THCB

What Dr. Oz Learned From His Cancer Scare

By DAVIS LIU, MD

Dr. Mehmet Oz recently had a piece in Time titled “What I Learned from My Cancer Scare” in which he became the more humbled Mr. Mehmet Oz.  As noted previously here, Dr. Oz last summer had a colonoscopy at age 50 and much to everyone’s surprise had a precancerous colon polyp.  He was advised to follow-up again for a repeat test in 3 months.

As the Time magazine piece noted, he didn’t return for 9 months despite repeated reminders from his doctor.

From this experience, he essentially stumbled upon what has been challenging American medicine and primary care.  How do we enable patients to do the right thing and get the screening tests done and treatments necessary to avoid premature death and maintain a high quality of life?  As a highly trained professional, Dr. Oz knows the risks and benefits of not doing a preventive screening test.  As a doctor, he knows all of the secret protocols and codespeak we use when calling patients or asking them to see us in the office for important matters.  As a doctor, he also understood the importance of a repeat colonoscopy to ensure no more colon growths.

Yet he didn’t return for 9 months.  Why?

None of us want to deal with our mortality.  Having a screening test means there is a possibility that the test may be abnormal and now we must confront it face to face. Skipping the test means to be blissfully ignorant, even if it is the wrong thing to do.

Also, as Dr. Oz noted, many individuals, particularly those who are otherwise healthy with no family history, feel that many of these tests or interventions don’t apply to them.  Trust me, I know.  As a practicing primary care doctor, do you know how hard it is to convince someone to get screened for colon cancer?  Get vaccinated for pertussis, influenza, or pneumonia?


Dr. Oz, however, did discover what will compel people to do the right thing.  It isn’t about statistics.  It isn’t about knowledge.  (And though he never discussed it, it certainly won’t be consumer driven health care where the theory is that forcing people to have more financial “skin in the game” will enable the right behavior).  It’s about getting to our emotions.

Most important, my colonoscopy wasn’t entirely about me. It was about my wife and our children. It’s about our someday grandchildren. It’s about my childhood friends whose lives remain closely intertwined with mine. It’s about my colleagues and patients at the hospital who teach me as I learn from them. I need to be there for all these people I know and care about. I need to show up in my own life. And you need to show up in yours. Sometimes that requires courage — the courage to undergo a colonoscopy or Pap smear or mammogram or chest X-ray. It’s not easy, but it could save your life. And if it helps even a little, remember that I will be rooting for you.

Reminding our patients that their inaction isn’t just affecting their own livelihood but their network of family and friends.  It’s the reason why certain topics in the media, like the concerns about vaccine safety and autism, gain far more momentum than the scientifically researched and proven life saving interventions and treatments do.

They focus on the emotional aspect of us that make us uniquely human.

Until we, as doctors, employ those same tools, too many Americans will not learn from Dr. Oz’s cancer scare or those from a variety of public figures.  The same problems will simply repeat themselves, just different people become spokespersons (note Katie Couric from a decade earlier regarding colon cancer screening).

Though highly unlikely Dr. Oz will ever read this article, one thing he must do is to highlight the need for a robust primary care workforce and inspire a generation of doctors in training to become the front-line of prevention.  Despite his work as a public figure, the intimate and personal conversations needed about preventive tests and treatments happen one on one at a primary care doctor’s office.  And we certainly need a lot more of us to get the job done.

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16 replies »

  1. Normally I can’t understand posting in blogs and forums, nonetheless prefer to declare that this particular write-up quite pressured me personally to look at as well as take action! Your own way with words has become surprised my family. Many thanks, really excellent post.

  2. I am fortunate to live in a country (Australia) where the hundreds of thousands of $s my cancer care has cost (because of the 18 months I was trying for a diagnosis – which allowed my cancer to move to stage 3) were picked up by the whole community. I doubted whether the Medicare system we’ve now used for many years, would work. But it has proven itself.

  3. As the Time magazine article notes, Dr. Oz did have a polyp on his repeat colonoscopy. The good news was it was a hyperplastic polyp which is a more normal growth. It does however mean he will need to continue to be more vigilant in follow-ups.

  4. Hi Susan. Had a look at the site you suggested.

    When you say ‘some of us feel we are not listened to’ that’s an understatement. I’ve been to so many conferences where individuals and doctors, for many different countries, acknowledge that this alone is the biggest problem world wide.

    And it’s the most dangerous. When they’re not listening they can’t know what the heck is wrong. Supposed specialist doctors nearly killed me in 2001 by their refusal to think I might know anything about my own body. Having a surgeon tell you you may not come off the operating table alive – because an undiagnosed colon cancer that I’d being trying to get a diagnosis for for 18 months, already had me close to death from a total blockage – was truly one of life’s defining moments.

    Next week their tests showed it had also gone to Stage 3 – into the lymph nodes. So even after 6 months of chemotherapy and ongoing tests for the rest of my life, I cannot be sure there’s not another cancer waiting hidden somewhere in my body.

    This is what shifted my ‘teaching role’ to trying to show doctors how to listen – and how to respond. I shake them up a bit – but those who are truly listening to ME love what I do and take it into their practice.

    I am constantly searching for health professionals’ groups who can come down from their ivory tower and employ me to hand on my easily learned and used techniques. Know anyone?

    My websites are :www.anotherlife.com.au & http://www.anotherlife.com.au/health

  5. Some of us feel we are not listened to or health care is not affordable or accessible. When we do get the care, I think it’s crucial that we continue to ask questions and be clear what we expect in a response. But the clinicians need to hear us and take the time to respond. I found this helpful when forming Qs:

  6. Thanks Dial Doctors. I agree that Dr Oz is providing a much needed service – and more power to him for opening up his own health issues. No one wants to talk about bowel cancer (think they see it as the ‘dirty end’ of cancer) but it causes the 2nd highest number of cancer deaths after lung cancer. If we’re not talking about it even more lives will be lost.

    I am fortunate to live in a country (Australia) where the hundreds of thousands of $s my cancer care has cost (because of the 18 months I was trying for a diagnosis – which allowed my cancer to move to stage 3) were picked up by the whole community. I doubted whether the Medicare system we’ve now used for many years, would work. But it has proven itself.

    In Australia, if someone presents to an emergency department at a hospital, they are not allowed to sent you away without doing something for you. My heart bleeds when I see reports of people not receiving the help they need because they don’t have the money, in other countries.

    Of course, our system does sometimes have delays for non-urgent care, because of the numbers using it, but it works so well I just hope the new ideas Barak Obama has will begin the US on the way to such a system, where the poor do not die by default.

    My own visit to a GP while in the US was an eye opener for me – enough said.

    Beryl Shaw (Down Under)

  7. As the Time magazine article notes, Dr. Oz did have a polyp on his repeat colonoscopy. The good news was it was a hyperplastic polyp which is a more normal growth. It does however mean he will need to continue to be more vigilant in follow-ups.

    Davis Liu, MD
    Author of Stay Healthy, Live Longer, Spend Wisely: Making Intelligent Choices in America’s Healthcare System
    (available in hardcover, Kindle, and iPad / iBooks)
    Website: http://www.davisliumd.com
    Blog: http://www.davisliumd.blogspot.com
    Twitter: davisliumd

  8. Beryl I think there might be a little bit of wounded pride there. I think it happens to every professional that finds an error or mistake in whatever he practices. Just try to mention something about a mechanic’s car.

    Regardless of pride, Dr. Oz is doing a service to his audience. I don’t agree with everything he shares but I can agree with him on this: most patients delay care especially preventive care. Whether it’s pride, ignorance and sometimes even hoping it isn’t so but it’s affecting the complete health care system.

    Luckily Dr. Oz’s second colonoscopy was clean (we assume because we haven’t heard otherwise) but what if it had shown another growth? That would have led to a more expensive treatment. He has the money to pay for it but what about millions of Americans who don’t? They either need to find someone who’ll foot the bill or go without care.

    Dr. Oz has helped his many followers by sharing his fears and doubts. Hopefully this will lead to more preventive care.

  9. Maybe Dr Oz’s pride was pricked too? e.g. ‘I’m a doctor and I know, don’t tell me!’ I’ve watched Dr Oz and see even he makes common mistakes in language e.g. ‘How are you?’ is a redundant term. Neither question nor answer. Wastes time – especially if you are a doctor and you ask this of a patient. Would they be there if they were well?
    I loved introducing doctors to the way their patients feel when presenting at a big health conference in Dallas in March. Their responses report that this experience teaches them many useful ways of communicating, that they haven’t been taught. I’ve been doing this for years since my own actual cancer which almost showed me ‘the promised land’. Would have, but for an amazing surgeon. Bless him.

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