Monday morning quarterbacking as a physician

Is it appropriate to comment on the perceived illnesses of public figures?

When Britney Spears had one of her famous meltdowns–I can’t recall if it was when she shaved her head or something worse–Dr. Phil of television fame came under fire for interjecting himself into the drama. He was providing medical opinion in public, and was doing so after seeing Ms. Spears for only about 15 minutes–and against her will. In fact, after this he was accused of practicing medicine without a license (he is an “entertainer” not a licensed psychologist). The privacy violations are a whole other dimension to this drama. The negative publicity eventually forced Dr. Phil to pull his planned one hour television show dedicated to Ms. Spears follies.

Well, all that drama is nothing compared to the drama of this election cycle, as I am sure you have noticed! The recent staggering and near faceplanting of Ms. Clinton have again unleashed scores of medical experts willing to go on the air and discuss Ms. Clinton’s health issues from their professional perspective. That’s not pneumonia! How come she drives in what looks like an ambulance instead of an SUV? It’s Parkinsons! The Russians poisoned her! She had a seizure. For God’s sake, who has the shoe?? But is all that professional medical opinion…professional at all?

“Armchair diagnoses” can also harm the reputation of the physician involved as well as, of course, the recipient (I can’t use the word patient here). Anees Chagpar, MD, associate professor of surgery at Yale University, as quoted in MedPage Today: “In medical school, we’re taught the value of a comprehensive history, a detailed physical exam and the value of appropriately considered laboratory and radiological tests in reaching a diagnosis. Given that one can rarely (if ever) do any of those through a TV screen or the pages of a newspaper, it would seem impossible to render any meaningful diagnosis about the health of public figures … whom we do not see in our practices.”

“If we play ‘armchair physician’ like everyone else, we run the risk that people may misinterpret the fact that we have an MD behind our names as evidence that we can render a remote diagnosis without the data we need to do so.”

For physicians, this sort of analysis, whatever the intentions, undermines our credibility in the community as critical thinkers who look at a mountain of evidence in every case. If you lead people to believe you can look at a 10 second video and make a concrete diagnosis, how can you claim to provide a valuable service as a physician to anyone? Worse, you offer proof you are not objective, and are swayed by either your political point of view or the small attention you get being the expert in the room (or on TV) for your 30 seconds of fame. Physicians should be better than that.

See the article in MedPage Today


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