From death panels to Dr. Oz: An interview with Joy Lee
Over the last couple of weeks I’ve written about a new AMA policy authored by a group of medical students and co-sponsored by medical residents and fellows. I’ve been sharing details about how this policy came to be not because I think it is exceptionally historical, but because it is an example of meaningful political progress and professional reform being instigated by medical students.
What “being a doctor” means is subject to an ongoing, iterative process of change — from both outside forces and forces within the profession. I think as medical students we can only gain an accurate understanding of the profession if early in our training we participate in this process of professional re-construction and renewal. We need to understand that the profession didn’t stop evolving after Hippocrates.
One of my colleagues, Joy Lee, a lead author of the AMA policy we’ve been discussing, exemplifies the value of student engagement with the professional institutions that define what it means to be a doctor. In the interview below she tells me about her experience with organized medicine.
Here’s how she describes herself: Joy Lee is a third-year medical student at Rutgers Robert Wood Johnson Medical School. She graduated from the University of Illinois, moved to the East Coast, and has been re-learning how to drive ever since. When she isn’t studying or doing research, she enjoys policy wonking and eating adventurously.
Read on for the entire interview.
Q: Why did you become interested in the issue of medicine in the mass media? How do you feel about the results your policy work so far?
JL: Medical issues in the media first came to my attention back in 2009, with the whole “death panel” debacle. I conduct research on end-of-life care, an area that is particularly influenced by public perception, so I’ve seen firsthand how public denial of medical treatments can affect people at their most vulnerable. The issue of TV doctors hawking false remedies is a natural extension of that concern. While the issue is something that I think every moral physician is concerned about, I started thinking it was an issue we really needed to take action on when wave after wave of media coverage denounced these TV doctors, without any input from the medical profession.
I believe the most effective physicians work with their patients, and in order to work together, there needs to be a bond of trust. It’s our duty as a profession to preserve that trust by signalling to patients that, yes, doctors are people, and people can do horrible things. However, we as a community don’t endorse those practices, and we will discipline them when necessary. I’m so proud of our team of student and trainee authors, and the progress we’ve made so far. I think we have a lot of work ahead of us in order to establish a culture of accountability, but I think that we have made a tremendous first step in passing this resolution as an official AMA stance on the issue.
Q: Have you had any first-hand experiences with patients being misled by false medical information in the media?
JL: Not just patients! Of course, we had patients who came through the clinic believing that they could lose an unhealthy amount of weight in 2 weeks with Dr. Oz’s plan, or that the newest supplement was going to be the breakthrough in their cancer treatment. But even people who work in the medical field will sometimes parrot these remedies as proven treatments! I have seen medical staff take raspberry ketones thinking that it will melt their fat away. I think this proves that even people with a medical education will try anything if they want the results badly enough — and it’s despicable that any licensed medical professional would at best, mislead, and at worst, harm, these people.
Q: As a profession, what should we do to ensure patients have access to accurate medical information?
JL: There is so much we as physicians can do! First, we can educate our local communities. I’m involved with our state medical society, and they do an amazing amount of work in education, especially when there’s relevant legislation being debated. My school sends medical students to local high schools to teach STD prevention classes. On a day-to-day basis, physicians have so many opportunities to educate people about accurate medical information outside the office or hospital environment.
Second, we can take to the internet. There are already fantastic physicians being employed at health sites online, and major hospital systems like the Mayo Clinic and the Cleveland Clinic publish tons of material on any medical questions imaginable. We should direct patients to reliable sites, because for every accurate medical site out there, there are at least three more put up by people without a medical education. We need to continue to boost our own involvement on the internet. Many medical students joke that Wikipedia is actually a more reliable source for medical information than you would expect a community-edited encyclopedia to be — that’s because there are physicians and students checking pages for accuracy!
And finally, when controversies do arise, we need to respond as a community in a timely fashion. A fragmented response from individual physicians can play in the media as a he-said, she-said situation. But the statement of an approved voice for the profession, such as the AMA, can give people a sense of how the majority feels about an issue or a treatment.
Q: What have you learned about the political advocacy process? What suggestions do you have for others who are hoping to improve the profession?
JL: When I came into the advocacy process, I didn’t realize the extent to which you have to talk to people to earn their support for your cause. That sounds silly, because that’s kind of the definition of advocacy — talking to people to get support for your issue. But it really surprised me how much discussion, negotiation, drafting, and re-drafting goes into policy that seems almost obvious at the end. It’s easy to get frustrated during the process, especially when someone is coming from a completely different viewpoint and doesn’t accept the same fundamental premises that you think are unalienable. However, it’s incredibly satisfying to succeed in your cause after all of that, knowing that the final product is a precise, effective action because of all those drafts.
For students who feel frustrated by the troubles that plague our current medical system, I would give two pieces of advice. First, get involved. Whether it’s in organized medicine, a committee at your institution, or with a few friends, there is always something that you can do. The profession won’t change unless we change it, and the more of us that participate, the more problems we can solve. Second, set realistic expectations. I’ve seen a lot of students get jaded because their great idea wasn’t accepted, or it was implemented and didn’t create shock waves of change. Failure is unfortunately just part of the advocacy process. That doesn’t mean that your advocacy is not worthwhile. In fact, your involvement is the future of medicine, and you might be surprised where it takes you. I didn’t plan to fight for this cause when I joined the AMA, but I’m here, and I’m incredibly grateful to have a chance to work on this issue with some of the brightest, most passionate people I know.