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Published: 2023-07-16
Last Updated: 2023-07-16
I have an increasing belief that the medical profession in its inner workings faces pretty much the same challenges as society in general in the 2020's. However, this may be underrecognized because people think that doctors are so smart that they don't succumb to the problems of the information age... If only it was that easy to deal with the challenges of the Information Age...
One of the key challenges for healthcare professionals is keeping up with the latest relevant scientific findings for their practice. (I mean primarily doctors based on my own role, but of course this extends to many adjacent professions, like nurse practitioners, physician assistants, etc.) Traditional ways of keeping up, like reading a big text book like Harrisons every few years, will quickly leave you behind, especially with rapid developments like a viral pandemic. Subscribing to a journal is also only a limited bandaid, as each journal publishes different articles and you will necessarily miss out.
One of the saner ways of dealing with this is curated article selection, as provided by the likes of ACP JournalWise/Journal Club, EvidenceAlerts or NEJM Catalyst... These aren't the focus of this article.
Instead, I want to explore the phenomenon of Medscape a little...
As a doctor, it's impossible to avoid Medscape. Very active on social media, this company also has numerous free newsletters and even educational programs, generally for free. This may sound too good to be true - vast, relevant, highly visible medical information that is updated very frequently...
A closer look at the headlines should lead a critical mind to have some concerns about what's going on... Review of the newsletter content shows that headlines appealing to our base emotions are very frequent from Medscape, compared to more traditional medical journals' newsletters... I took note especially of frequent and multiple times repeated headlines about anything related to malpractice lawsuits, like high-profile cases and the "top 10 reasons for internal medicine malpractice cases." I can't help but conclude that this medium, Medscape, is basing its business model on exploiting doctors' inherent fears to get attention and clicks. Don't get me wrong - there is nothing wrong with being aware of malpractice patterns and practicing good medicine such that no blind spots will lead you into a malpractice case. But repeating the same case 3-5 times within a few days?!?!
Here some other headlines from a quick look at Medscape in my backlog: (I have unsubscribed from all their content months ago, so I don't have the most recent ones)
"Born Between 1951 and 1980? You've Probably Lost IQ Points from This" - analysis: raise fear & clickbait.
"Top 5 Specialties Reporting Suicidal Thoughts" - analysis: not completely irrelevant, but also capitalizing on emotional drama and fear, along with "top 5" listicle tactics for clicks.
"Anger Over COVID Protocol Sparks Acid Attack on Hospital Staff" - analysis: multiple emotional words (anger, sparks, attack) creating a sense of intense conflict and personal hazard, likely also to exploit sense of self-preservation for clicks.
"10 Medical Slang Terms: Guess the Meaning" - analysis: listicle with appeal to FOMO (fear of missing out) for clicks.
Not all headlines are like these, but this tactic is pervasive enough that it raises doubt about the sincerity of the reporting there in general, and that any article there probably has been designed for clicks and not primarily for value and accuracy.
I took a look at the Medscape page today. There is still the mix of more neutral tone and the fear-inducing headlines. Examples of the latter from today:
"25 Years in Prison For Doc Who Used Dirty Surgical Devices"
"The Surprising Jobs with More-Than-Expected Ovarian Cancer" - analysis: "surprising" and "more-than-expected" are taken from how to make clickbait.
There are a couple of observations on Medscape that likely contribute to why they follow the internet attention economy business model that is so pervasive on social media and many tabloid-style newspaper webpages, but curiously absent from most of more traditional medical journalism like NEJM or Annals of Internal Medicine. Here a list of what might be contributing:
Public ownership since 1999 (trading on NASDAQ (MSCP)), then later traded to WebMD.
WebMD has pharmaceutical sponsors and has been criticised as steering its users in that direction, including feeding into hypochondria and disseminating misinformation or unscientific claims [1-2].
Revenue is generally generated through advertising and also has sponsored content [2].
In summary, Medscape is a very questionable source of medical information with high risk of misinformation or industry-shaped presentation of risks and benefits. It frequently uses common techniques to attract attention and rank high in search engine results. This means that both healthcare professionals and the general public (including patients) are likely going to encounter it when searching for health information online.
Information overload is a daily experience for doctors as for the general public. The solution presented by Medscape - fast, free, and highly connected - comes at the high cost of inaccurate and biased reports. Better solutions exist in the form of curated article alerts, like EvidenceAlerts, NEJM Catalyst, and ACP Journalwise.
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