Takeaway
When a patient chooses unproven or harmful remedies, first seek to understand why they did so rather than immediately address misinformation. Learning their reasons opens the way to discuss evidence-based treatments.
Connecting with patients | March 18, 2026 | 2 min read
By Asser Shahin, MD, Virginia Commonwealth University
Ms. Doe came to the clinic for many reasons—diabetes follow-ups, blood pressure checks, medication refills, and routine care. She was 92 years old, sharp, dignified, and always composed. Before immigrating to the United States, she was a successful politician in her country and had lived independently for decades. She was used to leading rooms, not sitting in them.
Over the course of many visits, something concerning became apparent. An ulcer on her diabetic foot worsened and became bigger, darker, hardened, and slower to heal.
An alternative, unproven treatment
Over several conversations, and with the help of the nurse, the reason was uncovered. She’d been applying a caustic “pen,” a device she was familiar with in her home country. It had been purchased in the U.S., directly to the wound and it had burned the tissue. What she believed would dry and heal the ulcer had instead deepened and burnt it.
Why she chose the pen
Ms. Doe had lived independently for over 60 years but increasingly felt the world changing around her. Medical devices looked different than they once did. Her glucose monitor display was confusing—even the lancets feel daunting. She was wary of vaccines because she’d heard a story of someone who “died from one,” though the details were uncertain. She depended more and more on her sons and struggled with that shift. The caustic pen was a tool familiar to her from her home country. It offered something the clinic couldn’t immediately provide—familiarity, action, and autonomy.
Beyond “misinformation” and “nonadherence”
As clinicians, we often describe situations like this as misinformation or nonadherence. But that framing is incomplete. The rising use of unproven and potentially dangerous treatments isn’t always a rejection of science. Sometimes it’s a response to the feeling that autonomy is fading—especially if a patient is aging in a system that feels impersonal, navigating unfamiliar technology, and quietly grieving independence.
If we want to help patients to discern what’s safe and what’s dangerous, we must do more than present evidence. We must understand what the alternatives represent—a sense of control, and sometimes familiarity.
A practical approach for clinicians
Across specialties, clinicians are encountering versions of Ms. Doe. The task isn’t simply to correct, but to connect: to ask where a treatment came from and what problem it’s solving—emotionally as well as medically—and then determine how to build or restore trust without dismissing their experience. Evidence matters. But relationship is what allows evidence to be heard.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.