questions that may reveal whether a bad source of information is underlying some decisions.

Overall, it’s been a great year. I’ve worked with a lot of amazing people, and learned a lot. With the circular nature of misinformation, I have no doubt many of the claims I’ve fact checked will pop up again in the future.  

But I hope the work I’ve done can help the public understand some topics better, combating bad actors and information, and ensuring that some false claims aren’t repeated.

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