Op-Ed: Medicine Is Not Entertainment – MedPage Today

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The subject of medicine — which includes medical care, illness, health, and death — has become a form of entertainment. Medical shows abound on television. It is amusing to watch actors play doctors. They seem so cool when struggling with life and death. From a medical perspective, much of what is presented is incorrect and/or unrealistic. But that doesn’t matter because the name of the game is drama, entertainment, and ratings. This would be fine and little more than fun and games, except some medical students and doctors like to copy what they see on television.

Once I was in the ER when a man who had fallen off a roof was brought in by EMS. They had not put a cervical collar on him. When a young resident saw this, he berated the EMS guys.

He said to a nurse, “Let’s get this man’s neck stabilized. There is no excuse for this. What did you guys think you were doing?”

After this resident finished his show, I spoke with the patient. His description of the fall was that he slipped, latched onto the gutter as he went down, then dropped from a height of about 10 feet, landing on his feet, then falling and stumbling down. He didn’t want an ambulance called, but his boss insisted. He did not have any pain in his neck. There was nothing about the fall to suggest a broken neck.

I saw the resident down the hall, and I walked over. I said, “That was a cute show you put on.”

He asked, “Who are you?”

I answered, “An attending in internal medicine. I’m working an ER shift today.”

“What do you mean I put on a show?”

I said, “You didn’t even take the time to talk with that patient before you went off. In fact, I never heard you say much to the patient. You just strapped him down, then ordered studies. I don’t know who taught you to practice medicine like that, but it doesn’t sit well with me.”

He responded, “It is standard procedure to secure the neck after any fall.”

I said, “Oh, really? Tell me the study that proves that. Maybe on Sundays every football player who gets knocked down should be put on a board and have his neck immobilized. Your little rant was nothing but you trying to act like a big man. I suggest you grow up.”

He said, “OK. Sorry.” His words made me feel sorry for him. I said, “I’m sorry if I was too hard on you. I just suggest you try to avoid behaving like that.”

I don’t know whether his behavior was influenced by medical dramas, but he certainly put on a show and was dramatic.

Medical entertainment can also be seen on news programs. For example, Rachel Maddow did a story about President Dwight Eisenhower’s heart attack in the 1950s. She said that Eisenhower’s doctor did not initially call a cardiologist. She implied that was malpractice. Then, with a tone of outrage, she said that Eisenhower’s doctor gave him morphine as a treatment for the heart attack. Apparently, MSNBC has no doctors to use as consultants. Or, if they do and one of them gave Maddow a green light to go off in the wrong direction, then they have hired some incompetent doctors. There was no specific therapy for heart attacks in the 1950s. Immediately calling a cardiologist would have accomplished nothing. Also, morphine was one of the few standard therapies for heart attacks at that time. Maddow did not know what she was talking about. But that didn’t matter because when medical care is used for entertainment, what is true is just not that important.

Another feature of this, as Maddow demonstrated, is finger-pointing. How dare that doctor give morphine to Dwight Eisenhower! Maddow and MSNBC are not alone in this regard. Fox News and others on the right are more dedicated to it.

This dedication was seen when some on the right called Anthony Fauci, MD, an “idiot.” One Republican said that Fauci should be killed and his head placed on a pike. President Trump called Fauci an idiot. It makes dumb people feel smart to say that smart people are dumb. So Fauci, as a smart guy, becomes a target. To take cheap shots and point fingers at those who are better educated, smarter, and fortunate appeals to mentally weak people.

This cheap shot approach was an integral part of the Trump campaign and an integral part of his presidency. As can be seen from his rallies, it was also a form of entertainment. When medical information is used and misused as weapons for taking cheap shots, then medical integrity is sacrificed.

Another source of medical entertainment are medical shows that pretend to give valid medical and scientific information. An example of this is “The Dr. Oz Show.” Sometimes he provides valid information. Other times he does not. He has become more of an entertainer than a doctor. Young doctors apply to work with him to learn the trade. This raises a question — Is medical education more interested in producing doctors or entertainers?

Sadly, medical blogs can also be a form of entertainment. To a large extent, this is an unintended consequence of sending out information that cannot be correctly understood by those who have not studied and trained in the profession of medicine. This problem can be easily identified in the comment sections on these blogs. People will write that they read an article, say it is great, and then write something which demonstrates that they did not understand the article. Even some doctors will do this.

Recently a study about dementia was presented on a blog. This study used cognitive tests from Framingham data to evaluate people with dementia. They took 50 patients with dementia and looked back at their tests. Then compared those with 50 who did not have dementia. A doctor commented on this study to say that because the study group had a high incidence of dementia, the cognitive test didn’t add much information. In other words, he applied Bayesian analysis to a retrospective study that did not lend itself to such an analysis. Yet, quite a few doctors said he was right. They were all completely off base. They did not take the time to read the article correctly. But what he wrote seemed smart, they wanted to seem smart so they jumped on board. Medical blogs have created a syndrome of people wanting to seem smart by commenting on medical subjects, whether they understand them or not. This has become a form of entertainment.

I think we should resist the temptations to use medical care as a form of entertainment. We as physicians can do better. People who are sick and suffering deserve better.

W. Robert Graham, MD, completed medical school and residency at UTHSC-Dallas (Parkland Hospital) and served as chief resident. Graham received a National Institutes of Health fellowship at the Salk Institute for oncogene research in 1985. He was a professor of medicine at Baylor College of Medicine from 1998 through 2016. In retirement, he enjoys writing and ranching.

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