Q&A: Expert States Loudest Medical Content on Social Media Is Typically Negative

Morgan McSweeney, PhD, social media and health influencer Dr. Noc, reflects on the vulnerabilities in America’s public health decision-making, emphasizing a troubling reliance on norms that traditionally guided agencies like the Department of Health and Human Services (HHS). He advocates for the establishment of formal safeguards and regulations to protect the integrity of advisory committees. Additionally, Morgan highlights the pervasive influence of emotionally charged social media content, which often misrepresents scientific data and undermines public understanding, stressing the urgent need for both institutional reforms and greater public scrutiny of health information.

Drug Topics®: In your opinion, what specific mechanisms are necessary within the HHS and FDA to ensure that ideological or nonscientific agendas do not compromise the integrity of the regulatory approval process or the issuance of public health guidelines?

Morgan McSweeney, PhD: I've been thinking about this a lot over the past 9 months, or however long it's been at this point, and what has occurred to me is that over the 5 or 6 decades that, for example, the Advisory Committee on Immunization Practices has been doing its thing. A lot of it has been based on norms and sort of handshake agreements and the expectation that, for example, the person appointed to secretary of HHS will follow evidence-based analyses of scientific data and will listen to the briefings from scientific officials within the CDC. It seems that there were very few safeguards about what would happen if somehow somebody got into that position of power who wasn't necessarily committed to rigorous analysis of scientific data and who wanted to listen to the opinions of political appointees and discount the opinions of scientific recommendation committees, and that hasn't happened before, just because it hadn't happened to happen up until now. Going forward, I think what we've seen is that this is not acceptable to rely on those handshake agreements or norm agreements and have the possibility that someone could come in and wipe out entire advisory committees of actual experts, replace them with people who share their own opinions, and then overhaul recommendations for the entire country's health care system. I think that's unacceptable. I don't know exactly what the safeguards are or the regulations that would be put in place to convert it from being norm based to regulation based. Clearly, something has to happen, though. We can't just go back to, even in the next set of elections, or whenever there's a new secretary of HHS. Probably there's going to be an actual evidence-based one that comes right back, and they can reverse the law that changes. I think we should still do something at that point, though, to make sure that this doesn't happen again. Were it to happen in 8 years or 12 years, or whatever it might be.

Drug Topics: Is there anything else you would like to add?

McSweeney: I think the big thing, and I think about this a lot as someone who makes content, unfortunately, is that the information about your health and about science and medicine that you see on social media is not necessarily the most accurate. It is the loudest. It's what is the most emotionally resonant with people we know very clearly that content that is emotionally charged, particularly negative emotions, that is based on anecdotes, just tends to perform better than content that is less emotionally charged [and] that is has more positive connotations. That kind of rage bait, ridiculous stuff, tends to go more viral than not, and so what you're seeing on social media is a skewed representation of reality. You're seeing the most out-there viewpoints, whether it relates to vaccines or other topics in politics or nutrition. What you're seeing is the loudest content, not the most evidence based, and sometimes it's helpful to keep that in check, because otherwise you can start to see from 5 different people in videos, you may hear the same message over time and time again, it starts to feel true, even subconsciously, just because you're hearing it over and over again but just know you're not getting an accurate representation of the data just because you're seeing it in multiple videos, or something like that.