“Ask your doctor if (fill in the blank) is right for you.”
How many times do we hear that statement in any given week on TV? We are bombarded with ads for all types of maladies, from the common to the (fortunately) relatively rare. These commercials are slick portrayals of a new symptom-free life, often including the obligatory graying, pony-tailed boomer tooling around in a classic convertible.
The direct advertising to patients about prescription medications presents a bit of a conundrum for me. On the one hand, we can all agree that the more informed patients are about their illness, the better chance we have of achieving a positive outcome.
On the other hand, there is a sense of intrusion between us and our patients. It is as if the drug companies know what is best, without even knowing the patient. This can lead to muddying the waters and darkening the skies. Although these ads for the most part apply to adult medicine and not my patients, that doesn’t stop me for wanting to have them all banned – with the exception of vaccine ads of course.
What bothers me most about these ads – besides the implausibility of the rosy scenarios depicted – is a sense of false promise that I am left with. As a society we have become victims of our own successes, as we are constantly reminded that we can have it all, have it now, with little consequence. When it comes to illnesses, we can be cured quickly with minimal, if any, discomfort. We tend to gloss over the etymology of the word itself: Dis-ease. Even our treatments can be unsettling. Ever notice how quickly the ads run through the side effects?
I struggle often with the uncertainties of medicine, of diagnoses I think I have in my grasp but then pass through my hands like smoke. This uneasiness is further complicated by the desire not to over-promise and under-deliver. I worry that the timeline I set in guiding a patient through an illness will be off, and not in a good way. Of course, I often get flustered when my patients aren’t completely better in a couple of days, which only means I don’t follow my own advice.
Instilling hope and positivity while tempering it with reality can be a tricky proposition. There are so many variables to take into account – and what’s worse are the unrecognized ones usually outnumber those known. Meanwhile the TV ads and internet continue unchecked. And the clouds accumulate.
So, as a doctor, how to navigate this journey?
1. The more you know the patient, the better, for starters. And then there are these basic points:
· Set a realistic timeline for patients.
· Clarify and correct what the ads and internet claim.
· Gently remind them that they are not their friend who had the “same thing.”
· And then write it all down for them.
2. One of the most important pieces of advice we can stress is to maintain as normal a life as possible. Don’t let your dis-ease control your life. Recognize that our bodies heal at their own unique speed, which seldom is as rapid as we desire.
I learned this myself as a child. By the time I made it to high school I had come through a yearslong life-threatening disorder and two major surgeries. I can recall the frustration of not playing (and fighting) with my siblings and being kept out of school activities.
3. As a pediatrician, I often allow my older patients with mild illnesses to make their own decisions on participating in extra-curricular activities. This not only reinforces the fact that illness is a part of life, but it also helps them learn how their bodies handle being sick and what reasonable limits are. I hope that whatever I face in the future, that my physician will encourage me to engage in those things I enjoy and define me. Although if he puts the kibosh on attending meetings, I most likely will not argue. It would give me time to finally start rocking the ponytail, for one thing.
Part of our job is to ensure our patients have expectations that they not only understand but can achieve. Once the course is set, with assurances that we will be there to aid and adjust, we can lessen the burden of illness, and enable our patients to once more see the stars.
Dr. Stephen J. Ezzo is a pediatrician at Matthews Children’s Clinic and immediate past president of the Mecklenburg County Medical Society.