PORTLAND, Ore. — The information age promised to empower patients. Instead, the same algorithms that recommend videos and products are now shaping medical choices, with dangerous consequences. Artificial intelligence can generate an article in seconds that looks authoritative but is completely fabricated. Social media can take a doctor’s name and reputation and turn it into a marketing machine for unproven remedies. Brian Druker, M.D., has spent his career building a different kind of legacy: as a pioneer in precision medicine, he developed imatinib—a drug that turned chronic myeloid leukemia from a terminal diagnosis into a manageable condition—and his work helped spawn a generation of targeted therapies that have saved countless lives. He is now the president of the OHSU Knight Cancer Institute at Oregon Health & Science University, where he has championed an ambitious initiative to end cancer as we know it. Yet even Druker could not prevent his own name from being weaponized. Colleagues began asking him why he was promoting ivermectin on social media; a fake Facebook account under the misspelled name “Brain Druker” was urging patients to take the antiparasitic drug for cancer, and a similar imposter account had surfaced on X weeks earlier. “I spent an entire career based on honesty and integrity,” Druker said. “For someone to be able to usurp my identity — and undermine the trust people have in me — is really disturbing.” His experience illustrates a sobering reality: if one of the most respected physician-scientists in the country can be impersonated online, no one is safe, and no one should assume that every credentialed-looking post is real. The episode also reflects a broader shift in how health information is created, distributed, and consumed—one that places enormous cognitive demands on patients who are already frightened, fatigued, or desperate for hope.
This is the environment that patients and healthcare professionals now navigate, and it is unlike anything medicine has faced before. “We live in a post-truth era,” said Fabrice Jotterand, Ph.D., director of the OHSU Center for Ethics in Health Care. “Everything is up for grabs. Your truth is not my truth.” For decades, medical knowledge was filtered through a system of peer review, professional standards, and institutional accountability. Scientific journals and medical associations served as gatekeepers, and while imperfect, that system provided a common foundation for clinical care. The digital revolution dismantled many of those gatekeepers. Today, an anonymous TikTok video can reach more people than a peer-reviewed paper, and an AI chatbot can deliver a response with the confidence of a Nobel laureate even when the underlying data is nonsense. A recent poll by KFF, a health policy nonprofit, found that about one-third of adults now turn to artificial intelligence for health information and advice, nearly the same share that relies on social media for medical decisions. That means millions of Americans are making health choices based on sources that have no obligation to be accurate. The implications are especially serious for patients with complex or terminal conditions, for whom false hope can lead to delayed treatment, financial devastation, and emotional ruin. The pandemic provided a preview: unproven treatments, once promoted by personalities and social media, found their way into emergency rooms and into the bodies of seriously ill patients who avoided proven vaccines. Yet medicine has always adapted to new technologies, and this moment is no exception. At OHSU, three experts—a philosopher, a librarian, and a physician who specializes in health literacy—believe the way forward lies not in rejecting digital tools but in reasserting the human relationships and critical-thinking skills that make evidence-based care possible. Their advice is practical, grounded in decades of clinical and academic experience, and urgently needed.
Cliff Coleman, M.D., M.P.H., is a primary care physician at OHSU’s Richmond Clinic in southeast Portland, but his influence extends far beyond the exam room. As a professor of family medicine in the OHSU School of Medicine, he has spent years training health professionals in health literacy and doctor-patient communication—fields that have become suddenly urgent in an age of algorithmically amplified misinformation. Coleman understands why people are drawn to online sources. The internet is available around the clock, costs little, and never makes a patient feel rushed. A chatbot will never sigh impatiently or glance at a clock. “Getting that positive message from an AI chatbot may satisfy your needs,” Coleman said, “whether it’s the capital-T ‘Truth’ or not. It may meet your needs to get something that feels like the truth, as opposed to a real physician where you confront the messiness and stresses of a real conversation.” The problem is that these tools are not designed to tell the truth; they are designed to satisfy, to engage, and to reinforce whatever the user already believes. Algorithms learn what keeps a person scrolling, not what keeps a person healthy. As a result, patients with a serious diagnosis can fall into an echo chamber of miracle cures, pseudoscientific theories, and false hope. Coleman says the medical profession must respond not with lectures but with connection. Trust, he emphasizes, is built through human relationships. Clinicians should begin by asking patients what they have seen and what questions they are carrying; they should acknowledge the anxiety and fear that lead people to search for answers; and they should offer evidence without judgment. “I worry about how AI presents itself as the truth and how that plugs into people’s willingness to believe it,” he said. “The thing that concerns me is the answer you get is delivered with such confidence that it sounds like the truth, when clearly you can’t count on that.” He tries to help patients build a shared understanding, drawing on reliable resources like OHSU’s websites, public health districts, medical librarians, and professional associations. That approach takes time, and time is scarce in modern medicine. But without it, doctors risk losing the very people they are trying to heal.
Kristin Whitman, M.L.S., the head of learning and information services for the OHSU Library, proposes a deceptively simple starting point: stop and think. When someone encounters a health claim online, she suggests asking two questions before acting on it: Why should I trust this information, and what happens if it’s wrong? The answers determine how much scrutiny is necessary. “The stakes matter,” Whitman said. “If you’re looking for the best Italian restaurant in your neighborhood, it’s fine. If you are looking to treat a medical condition, that is the time to stop and recognize you’re feeling an emotion of hope — and to create space for investigation.” That moment of awareness is crucial. Misinformation rarely looks absurd at first glance; it often arrives dressed in scientific language, a professional-looking chart, or a heartfelt personal story. It may come from a friend, a support group, or a trusted influencer. Whitman advises a technique known as “lateral reading”: rather than judging a source by its own website, readers should open a new browser tab and look for what other sources say about it. Is the claim backed by peer-reviewed research published in a legitimate scientific journal? Does the organization selling the treatment also control the evidence? Is the author an independent, professional journalist or someone with a financial stake in a cure? These questions can quickly reveal whether information is a medical breakthrough or a marketing invention. Whitman is also careful not to blame patients for wanting to believe. “We’ve all felt that,” she said. “We may have a medical condition where we would like to have a miracle cure. If my doctor isn’t giving me the answer I want, I may ask ChatGPT and get great news based on the way I phrased the question. That’s hope — and I’m going to go as far down that rabbit hole as I can.” Hope is not the enemy; it is part of what makes us human. The danger is allowing hope to bypass our critical faculties. To help, Whitman points to a four-step framework called SIFT: Stop, Investigate the source, Find trusted coverage, and Trace the claim to its original context. The method gives patients a structure for doing their own research safely. She also reminds people that librarians are trained in online skills and identifying misinformation. “You can always reach out to your local librarians for help,” she said. In an era of information overload, a librarian is one of the best allies a patient can have.
Fabrice Jotterand, Ph.D., a philosopher and medical ethicist, brings the perspective of both philosophy and medicine to the question of medical misinformation. As director of the OHSU Center for Ethics in Health Care, he has watched public trust in institutions erode, including the institutions of medicine and science. He does not believe that shouting scientific facts will fix the problem. “The tendency is to say that science is the only answer to any question,” he said. “But oftentimes people don’t trust experts anymore.” In a polarized era, Jotterand says, health professionals must relearn the art of civil discourse. That begins with humility. Scientists should not present themselves as infallible or treat every disagreement as ignorance. Medical knowledge evolves; treatments change; researchers make mistakes. Acknowledging uncertainty, he argues, actually increases credibility, because it signals honesty. It also invites patients into a genuine conversation rather than a lecture. “The way out is to put forward these questions and think together and work toward the common good,” Jotterand said. “Not in the sense that, ‘I’m a scientist and have all the answers.’ We need to understand it’s not by simply avoiding debate that we’re going to make progress — it’s the opposite.” Avoiding hard conversations may be comfortable, but it leaves the field open to misinformation. When a patient brings up a conspiracy theory or a questionable treatment, the clinician can either dismiss the patient—sending them deeper into the online rabbit hole—or engage with curiosity and respect. Asking “What makes you say that?” can reveal the underlying fear or experience that gives the misinformation its power. Jotterand also warns against equating scientific authority with moral authority. Medicine has a history of abuses and exclusion that has left deep scars in communities of color and other groups, and distrust is often rational. Restoring it requires more than accurate data; it requires repairing relationships over time. The conversation will not be easy, and it will not be quick. But Jotterand is clear: “When we’re willing to engage people who disagree with us, we’re going to make progress.” In the long run, that willingness is not just an ethical ideal—it is a practical strategy for protecting public health.
For Druker, the path forward is not to retreat from patients but to keep showing up. Even as president of the Knight Cancer Institute, with administrative meetings, fundraising, and strategic initiatives, he still sees patients once a week. The ritual keeps him grounded. It also brings him face to face with the very human anxieties that fuel misinformation. When a patient asks about an unproven remedy like ivermectin, Druker does not roll his eyes or unleash a lecture. He asks where they saw the idea, and he listens. “It comes down to having a conversation about, ‘where did you see this information?’” he said. “Ultimately, my job isn’t necessarily to dissuade people in their beliefs. My job is to give them the care that they need to get them the best outcomes.” That nonjudgmental stance is not weakness; it is the foundation on which treatment decisions are built. A patient who feels heard is more likely to trust a physician’s guidance, and trust is the most effective antidote to misinformation in an individual life. But individual conversations are not enough. Whitman suggests that everyone—patients, families, and professionals—adopt the SIFT framework to evaluate online claims. The first step, Stop, asks people to become aware of the emotions a post has triggered, especially hope or fear. The second, Investigate the source, asks who is speaking and what they stand to gain. The third, Find trusted coverage, asks whether the claim is supported by independent institutions—university news offices, professional medical associations, or established news organizations staffed by professional journalists. The fourth, Trace the claim, asks whether the original research, quote, or data actually mean what the social media post says they mean. This kind of detective work can feel burdensome to someone who is sick, but it is less costly than the harm of a false cure or a delayed diagnosis. The larger message from all three OHSU experts is that forging a healthier information ecosystem requires both individual vigilance and collective compassion. Patients need tools, but they also need doctors who listen. Scientists need humility, but they also need the courage to speak clearly about what is known. In a post-truth era, the simplest act of resistance may be a glance up from the screen—toward a trusted clinician, a local librarian, or the person sitting next to us—to ask: What is true, and how can we find out together? That human connection, more than any algorithm, is what will guide us through.