Are Americans naive about medicine?

Source: FilmsdeFrance.com

There was a follow-up letter to “The Last Well Person” (see previous post) from a doctor in Spain. He pointed out that the “extinction of well people” was anticipated in the 1920s by the French comedy, Knock, by Jules Romains. Dr. Knock purchased the unprofitable practice of a country physician and proceeded to diagnose everyone in the village with an illness. He prescribed cures commensurate with the patient’s income. (This is really quite considerate compared to the reality of bankruptcy caused by medical costs in the US.)

Just as Dr. Meador used the quotation “A well person is a patient who has not been completely worked up,” Dr. Knock was known to say “The healthy are ill people who are unaware they are ill.” Meador’s response to the letter mentions further explanations for the “The Last Well Person” phenomenon: insurance coverage that requires a specific diagnosis even when there is none, disability insurance, worker’s compensation, Medicare, and television advertisements.

American vs. European regard for doctors

It’s interesting that the response letter came from Europe. Lynn Payer, a highly regarded medical journalist and author, believes that Americans are especially susceptible to what she calls disease mongering: the attempt to convince those who are essentially well that they are sick (or people who are mildly ill that they are very sick).

One reason she cites for this susceptibility is that American literature does not contain disease-mongering characters. Britain has George Bernard Shaw’s play The Doctor’s Dilemma, in which Cutler Walpole diagnoses everyone as having a putrefying nuciform sac that requires surgery. France has the plays of Moliere, in which doctors exploit the hypochondria of various characters. Jules Romains’ play Knock was twice made into a film and is read by French high school students.

Is it true that we don’t make fun of doctors in the US? Or has that started to change? Traditionally doctors have been portrayed as heroes and heroines in literature and on television. At worst they are harmless. It’s true that the medical profession has lost its professional authority over the last fifty years, for a variety of reasons. But are Americans less cynical about medicine than Europeans?

Exaggerated expectations?

I do think we have exaggerated expectations of modern, scientific medicine. We believe we can prevent or delay disease and even death. The price we pay for this is increased health consciousness, anxiety about our health, and the risks inherent in many diagnostic procedures.

There’s a passage from Knock that fits right into “The Last Well Person” concept: “And I haven’t mentioned the bells. Their first office for all these people is to call them to my prescriptions; the bells intone my orders. Think of it: in a few moments, ten o’clock is going to sound, and for all my patients ten o’clock is when they read their rectal temperature for the second time: just think, in a few moments, two hundred and fifty thermometers will be inserted at the same time…”