Michael Joyce is a writer-producer with HealthNewsReview and tweets as @mlmjoyce
The Too Much Medicine (TMM) conference is small, but has a potentially huge impact.
We cover plenty of medical conferences about heart disease, cancer, and dementia (to name a few) that trigger tsunamis of media coverage because they –quite obviously and understandably — affect millions of people and involve grave outcomes.
But the TMM conference, wrapping up Friday in Helsinki, gets just a whisper of coverage even though — less obviously and much harder to fathom — it also affects millions of people and involves grave outcomes.
I realize this is comparing apples and oranges. And there may be plenty of reasons this symposium flies under the radar of most journalists including: the (unsexy?) nature of the topic, the lack of big industry backing and promotion, or the outwardly counterintuitive notion that less can be more when it comes to health care.
But understanding how too much healthcare can affect the health of millions, cause serious harm, and even threaten the financial and scientific integrity of healthcare worldwide, is precisely why we think the big message of this small conference needs a larger audience.
So we’ve opted to bring some aspects of the conference to you. We’ve chosen some slides presented at the conference that got quite a bit of social media attention. We’ve included recent examples of our own work that illustrate the real-world impact of the important themes highlighted in these slides, and suggest why these themes matter.
Theme One: “The focus of healthcare has shifted from the sick to the well” (aka the potential patient). These are often the “pre”-diseases or the medicalization of variations on normal.
Real World Examples:
Why This Matters: It boils down to who does it help and who does it hurt? Manufacturing diseases to boost sales undoubtedly affects newly minted patients (increasing risk for harms, and emotional and financial stress), the healthcare system (shifting resources away from more legitimate/pressing needs), as well as the public trust in journalism (when reporting lacks scrutiny) and in biomedical companies (who may profit while potentially misleading and harming their customers).
Theme Two: “If you’re not sick you just haven’t had enough tests.” (aka “Screen for More, Find More”)
Real World Examples: I doubt a week goes by at HealthNewsReview.org that we don’t come across a news release or news story that perpetuates these clichés in framing their narrative: screening saves lives, better safe than sorry, and newer or more is better. A very recent and very short list includes:
Why This Matters: The very notion that screening may NOT save lives, and may do more harm than good is counter-intuitive for many people. Challenging this thinking calls for nothing short of a paradigm shift. The ideal place for this to occur would be the doctor-patient relationship. But before that can happen more medical journals (kudos to BMJ’s ‘Too Much Medicine’ and JAMA’s ‘Less is More’), more medical meetings, more medical schools and centers, and certainly more medical journalists need to become more aware of the evidence-based scholarship on screening.
Theme Three: How can we expect the public to differentiate too much vs. too little health care if their sources of information are incomplete or misleading or toxic.
Real World Examples: This is our bread and butter at HealthNewsReview.org. After 12 years, >5,000 articles, and 46 podcasts we’ve documented sources of pollution at numerous points in the flow of health care information from its source to the public. Here’s a very abbreviated list of some of those polluted sources:
Why This Matters: What’s above is just a partial list. When you consider that medical media — broadly defined — would include advertising, talk shows, op-ed writing, network news, and social media (to name just a few), you can begin to appreciate the dizzying number of opportunities that exist for contamination of our health care discussions. It requires vigilance and scrutiny — our modus operandi — if we’re going to achieve our goal of improving the public’s critical thinking about health care. We see the roughly 200 participants of this year’s Too Much Medicine symposium as important allies in helping the public separate the sense from the nonsense in our dysfunctional medical industrial complex.
Editor’s note: Our publisher, Gary Schwitzer, spoke at the symposium in a session titled: How journalists often promote too much medicine: >3,000 lessons from HealthNewsReview.org. Tweets about his presentation and other information from the conference can be found at #TooMuchMedicine and #TMM.
My hero @garyschwitzer at Too Much Medicine Conference.
His @HealthNewsRevu exposes how crap media hype fails to report:
1)Costs
2)Harms
3)Scope of benefits
4)Quality of evidence
5)Alternate options
Media PR has contributed to overtreatment.
Only media truth can cure it.#TMM pic.twitter.com/nrgEyZ8mY8— Allen Frances (@AllenFrancesMD) August 15, 2018
Comments (4)
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Dale Hammerschmidt, M.D.
August 17, 2018 at 8:10 pmClick frequency is a major determinant of ad prices. This creates a huge incentive to present news as though every minor bit of progress is groundbreaking and likely to produce immense benefit; it’s even better if it negates all that has gone before. The more people access its stories on line, the more a publication can charge for advertising. Hyperbolic reporting is thus encouraged by market forces, and even very balanced articles may be presented with decidedly overblown headlines and illustrations. This is another source of pollution for the stream of information.
Gary Schwitzer
August 18, 2018 at 10:02 amIn addition to planning and delivering a powerful Too Much Medicine symposium, Drs. Teppo Jarvinen, Kari Tikkinen and colleagues added an important element. They had me and 4 other journalists speak in a day-long health care journalism event for Finnish health care journalists on the day prior to the start of the symposium. 50 journalists attended. That is something that more such conferences should consider: Preventing Overdiagnosis, Lown Institute, etc. Some of the journalist-attendees told me that they learned things they had never heard of or thought of before. Kudos to the Finnish organizing committee for having this foresight.
Gary Schwitzer
Publisher
Phillip J. Baker
August 18, 2018 at 2:44 pmI offer this for your thoughtful consideration: https://www.aldf.com/lyme-disease/#misinformation . It relates to the “epidemic” of Lyme disease.
Al Lewis
August 19, 2018 at 5:35 pmThis is spot-on and long overdue. The problem is that many wellness vendors — notably the one that claims to be the largest, Interactive Health, screen the stuffing out of employees in their hunt for disease, and then brag about how many sick employees they find. We call this “hyperdiagnosis.” We can’t yank their license because wellness vendors don’t need licenses and we can’t urge employees not to participate because they get fined if they don’t.
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