Closing the communication gap: The new priority in public health

The chasm of credibility between health scientists and the public has led to ongoing questioning of public health agencies and medical doctors. Some even wonder whether it is too late to close the gap.

There is a way forward, say four members of Yale’s health ecosystem: Yale Emergency Scholar Dr. Kristen Panthagani, MD, PhD; Dr. Megan L. Ranney, MD, MPH, Dean of the Yale School of Public Health (YSPH); Dr. Katelyn Jetelina, PhD, Yale Assistant Professor Adjunct of Epidemiology (Chronic Disease) and creator of Your Local Epidemiologist, and Dr. Ted Melnick, MD, MHS, Associate Professor of Emergency Medicine and of Biostatistics at Yale School of Medicine and YSPH.

In "Training Health Communicators — The Need for a New Approach," an op-ed published August 2 in the New England Journal of Medicine (NEJM), they lay out a case for how to make America trust health experts again. Communications is a core priority for YSPH, which this year will launch a skills-based course working across media platforms taught by Jetelina.

Panthagani writes You Can Know Things, a newsletter addressing science myths and rumors. She launched it in the early days of the pandemic, thinking she’d run out of topics in a few months. Five years on, she still spends her free time away from shifts in the Yale New Haven Hospital Emergency Department working on posts. She says when she started, she struggled over reactions to the informal style she used.

“Writing for a blog kind of feels like ‘that's not an academic publication, that's not prestigious,” Panthagani said. She doesn’t feel that way now. “People are starting to recognize that it's really important for people who have scientific and medical training to be able to communicate simply and through informal media like newsletters and social media posts, which the average person is more likely to read than a scientific study.”

She spoke with Michael F. Fitzgerald. This interview was edited and condensed.

Kristen Panthagani: We have this giant problem of people not trusting health and science institutions and a big communication gap between what we know about evidence-based medicine and what people are reading and believing on social media. I think the lack of people trained in communicating science to the public is one of the major problems. And I think as a society, we’re bearing the sour fruit of not teaching scientists and clinicians how to communicate with the public. So that's why we wrote it, to say, ‘Hey, we need to fix this.’

When I started “You Can Know Things” as a MD/PhD student, I didn’t know things like how to connect with an audience on social media. How do you balance the need to communicate simply with scientific nuance? How do you talk to a reporter? I was mostly able to figure it out on my own through trial and error and with the help of mentors along the way, but it would have been really helpful to have formal training and resources available at my graduate school to help me. We need more clinicians and scientists communicating with the public, and to get there, we need to teach them how to do it.

KP: All of our scientific training teaches us to talk to other scientists. A first step is even acknowledging that this is important – to teach scientists and clinicians how to talk about science in a way that the general public can understand. Getting that anywhere in the curriculum would be a win.

Medical and graduate school curriculums are already pretty jammed – but you could start by adding one required lecture on how to communicate with the public to give everyone exposure. Not that you're going to make everyone a master communicator in one lecture, but you also don't make everyone a master cardiologist in one lecture either. Then, training programs could develop resources for the people who are really interested to learn more, through electives, interest tracks, et cetera. I think you could do that both for clinical and and scientific training programs.

KP: If I could design that one lecture, the two most important things I’d put in it are one, the importance of communicating with empathy, and two, teaching people to talk without jargon. Online conversations about topics like vaccines can get really heated, and sometimes you end up with academics kind of blasting people for not trusting vaccines. That anger – when directed at someone who is already hesitant – can actually make the problem worse.

A much better approach is to have these conversations from a place of empathy and seek to genuinely understand people's concerns and values, instead of immediately dismissing them as "anti-science." This takes some discernment – there are trolls who harass scientists in the comments section. But there are many people who have genuine concerns who want to participate in honest discussions, and they're looking for someone with expertise to answer their questions without dismissing or attacking them.

To get practice talking without jargon, I recommend people try explaining a scientific topic to their family members and get feedback on whether or not they understood anything that was just said. It can be pretty enlightening to realize what words are tripping people up. For example, the word “immunity” really tripped people up during the pandemic. From a medical and scientific perspective “immunity” represents a very complex system in our bodies that is not an on/off switch. But in colloquial use, “immunity” often means a perfect protection, like legal immunity. Those different understandings caused conflict in what people were expecting about vaccination.

What's really helped me is to think of every word that people are unfamiliar with as a speed bump. Even if we define the word or acronym, each of those is a speed bump when people are listening to you. People might tolerate one or two, but if they run into too many they're going to want to get off the road. You can't always take every scientific term or acronym out, but I think people often overestimate how much jargon they have to use.

And my last piece of advice – if you are a clinician or scientist interested in communicating with the public— is to just start, even if you’re still a student! Create your own science channel on social media and see what works and what doesn't.