“It's kind of like we opened a Pandora's box and trying to close it up again is going to be very hard.” —Dr. Zachary Rubin

Dr. Zachary Rubin joins Dr. Mariam Hanna for a candid look at the “difficult and misinformed” patient — the growing phenotype every allergist now manages weekly. A double board-certified pediatrician and allergist-immunologist with a massive social media footprint, Dr. Rubin breaks down how misinformation spreads, why it resonates, and how clinicians can approach these encounters without burning out or burning bridges. From TikTok-fuelled certainty to patients demanding full panels, he offers a practical, clinician-first playbook for navigating the mess.

On this episode:

• Why today’s misinformation is stickier, faster, and more emotionally charged than a decade ago, and how parasocial trust amplifies it.
  
  
• How the “nugget of truth” inside misinformation gives it power and how to dismantle it without escalating conflict.
  
  
• A clinic-ready strategy to approach resistant patients: open-ended questions, triaging what must be corrected now, and focusing on one actionable change at a time.
  
  
• Why continuity, follow-up, and small pieces of information over time often outperform a single “big correction.”
  
  
• How to use shared decision-making to reframe testing and treatment choices, especially when patients arrive convinced they need “the full panel.”
  
  
• Practical tools to support patient understanding, including targeted education resources, structured discharge summaries, and multimodal materials for different learning styles.
  
  
• How teams can protect each other through debriefs, preparation, and collaborative communication during high-stress encounters.

A grounded, real-world conversation for clinicians who balance patient frustration, digital misinformation, and the realities of modern allergy practice.

Have an idea for the show or a comment, send us a text!

Visit the Canadian Society of Allergy and Clinical Immunology

Find an allergist using our helpful tool

Find Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_ca

The Allergist is produced for CSACI by PodCraft Productions