Playing for Sweeps

A friend just emailed me a question -- is piercing the cartilage of the upper ear more dangerous than piercing the lobe? He asks, because it's going to be featured on tonight's 10 O'clock News Health Check. Since I got my PhD in chondrocyte mechanotransduction, he figured I'd be an expert.

Well, I'm not. I mean, I could guess that infection and damage to the upper ear is potentially more disfiguring than the lobe damage, but hey. They're teaching me stuff in medical school that's, well, much important to more people.

The other day I heard a radio promo for a Health Beat Special Investigation: pharmacies leaving OTC meds on the shelf for too long! Some are several months past expiration!! How can this be?? More at 11!!!

You only hear about this kind of Hard-Hitting Investigative Reporting during Sweeps months: February, May, and November. For some reason, this is when advertisers decide allocations and actually pay attention to ratings. So, in addition to all the best TV shows and TV movies airing at the same time, the local news stations go apeshit. In Boston, for instance, Channel 7 just introduced a traffic monitoring system that's so complex and expensive, it might actually be cheaper for them to ferry viewers into the city via helicopter.

And in Sweeps month, the Health Beat reporters put down their JAMA abstracts and head out into the community, where their Hard-Hitting Investigative Reporting will do some real good. God forbid your prilosec is only working at 90% max potency.

I could get worked up about this -- about how the money and time spent on these sweeps month Health Beat shows, or SARS coverage, is essentially wasted. About how no one's health will really be improved by these segments, whereas a widely-viewed one-minute diatribe against sugar or cholesterol or nicotine might get a few people out of 'pre-contemplative' mode.

Even the massive coverage of estrogen and HRT risks last summer will 'only' save a few hundred lives a year. That's huge, of course, but pales in comparison to medical errors, lung cancer, and other preventable forms of death and disease. Using equal-time arguments, public-service announcements about smoking or computerized error-checkering should run continuously, in prime time, from now until mid-October. And start up again next year.

I could get worked up about this, but I'm not so much railing against networks ignoring their civic duty as I am railing against human nature. What's more, I'm guilty, too. I'm studying Wilson's disease tonight (again) rather than diabetes or coronary artery disease. I may never see a patient who benefits from my vast knowledge of Wilson's disease, but I'll see DM and CAD every day.

I've commented more on public health priorities here, and here, and here. Even here. Bottom line: if we were really serious about saving the most lives per healthcare dollar, our lives would change catastrophically, and we'd probably end up as a bunch of soulless automatons, working from home, eating only a cellular peptide cake (with mint frosting). But that shouldn't prevent us from trying to make incremental, real improvements in people's lives, one Health Beat at a time.