The Covid pandemic has served to bring into even sharper focus the amount of scientific misinformation that is promulgated through the media, both print and electronic. I think it reminds us that in addition to all the other responsibilities of a surgeon, we should not neglect our role as teachers and, specifically, as leaders in society.

The deficit in scientific knowledge begins early for Americans. Trends in International Mathematics and Science Study has been administered to fourth and eighth grade students every 4 years since 1995. In 2019, 580,000 students from 64 countries participated in the examination.¹ In mathematics, U.S. fourth and eighth grade students finished 15th and 12th, respectively. In science, U.S. fourth and eighth grade students ranked 9th and 11th, respectively. Although these results are in the upper quartile, they are nonetheless disappointing considering the pride this country places in its educational system, as well as the expenditures that are devoted to it.²

The deficit of math and science proficiency continues into high school. The Programme for International Student Assessment is another international examination that is given to 600,000 15-year-olds every 3 years.³ Of the 64 countries that participated in 2015 and 2018, the United States finished 35th and 30th in math and 17th and 11th in science, respectively.³

In the past, most universities had mandatory distribution requirements for undergraduates. However, this appears to no longer be the case in many colleges. A recent survey by the Association of Medical Colleges and Universities found that only 76% of colleges reported using distribution requirements in 2015, down from 79% in 2008.⁴ It is now possible for some humanities majors to complete their undergraduate studies without a single hour of math or science instruction.

The lack of science training extends to our policymakers and elected officials. In 2020, there were only 37 (7%) members of Congress with a science, technology, engineering, and mathematics (STEM) background. Contrast that with 35% of members with a law related background.⁵ In the 117th Congress, there are 17 physicians—4 senators and 13 congressmen.^6,7 Although not every physician in Congress always provides accurate scientific interpretation of data, it is reasonable to expect that the more individuals with scientific training who are in Congress, the more likely it is that Congress will make sound scientific judgments and prioritize scientific expenditures appropriately.

This backdrop of scientific training in both the general public as well as our elected officials provides a toxic vulnerability for scientific misinformation and flawed or misdirected legislation. Never has this been more visible than during the Covid pandemic. The misinformation has ranged from the origin of Covid⁸ to erroneous treatments such as bleach and ivermectin.⁹ Perhaps even more damaging has been false claims regarding the dangers of vaccines including insertion of microchips, altering the recipients’ DNA, live virus within the vaccine, and the possibility that the vaccine could impact male fertility and the menstrual cycle.¹⁰ Although not every piece of Covid-related information provided by physician legislators has been unequivocally accurate, the preponderance of information provided by these physicians has been useful to both their colleagues and the public.

A recent Kaiser Family Foundation poll has verified that Covid-19 misinformation is ubiquitous. The Kaiser Family Foundation tested 8 false statements about Covid-19 and found that 78% of the public believes or is unsure about at least 1 false statement, and nearly a third believe at least 4 of the 8 false statements tested.¹¹

The misinformation regarding climate change is no better. A recent poll in the UK of 1,722 adults found that 46% mistakenly believed that “scientists disagree on the cause of climate change” and 35% incorrectly thought that “Scientists believe the Sun has impacted the Earth’s rise in temperature.”¹² Further testing revealed that 32% of respondents could not identify as false that “Melting an ice cube in a measuring cup full of water doesn’t raise the water level, so melting icebergs cannot raise sea levels.”¹²

The degree of belief in misinformation is similar in the United States, as well. A recent Pew Research study found that although 77% of Americans agree that human activity plays at least some role in climate change, 22% still believe it plays no role.¹³ In order to manage future pandemics more effectively, it will be required for the public to have a greater scientific sophistication, and physicians are uniquely positioned to enhance public education.¹⁴

Climate change has direct health consequences which include respiratory illnesses, water-borne diseases, zoonoses, vector-borne diseases, and malnutrition just to name a partial list.¹⁵ As urologists, there are direct climate change health sequelae including nephrolithiasis, infertility, diabetes mellitus, type 2, and possible altering the interplay of Vitamin D and prostate cancer.¹⁶

The question is what, as physicians, can we do to confront these 2 existential threats of the Covid pandemic and global warming? We should recall that the word “doctor” comes from the Latin docere, to teach. In addition to being caregivers, we should not neglect our role as teachers.

The physician has the opportunity to use the office waiting room as a classroom. Pertinent materials on both the pandemic and global warming can be made available to patients in the waiting area. There are data to confirm that patients place a value on educational materials in the waiting rooms of physicians. Moerenhouf et al reported that “patients value health information materials in waiting rooms....helpful in improving patient-physician interaction.”¹⁷ O’Connor reached similar conclusions regarding optimization of the patient experience in the doctor’s office.¹⁸

Physicians should remember that we also occupy a respected position in society. Letters to the editor and editorials can be utilized as powerful tools to present factual information to the readers.¹⁹ Arranging speaking engagements at both lay and religious organizations can also be effective vehicles to promulgate accurate health information.

Physicians should also recognize both the power and reach of social media. Blogs, websites, Facebook, and Twitter are all options for the education of the public by informed medical professionals. Although the use of social media can be abused, when used correctly, it benefits both the patient and the physician.²⁰

Finally, physicians must vote and encourage their patients to vote. James Madison and the other Founding Fathers stressed the importance of the vote in the Federalist Papers.²¹ Voting is a precious privilege of citizenship, yet many of us squander that privilege. In a letter to the editor of The New York Times, Loughlin quoted the report by Grande et al that doctors vote 9 percent less than the general population and 22 percent less than lawyers.^22,23

The role of the physician continues to evolve. As society is faced with the existential threats of the Covid pandemic and climate change, it would seem that the era of the surgeon-citizen has arrived. Thomas Jefferson envisioned the appropriate role of the surgeon-citizen when he said, “That democracy cannot long exist without enlightenment.”²⁴ It is part of the physician’s responsibility to contribute to such enlightenment.