“I’m not a doctor but I play one on TV”–Peter Bergman playing Dr. Cliff Warner of All My Children
The trials and tribulations of doctors have long been a television staple. While plentiful, the shows were typically limited to comedy/dramas about doctors and hospitals where the medical scene was more of a backdrop to the doctors’ personal lives than an effort to educate the masses about true medicine (Dr. Kildare, Marcus Welby, General Hospital, Doogie Howser, MASH, St. Elsewhere, Cosby Show, ER, Grey’s Anatomy. Scrubs, House–the list goes on and on–who knew doctors were so damn interesting?).
This diversified slightly over the years with the advent of “realish” doctor advice shows, such as Dr. Ruth, Dr. Drew, Dr. Phil, and Dr. Oz, among others. The gist of these doctor advice shows was and is eternally the same: one or two very hand-selected patients getting “real world advice” from a doctor with all the answers. While the patients certainly volunteer for this publicity, proving my own personal assertion that people value fame and self-affirmation over medical privacy, those shows’ focus has typically remained squarely on the doctor as celebrity/expert. In the end, these are all personal fame vehicles for people who wear white coats and stethoscopes and who are there to bestow the gift of their all-knowing advice upon patients whose identities remain somewhat incidental and unimportant.
My how TV times have changed. We may not be able to generate consumer engagement in the health insurance system, but we can on the little screen. Reality television has now delivered us a world where people will abandon their families and forfeit their private lives to be the Survivor, the Bachelor, the Top Chef, the Top Model, the JackAss, or the Snooki (the last two are redundant? fair point). Compounded by the public fascination with true crime shows like 48 Hours Mystery, COPS, and Forensic Files, and fueled by a generation that shamelessly shares every single hangnail and gastric disturbance on Facebook, we have now reached the seventh circle of television hell where the only thing playing may soon be a reality medical mystery show. What’s particularly intriguing about these shows, if you get past the nausea factor that they exist at all, is the transference of focus from the doctor as star to the patient.
The first show I became aware of that so flagrantly merged the reality/medical/true crime genres is Mystery Diagnosis. This show, featured on Oprah’s OWN channel, describes itself thusly:
Every year, millions of Americans fall victim to real-life medical mysteries—ailments that go undiagnosed or misdiagnosed for years. Their lives are thrown into turmoil—sometimes their sanity is called into question—as medical professionals struggle to understand their baffling conditions. Mystery Diagnosis tells their stories….These interviews in combination with photos and home movies, highly stylized dramatizations and animated anatomy sequences take the viewer step-by-step through a medical odyssey. Symptoms emerge. Tests are analyzed. Specialists are consulted. But still, something is not quite right…
If only the audience could weigh in American Idol-style, voting for the most likely or at least most entertaining potential diagnosis, I could imagine this show giving Idol a run for its money. Better yet would be if the show featured a line-up of celebrity doctors, or simply celebrities who play doctors on TV, giving their critiques on the convincing-ness of patient suffering and calling people out for creative or potentially hypochondriacal symptoms. ”Nice tremors, Mike, but the cough is a little pitchy, Dog!”. I think the perfect expert judging panel would include George Clooney (Dr. Doug Ross), Patrick Dempsey (Dr. McDreamy), and Dr. Dre, for some street cred.
Not to be outdone, on June 25th, 2012 Discovery Fit & Health launched a show called “Diagnosis: Dead or Alive.” A truly twisted spin on Survivor (will they or won’t they make it through?), the program is described as follows in a June 25th NY Times article?
“The program explores medical mysteries through re-enactments and commentaries from the families and doctors who experienced them. Viewers don’t find out until the end of each segment whether the patient lives or dies, which gives the series an exploitative quality that is made worse by cheesy narration.”
I am guessing that the show is plenty awful enough without the cheesy narration, which may well be its saving grace. It is, no doubt, only a matter of time before a panel of judges, hopefully patients this time or at least people who have played patients on TV, get to light up the big red X, a la America’s Got Talent, when the doctor renders his third incorrect diagnosis. I can hear the theme song now..
“Bad Docs, bad docs, whatcha gonna do? Whatcha gonna do when they mis-treat you?”(sung to Bad Boys theme, as if you didn’t know).
In fact, what may be most notable about the Diagnosis:Dead or Alive show, other than its egregious tawdriness factor, is how far the mighty doctor has fallen from his heroic television pedestal as his diagnostic fallacies are exposed for all the world to ridicule from their Lazy-Boys. ”I told you Chester, I just knew that doctor had it wrong and that the poor writhing soul had Rocking Pneumonia not the Boogie Woogie Flu!” Armchair diagnosis indeed. One can only hope that they augment the charm of this entertainment nightmare by delivering the patient’s Life or Death outcome as Heidi Klum would on Project Runway, “I’m sorry, you’re out! Auf Wiedersehen!”
The NY Times article about Diagnosis:Dead or Alive ends with a quick comment about the cost of complex medical cases and a throwaway comment about “what becomes of the people–or their families–who have to face such things uninsured.” Add the cost of complex medical care into the story and now you have a reality show. Pit 3 people with simple medical conditions, no insurance and no access to primary care doctors against 3 people with horrific medical conditions but access to the best doctors and limitless resources and see who is more likely to survive. It is probably a tie for last place, which is neither good television nor good reality.
Interestingly, in a case of “life imitates art”, albeit in reverse, I read a Forbes article by David Shaywitz late last week in which he talks about how Facebook is being used as a crowdsourcing platform to diagnose mystery diseases in real life. In a specific instance, the husband of a female physician with unusual post-pregnancy seizures and no diagnosis despite herculean efforts to get one the old fashioned way, has set up a Facebook page with links to all of her medical information in the hopes that someone out there will recognize the pattern and give her the answer. This is clearly a perfect example of how the focus of the story has been seized by the patient, bypassing the medical system that has failed her so far.
This use of Facebook to find medical truth is an intriguing trend that bucks the conventional wisdom of the supremacy of physician and recognizes two critical facts: the importance of the patient’s role and how important it is that we use technology to recognize patterns that human beings, even the smartest doctors in the world, may not be able to see because their personal data points are too few. Studies out there have suggested it takes anywhere from 7 to 17 years from the time that best practices are identified and published in medical journals to the time such practices are adopted as the standard of care across the medical world. This is mostly a matter of the time it takes for everyone to actually get the message, since it is clearly impossible for every doctor to read every relevant medical story that is published, combined with the fact that inertia is a powerful force that fights against human intellectual growth every day of the week.
It will be interesting to see if Facebook can be the cure for both the time and inertia challenges that face the medical community and even more interesting to see how and if the medical community itself embraces this new medium. This may well be the next app you see on Facebook, as Shaywitz points out. Of course this begs the question as to whether the next reality TV show we see will be called Facebook: True Medical Mysteries. Host: Mark Zuckerberg. Operators are standing by to take your “likes.” If it’s a particularly nasty diagnosis, remember not to hit the “share” button.