Movie mogul Samuel Goldwyn once said if a [film] director had a message to deliver, he should call Western Union. Things are different on television. Dramas such as “House,” “ER,” “Grey’s Anatomy” and “General Hospital” are successfully incorporating important medical messages into their shows, often raising awareness about health-care issues more effectively than TV news medical reporters, documentary specials or infomercials.
At the National Conference of the Association of Health Care Journalists this week in Los Angeles, there will be a panel on Hollywood and health care to discuss how television entertainment programming has made a difference.
“The fictional TV shows have a much broader reach,” said Andrew Holtz, former CNN medical correspondent, board member of the Association of Health Care Journalists and author of “The Medical Science of ‘House, M.D.'” “They get through to a lot more people than journalists or the real-world medical shows, just because a lot more people are watching. A prime-time network show may have at least 10 million to 20 million people watching, much more than are watching the nightly news.”
Mr. Holtz points to awareness of the human papilloma virus (HPV) as an example of TV’s effectiveness. “The Kaiser Family Foundation did a study in conjunction with a subplot on ‘ER’ about the human papilloma virus and its link to cervical cancer, and the new vaccine,” said Mr. Holtz. “They talked to people before the show aired and then immediately after, asking if they were aware of a virus linked to cervical cancer and a vaccine that can maybe do something about the risk. There was very low awareness before. Awareness shot up after the show. When asked where they learned about HPV, most people said ‘ER.’ Very few people said they read an article about it or they saw it on the news. It was entertainment television that had the greatest immediate impact.”
“People like to watch and listen to stories,” said “General Hospital’s” Kimberly McCullough, who plays Robin Scorpio, a character living with HIV since 1996. She will be a panel member at the AHCJ conference. “It’s like if you put a message into a movie and make it fun to watch, that’s less work for people to comprehend than reading a newspaper article. At the time we started the AIDS storyline, I don’t think anyone knew where the disease was going, [or] if there would be a remission.”
Fact vs. Fiction
On “General Hospital,” Ms. McCullough’s character has been living with the virus for 10 years and her HIV status is always present in her storyline. “At the time when they first told me about the story, I was completely naive.
I didn’t know much about the AIDS virus and I didn’t know what they planned to do with the story,” said Ms. McCullough.
“After a while, they decided that Michael Sutton’s character, Stone, my leading man, would actually die of AIDS. I don’t think that was the plan to begin with, but I think they were proud that they went through with it and told the story realistically.”
Within the context of “General Hospital,” Ms. McCullough’s character has managed to keep the virus from progressing to AIDS by following a strict drug protocol and taking precautions in her sexual relationships. “The producers never let the audience forget about Robin’s condition, and we’re always keeping up with the latest medical information about HIV,” she said.
“I’m spoiled because I live in New York and L.A., where people have been talking about this subject for a long time,” she added. “But I think a lot of our audience is in Middle America.
“It’s been especially beneficial to the gay community in smaller towns, and I know that because I met a lot of people who have a brother or father who was gay and had AIDS, but nobody would talk about it until it was suddenly this day-to-day storyline on ‘General Hospital.’ That’s pretty incredible, the power that entertainment has on individual families and lives.”
In addition to awareness, there are other benefits in TV dramas that may trump straight news, like dispelling medical myths. “I remember one myth that they confronted on ‘ER’ was that cancer can actually be spread by surgery-that if you cut into cancer, you will cause it to metastasize,” said Mr. Holtz. “That is a fairly common myth in both cities and rural areas. Harold Freeman, the head of the oncology department at Harlem Hospital, pointed that out to the ‘ER’ writers because this was something he had encountered. That taught people, potential patients, that this was just a myth.”
The same myth could have been shattered on a network newscast or cable show. “But there are much greater limits on doing a news story,” said Mr. Holtz. “If you’re talking about a patient, you have to show the real patient. In an entertainment show, you can merge together the stories of multiple patients to clearly and powerfully make the point. You have emotional things happening that would almost never happen [before] a real news camera. A storyteller in a fictional show has much more latitude to connect to the human condition.”
“We have the ability to reach people in their homes,” said Ms. McCullough. “Anyone can watch network television and we can touch people where they live.”
In addition to dramatic television, there’s another method that has proven to be extremely powerful in reaching viewers with health news and information. “Direct-to-consumer marketing does influence prescribing,” said Mr. Holtz. Whether it’s learning about restless leg syndrome, erectile dysfunction or social anxiety disorder, medical commercials have changed the way people learn about ailments and their potential treatments.
“My sense is that, on balance, the surveys that have been done indicate that yes, people do respond to those ads,” Mr. Holtz said. “They do go to their physicians, they do ask for those drugs, and there are cases where doctors are prescribing the drugs that were heavily advertised.
“The drug companies will say they are doing a public service by raising awareness that there is a medical intervention available for this condition. On the other hand, you’ll find a lot of people who say you are seeking people who have just normal, minor issues that really aren’t that big a deal and you’re medicalizing them,” he said. “You’re sending them to a doctor and getting them on a drug that may or may not be exactly what they need.”
A 2006 study by Steven Woloshin and Lisa M. Schwartz called “Giving Legs to Restless Legs: A Case Study of How the Media Helps Make People Sick,” for Public Library of Science-Medicine, analyzed this health-care information source. “The news coverage of restless leg syndrome exaggerated the prevalence of the disease and the need for treatment, and failed to consider the problems of over-diagnosis. In essence, the media seemed to have been co-opted into the disease-mongering process,” they wrote. “It is easy to understand why the media would be attracted to disease promotion stories and why they would be covered uncritically. The stories are full of drama: a huge but unrecognized public health crisis, compelling personal anecdotes, uncaring or ignorant doctors and miracle cures. The problem lies in presenting just one side of the story. … We think the media could report medical news without reinforcing disease promotion. After all, their job is to inform readers, not to make them sick.”
Mr. Holtz will moderate the AHCJ’s Hollywood panel. Joining Ms. McCullough on the panel will be her “General Hospital” leading man, Jason Thompson; Neal Baer, M.D., executive producer, “Law & Order: Special Victims Unit”; Elizabeth Klaviter, director of medical research, “Grey’s Anatomy”; Vicky Rideout, director, Program for the Study of Entertainment Media & Health, Kaiser Family Foundation; and David Foster, M.D., a writer for “House, M.D.”
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