Bioethics Discussion Blog: Real Medical Reality vs. TV’s Brand

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Monday, March 06, 2006

Real Medical Reality vs. TV’s Brand

If the TV program “Miracle Workers” represent TV produced reality, here is an example of real reality. My second year medical student, last week, interviewed and examined a man who has a history of recurrent deep vein thrombophlebitis of his legs which causes leg swelling and pain but also carries the risk of lethal blood clots to the lungs. He was being maintained on a warfarin anti-coagulant pill. When he entered the hospital recently with a flare up of the thrombophlebitis, it was found on testing that the degree of anti-coagulation was far below acceptable. When asked by the student whether he had been following his doctors prescribed dosage schedule for the warfarin, he stated “no”. He had been taking only half the dose to “let the pills last longer.” Why? He didn’t have enough money to buy the pills and still buy important pills that his wife needed to take. So here is some sort of a system failure. The patient is unable to be compliant because of medical costs but yet someone is going to pay for the hospital readmission that will amount to many times more than the cost of the patient’s warfarin pills. This example is but one drop of what is happening in real life in the sea of rising medical costs and burden on those who can’t afford these costs.

Although the medical cost problem is not due to one single cause, there is no doubt that the public’s insistence for tests, medications and other treatments that in many instances is unnecessary or even in some cases irrational fuel the rising costs. This then reflected back, for example, to that thrombophlebitis patient, who can’t afford medical insurance and can’t afford to pay for essential medications both for his wife and himself. My point has been that the media through magazines, newspaper reporting, TV programming and direct-to-consumer pharmaceutical advertising is responsible for a large part of the public’s unrealistic expectations of medical care including “miracles”. Of course, it is also physicians who are then yielding to the pressure of their patients by ordering these treatments or tests.

May I suggest that my visitors read about the ABC television program “MiracleWorkers” in an article in the March 5th 2006 Cleveland “The Plain Dealer” The article describes the concern of doctors and others about “Miracle Workers”, other TV doctor programs and medical ads contributing to medical misinformation and unrealistic expectations by the public. Let me know what you think. ..Maurice.

4 Comments:

At Tuesday, March 07, 2006 7:34:00 AM, Anonymous Moof said...

Dr. Bernstein, I believe that you're right, and that these reality shows are really only the tip of the iceberg.

I believe that drug company advertising to the public is also not helpful, in much the same way.

This causes those who are not medically savvy to challenge their physicians ... who in turn are concerned about lawsuits and losing patients ...

It's a lose-lose situation.

Another facet of this is when the physicians aren't able to perform the advertised and expected "miracles," a growing number of patients are turning to alternative medicine.

Everyone is trying to profit from the health fears of the public: those who create those reality shows, drug companies, insurance companies, alternative medicine hawkers ...

I believe that this is just one of the reasons that our medical system is failing ... and short of some sort of immense overhaul, will continue to do so.

Those who are going to suffer the most are going to be the people who fall through the cracks - like the fellow you mentioned with the thrombophlebitis.

Do you see a solution to all of these problems, Dr. Bernstein? It appears to me as if circumstances really can't continue in this direction much longer without some very serious consequences.

 
At Tuesday, March 07, 2006 2:09:00 PM, Blogger Maurice Bernstein, M.D. said...

"Do you see a solution to all these problems?". Sure, Moof, sure.. all that is necessary is for all our citizens to stand by their windows and yell out to the world, as in the 1976 movie "Network", "I'm as mad as hell, and I'm not going to take this anymore!" Somebody, maybe even the politicians should be listening. ..Maurice.

 
At Tuesday, March 07, 2006 2:51:00 PM, Anonymous Moof said...

Dr. Bernstein ... are you saying that you believe the politicians could make a difference? Or even that the government could make a difference?

I really don't.

I think that the change has to be "grass roots." It has to come from the people - and from their physicians. Involving politicians and the government only creates a larger quagmire ... it complicates and exacerbates already existing problems, and involves yet another group which has no business with its nose in medicine.

I believe that properly trained physicians could reclaim the patients lost to medicine's fringe contingent, and then reeducate those (and the rest of their) patients. It would be a long term endeavor, and it would only fix part of the problem, but it would be a start.

By the way, was that cynicism I read in your response? ;-)

 
At Tuesday, March 07, 2006 3:13:00 PM, Blogger Maurice Bernstein, M.D. said...

Moof, no cynicism, I agree that it is the public that must change the medical system and their understanding of what medical care is all about. However, in our system of government, change is performed without anarchy since it is the government and politicians who should be carrying out the desires and needs of the public. I also think that without the pressures of potential law suits, and I think that suits are the main influencing factor, physicians will more likely avoid unnecessary and inappropriate treatments and tests. ..Maurice.

 

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