We often hear various representatives of the public lamenting yet another health missive or directive to change behaviors to improve or protect their health and well-being. Most often, physicians are identified by both the agencies responsible for disseminating this information - whether government or voluntary sector - and by people as the most authoritative and credible 'source' (let's start calling them for what they are - interpersonal channels) for communicating this information.
And new evidence is in this month's issue of Pediatrics to suggest that the channel is swamped [Drowning in a Sea of Advice: Pediatricians and American Academy of Pediatrics Policy Statements].
The authors identify 162 separate pieces of verbal advice pediatricians are recommended to provide their patients by policies established by their professional association (forget what the government and voluntary health associations also want them to say!). These 'words of wisdom' include 109 for preventing injuries, 19 about media use and 8 for substance abuse.
The authors conclude; The expectation that delivery of all of this advice can be achieved is unrealistic. Moreover, none of the reviewed statements were found to include an evidence-based discussion of the efficacy of the suggested advice. In light of these findings, we suggest that committees should consider both the feasibility and the evidence of efficacy of office-based health advice when generating future policy statements.
Two points here: (a) the channel is swamped, and the knee-jerk tactic of 'have their doctor talk to them about it' is just that. Remember at some point they are also suppose to diagnose and treat presenting complaints and on-going medical conditions; (b) as the authors note, many recommendations for physicians are not evidence-based as to their anticipated effectiveness, but rather are based on the source credibility myth ['if we say it, they will change'].
Good to remember that doctors are audiences too!