Wednesday, November 26, 2014
Over-reactors do not help health conversations
One morning, driving to work, I listened to Mike and Mike (a radio sports talk show). Mike Greenberg made a wonderful point about his job. He described what they do as “professional over-reactors”. They take every game and extrapolate, sometimes irrationally, about the implications of that game.
Does this remind you of health reporting? A study appears in a serious medical journal, and the press “blows it up” as the next great advance. But scientific knowledge grows slowly, with fits and starts. Too often initial research reports are not confirmed with later studies.
While this is a major problem, perhaps a bigger problem occurs when a new disease or epidemic occurs. Many opine dramatically and profess to have the answers. Many use the retrospectoscope to criticize public health, or individual physicians or other health care workers. Often the critiques of the situation take a serious health issue and use it to highlight an issue that they want to espouse.
Likely, I am guilty of this tendency. I wrote recently about the emergency department missing the first Ebola patient’s diagnosis to highlight my concern about diagnostic accuracy. Others have used this unfortunate story to highlight concerns about electronic health records. We use anecdotes to highlight our concerns. Perhaps we overreact.
But our concerns pale compared to political candidates. We now have the Republicans blaming the Democrats and vice versa for the Ebola epidemic. Balderdash! Neither side makes a convincing case, and they have each stooped to using a public health crisis to make political hay.
As we work to understand the Ebola epidemic, we have a responsibility to not over-react. We must let the public health professionals and the infectious disease experts carefully examine the data. Our over-reacting just leads to hysteria.
Of course the press will continue to over-react and politicians will over-react, and bloggers will over-react. That is what we do. But are we helping anyone? Are we just fueling hysteria? What do you think?
db is the nickname for Robert M. Centor, MD, FACP. db stands both for Dr. Bob and da boss. He is an academic general internist at the University of Alabama School of Medicine, and is the Regional Associate Dean for the Huntsville Regional Medical Campus of UASOM. He still makes inpatient rounds over 100 days each year. This post originally appeared at his blog, db's Medical Rants.
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Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital.
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Run by three ACP Fellows, this blog ponders vexing issues in infection prevention and control, inside and outside the hospital. Daniel J Diekema, MD, FACP, practices infectious diseases, clinical microbiology, and hospital epidemiology in Iowa City, Iowa, splitting time between seeing patients with infectious diseases, diagnosing infections in the microbiology laboratory, and trying to prevent infections in the hospital. Michael B. Edmond, MD, FACP, is a hospital epidemiologist in Iowa City, IA, with a focus on understanding why infections occur in the hospital and ways to prevent these infections, and sees patients in the inpatient and outpatient settings. Eli N. Perencevich, MD, ACP Member, is an infectious disease physician and epidemiologist in Iowa City, Iowa, who studies methods to halt the spread of resistant bacteria in our hospitals (including novel ways to get everyone to wash their hands).
db's Medical Rants
Robert M. Centor, MD, FACP, contributes short essays contemplating medicine and the health care system.
Suneel Dhand, MD, ACP Member
Suneel Dhand, MD, ACP Member, is a practicing physician in Massachusetts. He has published numerous articles in clinical medicine, covering a wide range of specialty areas including; pulmonology, cardiology, endocrinology, hematology, and infectious disease. He has also authored chapters in the prestigious "5-Minute Clinical Consult" medical textbook. His other clinical interests include quality improvement, hospital safety, hospital utilization, and the use of technology in health care.
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Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.
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