How to Manage Patient Expectations Created by the Media

September 20, 2012
James Doulgeris

The Internet and a constant TV news cycle have created challenges for physicians in addressing all the information patients now have access to.

We live in very complex times. An abundance of data and information is easily accessible by more of the population in more of the world at this moment, than all of history combined. up to 10 years ago today.

For healthcare, make that this moment than all of history combined up to five years ago, and it grows moment by moment at a ferocious pace.

The issue for all of us in healthcare is that not all of it is accurate, or responsible, or ethical.

Google any ailment, ache, pain, disease, or condition in lay terms or clinical terms and the results are in the hundreds of thousands, and, often, millions and tens of millions. But, it is only the first few pages that count, and who is on them has very much to do with how good they are at making themselves look relevant to search engine algorithms.

The authors and their motivations are hidden from view by sophisticated graphics, unverifiable testimonials, and professional endorsements, carefully crafted, subtlety clever, sales pitches, and everything in between that makes the line between fact and fiction invisible.

The popular press, which is now print, broadcast, cable, Internet sites, blogs, and more, is in fierce competition with one another and news that Googles well means eyeballs on that news and its advertisers.

Snake oil sales has adopted sophisticated mass marketing and public relations techniques. Media cutbacks and competition have lowered the experience level of reporters and with it, the motivation to be less discerning in what they report.

Healthcare “breakthroughs” Google well, and the standards of experience-based validations have been compromised. Nutraceuticals, genetic research advances, and natural avatars for FDA-approved medications make claims of “shocking” results and clinical equivalency. The FDA required disclaimer that “This product has not been evaluated by the FDA and is not intended to diagnose, treat, cure, or prevent any disease,” has turned into white noise for many.

The problem for physicians is threefold: it is virtually impossible to keep up, to separate the real from the hype and, most vexing, to spend the time with patients to discern the difference.

I am not a clinician or physician, but my lay opinion matches that of many physicians: If the patient feels better, and it is chicken soup, it couldn’t hurt. But that doesn’t apply universally because the science doesn’t exist to differentiate.

From a regulatory standpoint, claims of equivalency to FDA-approved drugs should be proven and the rules need to change.

From a medical practice standpoint, excess in anything can be harmful; common sense advice, but, this is the easier of the two. News of advances in diagnostics, genetics, stem cell therapies, and others can take years to make it to implementation in medicine. They make good headlines, and look promising, but it will take time to be sure that they are safe and effective. That is the explanation to patients from my perch.

At its heart, however, the issue is constitutional: the right of free speech balanced with public safety. This is a tough issue that has to be sorted out one claim at a time.

I believe that this is impractical by virtue of the sheer volume. Public education, and improving medical literacy would be a more practical and effective solution.

The concern is not in the exam room, but in the family room, where decisions to buy into claims equal decisions to forego care. Unfortunately, many of these symptoms can be precursors for more serious problems that could be treated easily now, and will be more invasively and expensively treated later.

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