Longer looks: Dr. Oz, deconstructed; Malpractice and apology

Feb 1 2013

Every week Ankita Rao selects interesting reading from around the Web.

The New Yorker: The Operator
Oprah Winfrey first referred to Mehmet Oz as "America's doctor" in 2004, during one of his earliest appearances on her television show. The label stuck. Oz was a rare find: so eloquent and telegenic that people are often surprised to learn that he is a highly credentialled member of the medical establishment. ... "The Dr. Oz Show" frequently focusses on essential health issues: the proper ways to eat, relax, exercise, and sleep, and how to maintain a healthy heart. Much of the advice Oz offers is sensible, and is rooted solidly in scientific literature. That is why the rest of what he does is so hard to understand. Oz is an experienced surgeon, yet almost daily he employs words that serious scientists shun, like "startling," "breakthrough," "radical," "revolutionary," and "miracle." There are miracle drinks and miracle meal plans and miracles to stop aging and miracles to fight fat. ... I asked Oz several times why he promotes that kind of product, and allows psychics, homeopaths, and purveyors of improbable diet plans and dietary supplements to appear on the show. He said that he takes his role as a medium between medicine and the people seriously, and he feels that such programs offer his audience a broader perspective on health (Michael Specter, 2/4).

The Boston Globe: Medical Malpractice: Why Is It So Hard For Doctors To Apologize?
The paradox of modern medicine is that the increasing specialization that has revolutionized care has also depersonalized it. When a mistake is suspected, it may be unclear who from a team must step in to take responsibility. For patients seeking information, the only obvious recourse is to call a malpractice lawyer, whose livelihood depends on replacing a patient's desire for comfort and understanding with a need for vengeance. There is reason for hope that things can be done differently, even among doctors like myself who are conditioned to be suspicious of malpractice claims. Massachusetts recently enacted a law that, among other things, usually allows doctors to speak more openly to patients and families who were harmed, even apologize to them, without worry that their words will later be used against them in court (Dr. Darshak Sanghavi, 1/27).

The Atlantic: 'He Didn't Seem Crazy': Where Violence Meets Health Care
In 2008 Thomas Scantling, who at the time was not taking medication to treat his schizophrenia and who compounded his mental health problems by abusing PCP, attacked 20-year-old Dewayne Taylor ... Around the same time as Scantling's subway hammer attack, Philadelphia rolled out its criminal mental health court. Designed to steer low level offenders towards outpatient mental health treatment instead of county jail, ... Advocates of mental health courts say they can prevent terrifying high profile violence of the sort described here by catching mentally ill offenders early and providing them with supportive services. Critics claim that expanding the reach of the judicial system into the lives of people with severe mental illness will actually backfire, driving people away from therapists and doctors for fear of being reported to the police (Jeff Deeney, 1/23).

HealthyCal: The Difference Between Poverty And Mental Illness
Anxiety isn't always necessarily mental illness. Sometimes it is a normal reaction to life's challenges, such as the level of poverty [Judith] Baer experienced. In the 1960s, Baer and her children were living on $300 a month. Making the money stretch to cover their needs was no easy feat. She was stressed. But she wasn't mentally ill. "The last thing I needed, on top of everything else, was to be called disordered," she says. "I was very anxious-;yes, but not disordered." Recently, Baer and colleagues at the Rutgers School of Social Work examined the relationship between poverty and generalized anxiety disorder (GAD), a psychological disorder characterized by "excessive anxiety and worry" that lasts for at least six months (Elise Craig, 1/28).

Time: Time to Curb Unintended Military Pregnancies
The U.S. military faces numerous challenges. Among these are the burgeoning costs of healthcare and persistently limited participation of women. Practical solutions exist which can tackle both of these problems simultaneously. ... Unwanted pregnancies are a significant contributor to healthcare expenditures. Indeed, according to the April 2012 issue of Medical Surveillance Monthly Report, ... about half of all pregnancies to military women were "mistimed or unwanted at the time of conception." ... there is no denying that fewer unwanted pregnancies will mean fewer abortions, improved health for women, greater participation (recruitment and retention) of women in the military, and a smaller healthcare bill for the nation's taxpayers (Dr. Artin Terhakopian, 1/31).

The New Republic: Why Do Grandmothers Exist?
The question is not as unfeeling as it sounds. From the point of view of the selfish gene, creatures are supposed to drop dead as soon as they lose the power to reproduce. ... [The "grandmother hypothesis"] holds that women past childbearing age helped not just their children, but their children's children, and lengthened the human lifespan in the process. Without babies of their own to lug around, grandmothers had both time and a very good reason to be useful (Judith Shulevitz, 1/29).