Health Policy – A laughing matter By Michael Millenson

Michael L. Millenson, president of Health Quality Advisors in Highland Park, IL and author of the book Demanding Medical Excellence, has previously contributed to The Health Care Blog and been featured in a THCB podcast

Those who pore over The New York Times and Wall Street Journal for their news miss a chance to feel the real pulse of health care public opinion – the comics. Dilbertisms2This past Sunday, Dilbert, compulsory reading in cubicle world, neatly skewered the idea that “empowering” consumers is a sure-fire route to better care.   

Catbert, “evil director of human resources,” announces, “The new company health plan is Google. From now on, employees must use Google to diagnose their own illnesses.” After a quick search on his BlackBerry, Catbert diagnoses an employee’s hitherto unnoticed growth on the neck as caused by the actions of a “pregnant termite” and hints menacingly at treatment involving “an arc welder and a barrel of kerosene.”

Interestingly, Dilbert author Scott Adams felt compelled to counter the impression left by his own long post a year ago about the way in which Google helped him correctly identify a rare and serious condition that his doctors failed to diagnose. The key difference, of course, is the context: Web searching as a supplement to top-notch doctors or Web access as a cheap substitute for actual medical advice. Those who soothingly promote cut-rate “consumer-driven” care should note that actual consumers will be less credulous than the consultants’ current Catbert-like customers at big corporations.

Providers are also becoming targets for satirical barbs. The sardonic Sylvia, which comments on the trials and tribulations of modern life, devoted two consecutive daily strips last summer to drug errors. The first, noting that 1.5 million Americans are harmed by medication mistakes, features pickets holding warning signs in front of the local hospital (e.g., “Danger! Do Not Enter”). The second strip , searching for a solution, muses whether we all should have an RN accompanying us to the doctor’s office. 

Meanwhile, the satirical weekly The Onion ran a fictional news item in which an Iraqi hospital begs for a new supply of bilingual “Employees Must Wash Hands” signs. The hospital’s director notes that the importance of hand-washing “could not, unlike doctors and nurses, be overstressed.”

We are still a long way from the time when the 45 percent failure rate in the practice of evidence-based medicine unleashes a barrage of biting commentary on Leno, Letterman and The Daily Show, the accepted articulators of American angst. But Time has recently noticed the importance of EBM – and that’s a start.

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concernedDavid Moskowitz MD FACPbill kincaidAtul Salgaonkar Recent comment authors
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It is always important to empower oneself, whether it be learning about a medical diagnosis or another area of concern. Well meaning doctors are often overworked (especially in the ER) and DO make mistakes, sometimes life threatening mistakes!! Always seek medical advice when needed, but be an advocate for yourself as well.

David Moskowitz MD FACP

With over 30,000 life science journals, nobody can read them all, especially a busy physician. Even Google falls down: http://world-science-blog.blogspot.com/2007/02/from-david-moskowitz-md.html The new “Google” world is not that different from the old, pre-Google world. There’s still a huge gap between what’s written and what people (including physicians) have actually heard about. Patients would do best by educating themselves, and then their physicians, about their own case. After all, it’s much more in the patient’s interest to get the diagnosis and treatment right than it is in the physician’s. And the patient has a lot more time to spend on his/her own… Read more »

bill kincaid

There’s a reason that so few people have graduated from medical school: there’s a lot you need to learn to be a physician. I don’t see much harm in being involved and aware when it comes to one’s personal health conditions, but there will no doubt be many occasions when the limited medical knowledge of the average person will lead to misunderstandings. Knowing how my own well-meaning suggestions and comments to my physicians have resulted in ruffled feathers, I hesitate to say anything to a doc that might offend his fragile ego, especially something that I only know about through… Read more »

Atul Salgaonkar
Atul Salgaonkar

While less humorous than Dilbert, the cover story in the latest issue of Business Week magazine is very apropos. (currently on newsstands,softcopy link at:
http://www.businessweek.com/magazine/content/07_09/b4023001.htm?chan=careers_careers_top+story )
Titled “Get Healthy-Or Else”, the story talks about Scotts Miracle-Gro (a 2.7 billion dollar! company) and their approach to managing healthcare costs.
I found the readers’ comments at the magazine website quite interesting, tho’ many are largely predictable.