Resolution: AAFP Patient App

Introduced by: Brian Bachelder, MD, FAAFP

Whereas, the vision of the American Academy of Family Physicians (AAFP) is to transform health care to achieve optimal health for everyone, and the mission of the AAFP is to improve the health of patients, families, and communities by serving the needs of members with professionalism and creativity, and

Whereas, patient education is integral to the process that changes or enhances a patient’s knowledge, attitude, or skills to maintain or improve health, and family physicians should take a leadership role in improving the health of the American public by providing accurate, evidence-based, culturally proficient, and meaningful patient education in an inclusive manner. (2004) (January 2022 COD), and

Whereas, the AAFP encourages members to take an active role in providing health education to their patients and the public, and the AAFP believes that patients and members of the public who are educated about their health are better equipped to prevent disease and to play an important part in managing health problems which occur (1990) (September 2024 COD), and

Whereas, the 2023-2025 AAFP Strategic Plan mentions “coalition strategy” under Be the Most Effective Influencer on FP priority issues in Government Advocacy, and “integrate the voice of family physicians into health technology development” under Understanding, Adopting, & Leveraging Technology in Medicine, and

Whereas, the proliferation of health misinformation poses a significant threat to patient well-being, eroding trust in healthcare professionals and leading to suboptimal health outcomes, and the only source of AAFP patient education is the web-based familydoc.org, and

• Delayed or Avoided Care: Patients may disregard medical advice or postpone necessary treatments based on false information.
• Adoption of Harmful Practices: Individuals may engage in unproven or dangerous “alternative” therapies.
• Erosion of Trust: Misinformation fosters distrust in healthcare providers, public health institutions, and scientific consensus.
• Increased Health Disparities: Vulnerable populations with lower health literacy or limited access to reliable sources are disproportionately affected.
• Public Health Crises: The spread of false narratives around vaccinations, disease prevention, and treatment protocols undermines public health initiatives, and

Whereas, family physicians are on the front lines of this battle, often spending valuable clinical time debunking myths and correcting erroneous beliefs, so that an AAFP-backed app can serve as a vital tool to pre-emptively address these challenges, and

Whereas, the development of a patient-centric mobile application designed to empower individuals with accurate, evidence-based health information directly from a trusted source: the AAFP, would meet patients where they are and reinforce the AAFP’s role as a leading voice in primary care and public health, and

Whereas, beyond its primary objective of combating misinformation, the app offers two critical secondary benefits: the ethical gathering of anonymized demographic data to inform and strengthen the AAFP’s federal advocacy efforts, and a direct channel for disseminating timely, relevant health information and AAFP initiatives to patients, and other patient centric features could be added over time, therefore be it

Resolved that, the Ohio Academy of Family Physicians take to the American Academy of Family Physicians (AAFP) a resolution requesting that the AAFP investigate and develop a scalable patient centric app for the primary purpose of patient education, and therefore be it further

• Informed and Targeted Advocacy: Anonymized demographic data will provide actionable insights, allowing the AAFP to advocate more effectively for policies that address real-world patient needs and health disparities.
• Direct Communication Channel: A powerful platform for the AAFP to disseminate critical health information and advance its strategic priorities directly to patients.

• Simple Apps (basic information, limited features): $30,000 – $100,000+
• Moderately Complex Apps (telemedicine, appointment booking, basic integrations): $50,000 – $200,000+
• Highly Complex Apps (AI-driven features, real-time monitoring, extensive integrations, advanced security): $150,000 – $500,000+ (and even higher for enterprise-level solutions)

Explain how this issue is in line with OAFP Policies and/or the Strategic Plan
Vision Statements

• Be viewed as the authority in primary care and trusted voice on family medicine issues
• Be recognized as the leading advocate and primary source of support for members and patients in the changing health care landscape.

Values

Our work is guided by fundamental values that inform what we do and guide our work.

Whole patient-centeredness: We always consider what is in the best interest of patients and the ability of our physicians to provide care for the whole patient.

Existing Evidence
https://www.aafp.org/about/congress-delegates/2017/resolutions/organization-finance/arizona-b.mem.html

• Erosion of Trust: Patients exposed to misinformation, particularly from seemingly credible online sources or social media, may develop skepticism towards evidence-based medical advice. This can lead to a lack of trust in their doctor’s recommendations, even when those recommendations are in the patient’s best interest. Some studies indicate that while physicians perceive a greater decrease in patient trust, the general population’s trust in physicians hasn’t decreased as much, except for specific groups like those unvaccinated for COVID-19.
• Delayed or Rejected Care: When patients believe misinformation, they may delay seeking necessary medical care, refuse recommended treatments (like vaccinations or specific therapies for chronic conditions), or opt for unproven, potentially harmful alternative remedies. This can lead to worse health outcomes, increased hospitalizations, and higher healthcare costs.
• Challenges in Shared Decision-Making: Effective healthcare relies on shared decision-making, where doctors and patients collaborate on treatment plans. Misinformation complicates this process as patients may come in with preconceived notions or strong beliefs based on false information, making it difficult for doctors to present evidence-based options and for patients to make informed choices.
• Increased Physician Burden and Burnout: Doctors are increasingly spending more time addressing patient concerns stemming from misinformation, often needing to patiently debunk false claims and re-educate patients. This added burden can contribute to physician burnout, especially when faced with resistance or distrust.
• Difficulty in Communication: Misinformation can make communication challenging. Patients may be less receptive to scientific explanations, preferring anecdotal evidence or emotionally charged narratives. Doctors need to employ specific communication strategies, such as empathetic listening, acknowledging fears, and using plain language and analogies, to bridge this gap.
• Rise of “Infodemics”: The COVID-19 pandemic highlighted the widespread nature of medical misinformation, leading to “infodemics” where false information spreads rapidly, often alongside accurate information. This overwhelming flow of conflicting information can confuse patients and make it harder for them to discern reliable sources.

• Empathetic Listening and Acknowledgment: Instead of immediately refuting misinformation, doctors are encouraged to listen to patients’ concerns and fears, acknowledge their perspectives, and create a safe, judgment-free space for discussion.
• Patient Education and Clear Communication: Providing clear, simple, and culturally appropriate explanations of diagnoses, prognoses, and treatments. Using “teach-back” methods to ensure patient comprehension is also crucial.
• Citing Credible Sources: Guiding patients to reputable sources of health information, such as official health organizations or peer-reviewed journals.
• Personalizing Information: Tailoring explanations to the patient’s specific needs and experiences, and using analogies to make complex medical concepts more understandable.
• Shared Decision-Making: Engaging patients in the decision-making process by discussing evidence-based options and addressing their concerns directly, fostering a partnership approach.
• Professional Advocacy: Healthcare professionals are increasingly speaking out against misinformation, sharing accurate information on social media, and collaborating with organizations dedicated to combating false health claims.
• Media Literacy Education: Some efforts also focus on educating the public on how to critically evaluate information online and identify misinformation.

In essence, medical misinformation necessitates a shift in the doctor-patient dynamic, requiring greater empathy, improved communication skills, and a proactive approach from healthcare providers to rebuild and maintain trust.

American trust in family physicians, and doctors in general, is generally high compared to many other professions, though there has been some “slippage” in recent years. Here’s a summary based on recent polls, particularly from Gallup:

• Nurses are consistently the most trusted profession: For 23 consecutive years, nurses have topped Gallup’s annual poll on honesty and ethics, with a very high percentage of Americans viewing them as highly honest and ethical (e.g., 76% in the latest poll).
• Doctors are highly trusted but have seen a decline: Medical doctors consistently rank among the most trusted professions, usually in the top five. However, their trust ratings have declined in recent years.
• In the most recent Gallup poll, 53% of Americans rated medical doctors as having “high” or “very high” honesty and ethical standards.
• This is down significantly from a peak of 77% in 2020 (during the early pandemic) and is now the lowest since the mid-1990s. The decline has been particularly sharp since 2021, falling 14 percentage points.
• Rank Order of Trusted Professions (generally consistent): After nurses, professions that consistently receive high trust ratings include:
  • Nurses
  • Grade-school teachers
  • Military officers
  • Pharmacists
  • Medical doctors
• Least Trusted Professions (at the bottom of the list are typically):
  • Lobbyists
  • members of Congress
  • TV reporters
• Trust in Individual Doctors vs. the Healthcare System: It’s important to note a nuance: while trust in individual doctors remains relatively strong, public confidence in the healthcare system as a whole has seen a more significant and steady erosion. Many people may trust their personal physician but have concerns about the broader system.
• Factors in Declining Trust: The decline in trust for doctors may be influenced by various factors, including the politicization of health during the pandemic, increased awareness of healthcare costs, and broader societal trends of declining trust in institutions.

In summary, while family physicians (as part of the “medical doctors” category) are still among the most respected and trusted professions in the U.S., they are not immune to the broader trends of declining institutional trust and have seen their ratings decrease from pandemic-era highs. However, they continue to be viewed much more favorably than many other professions.