Blog | Tuesday, April 16, 2013

#sellingsickness 2013

I attended a fascinating conference called "Selling Sickness" that took place in Washington, D.C. It was three years in the making, as the previous iterations of it took place in Australia in 2006 and Amsterdam in 2010.

How did I wind up there? An academic paper that I co-authored was noticed by some smart folks in the UK, who linked to it on their website. Subsequently, some Twitter friendships developed, and I was quickly made aware of the conference.

What was the conference about? From the material: "We're at a critical moment in public awareness about overtreatment and overdiagnosis and the harmful consequences in terms of health and financial waste. There is growing awareness, too, of the corruption of science as a result of marketing. This conference is called to raise awareness further and create new collaborations among the stakeholders from academic and consumer worlds."

To whom could such a mission statement appeal? In addition to cranky academics like me, this was a high congress of journalists, patient advocates, and consumer activists, or in other words, the best kind of conference for making connections across disciplines and (for me) getting out of the siloed world (think 'ivory tower') that is academic medicine.

What are the stakes?

For journalists: Amidst a hemorrhage of job and revenue losses, mission-driven writers and broadcasters are continuing to report about harms from overzealous and often inappropriate application of medical technology. This, despite ungodly pressure to produce. Produce now. Produce yesterday. Without fact-checkers or other resources of yesteryear. These stalwarts are telling people's stories and offering a critique of all-too-frequent medical cheerleading that passes for journalism in our voracious, short-attention-spanned digital news environment of today.

Patient advocates: Many of the attendees were themselves (or had a loved one) harmed by medicine or medical technology. Think of adverse drug reactions; cardiac devices like pacemakers causing trauma, heart injury, bleeding or infection; orthopedic device failures; surgical mesh causing chronic pain. Many of these victims have admirably used monetary settlements to create foundations devoted to preventing others from suffering harm.

Consumer activists: Many representatives of the Consumers Union, the folks that bring us Consumer Reports, were on hand to share their methods of non-biased evaluation, to discuss their projects and seek additional collaboration.

The conference was engaging, and dare I say: fun. I met many people whose work I'd only read or seen online, which is validating. The collaborative aspects build energy. The chance to engage in meaningful discussion and ask lots of questions led to new ideas for projects, papers, and activism.

One thing bothers me, though. At a panel on the harms that can come from screening (see this), I asked a question no one could answer: In a world of inequitable resource distribution, how should the disease mongering/selling sickness movement address the fact that so many worldwide lack for basic health care?

In other words, coming from a state near the bottom of the U.S. in health outcomes, doesn't it come across as, say, overly entitled (whining?) to complain about over-abundance of health care? I know that the harms of over-medicalization are real; I'm just troubled by the disconnect between two strong advocacy strains in the worlds of health and health care.

Suggestions welcome.

This post by John H. Schumann, MD, FACP, originally appeared at GlassHospital. Dr. Schumann is a general internist. His blog, GlassHospital, seeks to bring transparency to medical practice and to improve the patient experience.