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. This 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.