Combating disinformation, and time to stop spinal injections for chronic pain
Feb 26, 2025
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Heidi Larson, a professor of anthropology and vaccine communication, joins Martin McKee, a public health expert, and Jane Ballentyne, a chronic pain management specialist. They tackle the urgent issue of health disinformation, exploring its impact on vaccine hesitancy. The conversation pivots to new guidelines against spinal injections for chronic pain, discussing the difficulties this poses for patients and doctors alike. The episode also reflects on progress in combating racism within UK medical schools, emphasizing the need for continued vigilance and change.
Disinformation in health undermines public trust and requires collaborative strategies from scientists and communication experts to combat effectively.
Recent guidelines recommend against spinal injections for chronic pain, challenging both patients and doctors to consider alternative management strategies.
Deep dives
Addressing Health Disinformation
Disinformation poses significant challenges to public health, requiring decisive action from health institutions. Public health agencies should implement surveillance systems to monitor and combat health-related misinformation similarly to how they track infectious disease outbreaks. The motivations behind disinformation can range from generating clickbait to undermining trust in democratic systems, with notable implications for vaccine acceptance. Addressing these issues demands not just the involvement of scientists but also the collaboration of communication experts to effectively counteract harmful narratives.
The Controversy Surrounding Spinal Injections
Recent guidelines strongly advise against the use of spinal injections for chronic back pain, highlighting a lack of conclusive evidence supporting their effectiveness. While injections appear to have a low risk of catastrophic outcomes, the absence of demonstrable benefits has led to discussions regarding their continued use, particularly in private practices driven by financial incentives. Patients facing chronic pain often seek quick relief through injections, posing a challenge for physicians to shift their focus toward more sustainable management strategies involving lifestyle changes. The healthcare system's reliance on procedures that patients demand calls for a reevaluation of the financial motivations influencing care delivery.
Progress and Challenges in Addressing Racism in Medical Education
There has been a notable increase in the collection of data on racism complaints within UK medical schools, signifying a shift toward greater acknowledgment of these issues. Nonetheless, the rise in recorded incidents—from only 11 complaints over a decade to 138 in recent years—suggests that underreporting remains a significant challenge. Stakeholders urge that confronting racism in medical education and healthcare requires coordinated efforts beyond individual institutions, involving employers and society at large. Continued focus on these systemic challenges is essential to foster an environment where all students can thrive free from discrimination.
In this episode of the BMJ's Medicine and Science podcast, editor-in-chief Kamran Abbasi discusses the urgent need to tackle disinformation in health, especially in the context of the US, with Heidi Larson and Martin McKee from the London School of Hygiene and Tropical Medicine.
We also hear from Jane Ballentyne, professor of anaesthesia and pain medicine at the University of Washington, about new guidelines that strongly recommend against the use of spinal injections for chronic pain - and why that recommendation might be hard for some patients and doctors to hear.
Finally, we revisit the progress made in addressing racism in UK medical schools over the past five years with Gareth Iacobucci, The BMJ's assistant news editor.
Running order
01:44 Defining Misinformation and Disinformation
04:08 Vaccines and Misinformation
05:38 Strategies to Combat Disinformation
10:04 Denialism and Its Implications
16:21 BMJ Rapid Recommendations on Spinal Injections
26:27 Racism in Medical Schools: An Update
Reading list
Spinal interventions for chronic back painRacism in medical schools: are things improving?
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