domingo, 1 de outubro de 2017

Reflexão - Scientific American (os "doutores nos media")

(Artigo no Scientific American)

Beware of Social Media Celebrity Doctors

Too many of them offer advice outside their specialties, choose brand-boosting over integrity and tout dubious treatments


The celebrity doctor phenomenon is not new to Americans. With the release of his first baby-care book in the 1940s, Benjamin Spock became a household name by helping mothers across America feel more confident in their child-rearing skills, long before the age of social media and daytime television. Now, decades later, some of the most prominent players in the game of celebrity doctoring are integrative medicine expert Andrew Weil, cardiothoracic surgeon turned daytime television health guru Mehmet Oz, and television’s go-to-psychologist, Phil McGraw.
All of these men have come under fire in the past, usually due to questions regarding the medical safety and efficacy of their recommendations. But the controversies surrounding them have hardly made a dent in the profitability of their longstanding empires or in the dedication of their fans. Doctors and researchers have been so riled up by the lack of medical evidence for the recommendations handed down by medical television shows that a 2014 study looked specifically at this issue. Not too surprisingly, only 54 percent of the recommendations studied had even one piece of medical evidence to back them up. And less than 1 percent were accompanied by disclosures of potential conflicts of interest.
But now, in the era of social media influencers, celebrity doctoring is no longer exclusively available through the handful of physicians writing books or starring in television shows; it can be found across just about every social media platform. Medical bloggers, doctor instagrammers, and physician twitterati are all reaching out to the American public, and this is a slippery slope to disaster.
What started as a way to improve professional development for physicians and help disseminate credible information for patients has slowly started to devolve into a world of glamour shots, with physicians often exaggerating their credentials at the expense of a gullible social media audience. As a result, social media has created microcosms of celebrity doctoring that have started to expand unchecked and unfettered, usually at the expense of their target audience.
Today’s self-promoting physicians have strayed far from the “no advertising rule” in the original American Medical Association (AMA) Code of Ethics that was in place from 1847 to 1975—mainly to prevent the practice of medicine from turning into a practice of solicitation. And while the rule ended to allow hospitals and medical practices to work on public relations efforts for the betterment of healthcare, we have to wonder about the significant potential for harm that stems from often misleading and misrepresentative healthcare information coming from these physician social media accounts.
With 2.5 million Instagram followers, Dr. Mike Varshavski is one of the most popular young physicians on the social media playing field. His account can often be entertaining, albeit misleading: many of his followers likely do not realize that Dr. Mike’s experience is very different from the experiences of the average American physician-in-training, based on previous studies looking at resident quality of life. This is fairly harmless, but he also ventures into some dangerous territory, where the line between physician and social media maven begins to blur. Recently, Dr. Mike’s Instagram account has been a collection of promotional photo shoots for companies ranging from Charmin to Kenneth Cole to Braun, raising the question of how appropriate is it for a physician to be profiting from Instagram views of posts on the same platform that provides medical commentary? Unfortunately, my requests for comments from Varshavski went unanswered.
Pop-star status for physicians has the potential for harm, simply because of the power wielded by physicians who have such wide access to the American public. Thankfully, in many instances, the Food and Drug Administration has cracked down on misinformation and false claims from such celebrity physicians as Oz and Weil. Oz’s claims regarding potentially unsafe arsenic levels in apple juice caused unnecessary hysteria, while Weil’s claims for his immune boosting supplements came with zero evidence that they could in fact “ward off” swine flu.
When the practice of clinical medicine begins to be trumped by individual physician brand-building, patient safety and well being can become endangered. And while many of the mega-media physicians often do face scrutiny for their practices, physicians who are merely social media celebrities attract less, even though they might have just as large an audience.
I am not advocating for a witch hunt, but physicians should be held to high clinical standards across every platform in which they practice—from their clinics to their Instagrams. Unfortunately, clinical standards seem to disappear in the realm of social media, where private practice physicians tout affiliations with academic institutions that they truly have no day-to-day dealings with; pediatric physicians branding themselves as integrative medicine experts for adults; internal medicine physicians branding themselves as skincare experts; and even non-endocrinologists branding themselves as thyroid and adrenal gland experts and pioneering “hormone revolutions.” The list goes on ad nauseam. Maybe we should have kept some form of the AMA’s original “no advertising rule” around.
Ultimately, there is an almost complete lack of evidence about the long-term effects of social media on the practice of medicine, and right now, there are several accounts that could potentially be deceiving their followers. So what can be done in the meantime? Take everything you see, read, and hear from social media physicians with a grain of salt. Google their credentialsbecause for nearly all physicians with legitimate training, this information is readily available online. Lastly, take some time to scrutinize those credentials to understand if their current area of medical practice is consistent with their training.
It's wise to remember that not everything “natural” is safe, and not all “expert” advice is sound.

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