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The waiting game

Spare us the heartsink celebrity endorsement

Dr Pete Deveson

Dr Pete Deveson BLOG duo_3x2

We’ve all heard of heartsink patients, but what about Heartsink TV? I refer to the phenomenon where a GP’s evening viewing is ruined by the appearance of a well-meaning celebrity giving out counter-factual medical ‘advice’ which you realise with mounting horror will comprise the watercooler moment of your next days’ discussions with the worried well.

This week Celebrity Bake Off contestant Bill Turnbull announced he has prostate cancer, and like Stephen Fry and Ben Stiller before him, urged all men to see their doctor for testing.

One minute I’m relaxing en famille, idly wondering what Mary Berry’s up to these days, and the next I’m grinding my teeth with the realisation that the nations’ GPs will be shortly putting their index fingers to more use than Lord Kitchener and Tony Manero officiating a 1990s England second innings run chase.

Now I’m not simply complaining about the extra work created for me; I’m a big fan of all the above-named celebs and have no wish to kick them when they’re down, but the problem with raising awareness of disease without simultaneously raising awareness of the complexities of how we diagnose and treat it is you end up doing more harm than good.

These well-intentioned but ill-informed statements have real-world consequences

Older readers may recall the time when housewives’ favourite Richard ‘not even a real hamster’ Hammond resolved that, despite recognising there was absolutely no evidence it was harmful, he would not only decline to give his daughter the MMR, but dedicate a half hour of prime time TV to the decision; for a man who gleefully strapped himself into a rocket powered car to publicly announce he found the UK vaccination schedule too big a risk to bear was jaw-droppingly irresponsible.

Similarly, Stephen Fry’s modus operandi is revealing that widely-held beliefs are actually counter-intuitively far more complicated than they first appear; for him to repeatedly advise his millions of followers that all men should have regular prostate screening – the direct opposite of what the evidence actually recommends - without a klaxon going off and the camera cutting to Alan Davies pulling a face, struck me as Quite Ironic.

These well-intentioned but ill-informed statements have real-world consequences; the Hamster’s MMR scare-piece might have been just another pay cheque to him, but the anti-vax seeds he sowed ten years ago will be reaping a harvest of orchitis in today’s unvaccinated teenagers. And the latest evidence tells us that all the PSA tests we’ll send off in the wake of this month’s Heartsink TV will lead to an epidemic of overdiagnosis, WITHOUT PREVENTING A SINGLE DEATH FROM PROSTATE CANCER.

George Monbiot has shown it’s possible to go public about a prostate cancer diagnosis without recommending non-evidence-based testing. If we can squeeze the complex nuances of screening science into a short YouTube video, could we maybe do it on the Great British Bake Off?

Dr Pete Deveson is a GP in Surrey

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Readers' comments (16)

  • Helen Lampard-Stokes did two consecutive days of fairly well reasoned and presented explanation on Radio 4, and their idea of 'balanced' journalism was to then have a montage of phoned-in, emotion laden anecdotal evidence from patients, and an opposing view from a private Urologist. Really makes you despair.

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  • Stokes-Lampard...apologies to our revered leader.

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  • “These well-intentioned but ill-informed statements have real-world consequences”
    The problem is that this is happening in all walks of life. From the very top, there is deep suspicion in the ‘experts’ and denigration of what they say.
    Nothing will change until this changes

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  • Good article Pete.
    And I have had about 4 or 5 patients in their 50s and 60s in the last week in about this, with no good symptomatic reasons otherwise.

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  • Cobblers

    Pete save 10 minutes of your time per prostate consult. Stop doing DREs.

    "A meta-analysis recommends against using digital rectal examination (DRE) for routine prostate cancer screening in primary care settings to avoid unnecessary testing, overdiagnosis, and overtreatment".

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  • AlanAlmond

    Apparently ‘men don’t go to the Dr’. A common refrain from the hordes of worried men who you just know are coming in with the express intention that you stick your finger up their arse. Men who will be most unhappy if they leave without you doing so. :(

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  • AlanAlmond

    I sometimes find myself reflecting on the uncomfortable reality that I chose a career that involves the obligation to stick my finger up the backside of any man over 50 who wanders in off the street and wants it done. An unfortunate consequence of being a man and a GP. I suppose it’s kind of kind of Kama, balancing out all the gynae stuff disproportionately carried out female colleagues.

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  • Really well written Pete

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  • It is illegal to advertise a prescription only drug to the general public,but not a test,not a charity,not a health concern.This has always been an anomaly and gives rise to these situations.
    In fairness there are worse examples,Matt Baker on the one show discussing casualty closures closed hurriedly by advising anyone in the nation who was concerned to fully discuss it with their GP.
    Celebrities cannotbe blamed for such nonsense,indeed nonsense is inherent in the concept of celebrity.
    The question is how can the GP population have become so weak and lacking in influence
    How can any of them still subscribe to the BMA or College.Many thousands still do so.
    Until the profession addressses their lack of effective representation it will be a free for all for every celebrity to advocate anything they like

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  • After the 5th request in 2 days thought i had surfed the tsunami then walked in a 36yo drinking 7 cups of coffee a day and wanting a PR on a Friday on call!!....Took a 5 minute walk.. contemplated my life/career choices and decided that only a gmc compliant reflective entry on why i signposted him for a full, anxiety inducing, BMI health screen would make karmic sense.
    Still in my self made prison but passive aggressive on so many levels.

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