I was a panelist at Edelman’s CHPA New Media Summit today in New Brunswick, NJ. Matthew Holt (of the Healthcare Blog and Health 2.0) was the keynote speaker, and I participated on a panel discussion with Dr. Roy Poses. It was exciting to meet Roy in person for the first time, as I’ve been following his policy blog for some time.
Matthew presented a very rosy picture of Health 2.0 (consumer-driven healthcare), more or less suggesting that it could provide a large part of the solution to our current healthcare crisis. I countered with a more cautious view, explaining that expert engagement would be critical to Health 2.0’s success.
Matthew argued that sites like Patients Like Me were enabling patients “to do their own clinical trials online,” and that this was opening a whole new avenue for research. Dr. Poses and I were fairly concerned about this suggestion, primarily because we understand how easy it is to draw false conclusions from data, especially when the data are not collected in a systematic fashion.
I explained to the audience that association does not prove causation (E.g. Do matches cause lung cancer? No, though it’s true that people who smoke are more likely to carry matches). I also described a case in which a Health 2.0 principle went terribly awry: a group of consumers were asked to rate their medications for efficacy by disease/condition. This was supposed to leverage the “wisdom of the crowds” to determine which medicines worked best (by popular vote). Of course, the result was that every pain syndrome (low back pain, headaches, fibromyalgia, etc.) resulted in a narcotic pain medicine as the highest ranked treatment option. Do you really need Oxycontin for that tension headache of yours? Obviously, narcotics are popular among users – but are a last resort for pain management in the real world. The “wisdom of crowds” rarely works in healthcare.
Matthew agreed to disagree with me on a number of issues – but we certainly found common ground on the primary care crisis. He and I both believe that a shortage of primary care physicians is going to result in a catastrophic shortage of care for Baby Boomers in the next decade. Dr. Poses added that primary care physicians make the same salary as school teachers in his home state of Rhode Island.
I think we have to agree with KevinMD – the way forward is not going to be pretty.