A friend recently developed his first kidney stone. He immediately logged on to the Internet and found a host of recommendations for passing it more quickly and less painfully, from adding vinegar to his water to avoiding rhubarb. How is a layperson to know what advice is valid and trustworthy? We live in an age in which the family doctor no longer has the time to counsel patients or intimately know their medical histories. No longer is the doctor’s word the “final say” on how to treat a kidney stone … or anything else for that matter. Having been a nurse practitioner for more than 30 years, I have witnessed a transformation in patient expectations and self-advocacy.
Years ago, I would urge patients to ask questions and to seek second opinions for serious medical conditions. Above all, I would counsel patients to remember that it was their body and their right to understand their treatment options and collaborate with the health care provider rather than to accept a therapy at face value.
Today, we are inundated with television commercials hawking pharmaceuticals and infomercials by celebrities on health products that often make unsubstantiated claims that they are miracle cures and fast-track solutions for everything from obesity to hair loss.
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Complicating matters even further is the influence of physicians on television, such as Dr. Mehmet Oz, who has impeccable credentials and who has been vetted by Oprah Winfrey and others. She calls him “America’s doctor.” Although there is no doubt that Dr. Oz is well-trained, some of his colleagues in the medical profession, as well as researchers, have publicly criticized him for having questionable “experts” on his television show, which is regularly seen by 4 million viewers per episode. Many of the so-called experts and the products or advice he showcases have, at a minimum, not been subject to randomized, controlled trials; worse, others have been disproven or border on dangerous.
However, if there is a role for physicians such as Dr. Oz and other celebrities such as Angelina Jolie or Michael J. Fox, who bravely and publicly discussed their medical histories to encourage others to seek help or fund research, it is to encourage patients to do research and be savvy consumers in the same way they evaluate other important decisions in their lives. It is also to encourage patients to be prepared to ask questions, discuss treatment options, and consider (if not necessarily adopt) alternative therapies.
On the physician’s end, the advent of celebrity influence requires health care providers to learn about, and possibly recommend, therapies that may not be within the confines of traditional Western medicine, but may have value. Most of all, it behooves clinicians to be more open to discussion.
The key is for patients to be educated advocates for themselves. In other words, just because a celebrity is recommending the latest miracle cure or a news anchor person is quoting statistics from a health study, the patient needs to understand:
- how the study was conducted;
- what the evidence base is for the recommendation; and
- whether it applies to that patient’s specific condition or circumstance, as well as many other variables.
This is the basis for the scientific method, as well as for balancing the art with the science of medicine. As health care providers, we can make the most of this media opportunity to start the conversation with our patients.
Judi Greif, MS, RN, APN-C, is a family nurse practitioner currently residing in East Brunswick, N. J.
