Media, Medicine & the Masses
NOTED PHYSICIAN, WRITER, AND THOUGHT LEADER DR. EZEKIEL J. EMANUEL BRINGS HIS UNIQUE PERSPECTIVE TO THE BERKSHIRES
SOME OF THE COUNTRY’S leading writers, artists, and scholars will converge in Lenox for the inaugural field, a new festival to be held from October 23 to 25 that will be devoted to ideas, conversation, learning, and discovery.
Among the guests is Ezekiel J. Emanuel, M.D., Ph.D., an oncologist, bioethicist, author, and one of the country’s most prominent voices on health policy. Dr. Emanuel is Vice Provost for Global Initiatives and the Diane v.S. Levy and Robert M. Levy University Professor at the University of Pennsylvania, with appointments in medical ethics and health policy at the Perelman School of Medicine and health care management at the Wharton School. He previously served as the founding chair of the Department of Bioethics at the National Institutes of Health and, from 2009to 2011, as a special advisor on health policy in the Obama administration, where he played a role in the development of the Affordable Care Act. His career has placed him at an unusual intersection of clinical medicine, ethics, government, academia, public policy, and media.
Dr. Joshua Sherman, publisher of Berkshire Magazine, who is passionate about the intersection of media and medicine, recently asked Dr. Emanuel about the consequences of misinformation—and how providers today can rebuild trust with patients.
You’ve navigated and investigated healthcare from an extraordinary number of perspectives. At the same time, the media environment has changed dramatically. Patients are receiving medical information from pharmaceutical advertising, traditional media, social media, influencers, political figures, and countless other sources before they ever even speak with a doctor. Given today’s media landscape, do you think it is even possible to rebuild trust between the American public and the healthcare system?
There are a lot of components to this question.
First of all, our healthcare system has a lot of dysfunctions, and those dysfunctions feed into and create a lot of skepticism and lack of trust among patients. It’s hard to get an appointment. Doctors don’t get back to patients with relevant information. Providers are often bad at managing chronic illness. I also don’t think we [in the medical profession] have been sufficiently empathetic for what patients are going through and the challenges of navigating the healthcare system today.
So, there’s a lot of good reasons for patient dissatisfaction. That’s one aspect, and we must take some responsibility. But, of course, there are many other complicating factors: insurance companies, drug companies, hassles, outrageous expenses, etc.
The second part of it, I would say, is that the medical profession hasn’t adapted to the social media marketplace.
I am a terrible person to comment on social media, because it’s just not part of my DNA. I do it. I’ve more or less gone into it because of my book, but I only do it because of that.
But social media requires a different kind of engagement that providers are not used to doing. Doctors are used to being the authoritative source, and social media puts a lot more emphasis on authenticity, intimacy, and “being your friend,” as opposed to being “the expert.”
And we have not adapted to that distinction. We’ve ceded this very powerful communications platform to all sorts of other people who are authentic and intimate, but totally uninformed. And that’s, I think, one of the biggest problems, as far as I can tell. What counts on social media is not the white coat and the stethoscope, but someone thinking you’re believable.
What do we need to do to solve the problem?
Well, the first thing I think we have to do is recognize that the information landscape has changed, and that expertise alone is insufficient. Is it necessary? Absolutely. Despite what lots of people and what TikTok thinks, education and expert understanding are still necessary. There are lots of idiots out there, and we can’t cede the terrain to them.
But expertise alone is not sufficient, and I think this is a very important thing for us to understand. It’s not just what the message is; it’s also how the message is delivered. And that, I think, is something we have not grappled with. Doctors still use arcane language, partially because a lot of the senior doctors who can expertly comment are my age, and therefore, they grew up with only three television networks.
The fragmentation of the media market and the focus on short video formats, well, we have to adapt to that. We need to have real doctors who are authorities present on social media. Senior physicians must be willing to try it. And some of them have succeeded. So, if I had to make a recommendation to the profession, adapting to new media would be very important.
ABOUT EAT YOUR ICE CREAM
There is a certain appropriateness to Dr. Emanuel promoting his 16th book—a book about wellness—while simultaneously taking his own advice and learning to make Instagram and TikTok videos. Eat Your Ice Cream: Six Simple Rules for a Long and Healthy Life takes aim at what Dr. Emanuel sees as an unnecessarily complicated modern wellness culture. Rather than another program promising radical life extension through supplements, expensive testing, extreme diets, or elaborate routines, he argues for something considerably less glamorous: follow the evidence, practice a handful of sustainable habits, and stop making health so complicated.
Dr. Emanuel’s six rules are straightforward: Don’t be a schmuck. Talk to people. Expand your mind. Eat your ice cream. Move it. Sleep like a baby.
Behind the deliberately playful language is his argument that many of the behaviors with the strongest evidence behind them are already familiar. Avoid obviously destructive risks. Maintain relationships and social interaction. Continue learning and preserve a sense of purpose. Eat reasonably well without treating food solely as medicine. Exercise consistently. Get enough sleep.
The ice cream in the title is not simply permission for indulgence. Dr. Emanuel uses it to illustrate a larger philosophy of moderation—and the somewhat counterintuitive nature of nutritional evidence. But the broader message is simpler: a healthy life has to be livable.
“We’re all interested at some level in wellness,” he says. “Even if we don’t want to live to 200, we want to be well for the time that we are alive.” For Dr. Emanuel, that means resisting both miracle cures and the personalities selling them. And perhaps that brings the book back to the same problem Dr. Emanuel identifies in medicine and media: good information does little good if people cannot understand it, trust it, or realistically incorporate it into their lives.
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