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Evidence-based medical practice is a noble goal. As a nation, by making patient care choices according to hard scientific evidence, we can reduce unnecessary expenses for unproven therapies and decrease the huge geographic variations in prevalence of different health care choices. At least that’s the current conventional wisdom promulgated by many of our fellow physicians, who believe completely in the scientific method as the only truth in making choices among care options. For the moment, I won’t take sides in the debate about whether patient care is better served by the science or the art of medicine. Rather, I would like to point out that among all the beings on this planet, physicians, scientists and a few other intellectuals are the only ones who are totally devoted to the scientific method. Everyone else is influenced as much or more by testimonials and stories.
As I pointed out in my Opinion of January 2005, we are hardwired to remember stories—they have been the basis of history, religion, literature and language since the dawn of humanity. It makes sense that our brains give stories preferential treatment, linking them to emotion and behavior in an automatic lockstep that scientific results have never achieved. Maybe that is why a patient, after a long informed-consent discussion about the relative (scientific) merits of surgery, will return saying that Aunt Sadie had a cousin who had problems with her eye after surgery, so she has decided against having the operation. Or why another patient will take herbal medicine instead of the equally expensive prescription variety, and may or may not own up to it on his next visit. Or why some glaucoma patients refuse to believe that the disease can mess up their vision until it actually does because they never knew anybody who went blind from glaucoma. It’s no secret why newspapers, radio, television and the Internet are more interested in stories about people—“human interest,” they call it—than about earthshaking scientific results.
Ophthalmology has some great stories to tell, about the miracle of restored sight after cataract surgery, about the new treatments for the scourge of age-related macular degeneration ... the list goes on and on. Every one of us knows stories our patients tell us that we keep close for our personal recollection when we wonder if what we do is worthwhile. In most cases, patients haven’t kept their story secret—they’ve told their friends, relatives and several acquaintances, as well. In many cases, patients don’t mind making their story even more public so that others might learn from their experiences. You might be surprised to find that some of your patients will actually volunteer to talk to reporters from the media, if the idea comes up in conversation.
The Academy would like your help in providing us some of these human interest stories that we can use to pique media interest in the larger story we have to tell about the effectiveness of eye care. Our media professionals tell us that they could place good stories—especially if patients agree to be interviewed—if only they had more to choose from. While we are on the subject, celebrities from movies, politics, sports and the like could boost media interest in our stories, if only we knew which of them might be interested. If you happen to be their ophthalmologist, you know. So help us out, and send us some good patient or celebrity leads (firstname.lastname@example.org).