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.
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