Marianne Matthews

I’ve never played a video game. I inherited an iPod Shuffle from my musician husband, but I never use it. A BlackBerry is something I eat. While my friends refuse to miss a Hollywood blockbuster, I spend my time at run-down off-Broadway theaters. I was never a fan of popular culture, and I’m not your typical American consumer. Time to get with the program. Popular culture and consumerism are two of the driving forces behind the changing face of health care in the United States.

Recently, I was speaking with one of our editorial advisory board members. She noted that the newest generation of health care consumers might be more likely than any previous generation to embrace the role of radiology in quality health care. Her rationale: While so many people no longer trust their doctors, the younger generation does trust technology—and radiology is a technology-driven discipline.

While it’s just her hunch, I think she’s onto something. Her comment inspired me to surf YouTube. I typed in “medical imaging”—a rather broad key phrase—and I immediately discovered 98 “home” videos on the subject.

In addition to promotional videos from imaging centers and manufacturers along with research presentations from experts, I found everything from the silly to the sublime. For a good laugh, see “Chair gets stuck in an MRI machine”; for patients seeking moral support, take a look at “Mum, 28th Jan. 2007 Radiotherapy.” Then there’s one on Israel’s role in breakthroughs like breast imaging as well as an ingestible video camera. Don’t miss “How strong is an MRI magnet?” where a geek demonstrates the power of pull using a tennis ball packed internally with small screws.

And the power of pull is precisely my point. If sexy media outlets like YouTube can aid the average patient in understanding the benefits of radiology, then why not? Sure, there will be misinformation (and goofiness) along with valuable educational insights. The point is, Americans now have access—with a simple keystroke—to life-changing health care information. And it’s served up in an entertaining format.

Even so, all this pop culture/consumerism troubles me. Consider, for example, consumer-directed health care (CDHC) plans. According to a 2005 industry survey, 49% of US companies with more than 500 employees say they are promoting consumerism as part of their health care strategy.

“Consumerism” translates into “choices.” Will CDHC plans prove effective when it comes to medical imaging? So much is left to patient choice. It takes a pretty sophisticated patient to know when they need to request a medical imaging exam.

And here’s the latest, from The New York Times (August 23, 2007) front page, “Drugstore Clinics Spread, Scrutiny Grows.” The concept, according to the writer, has been called urgent care “lite.” As she puts it, “Patients who are tired of waiting days to see a doctor for bronchitis, pinkeye or a sprained ankle can instead walk into a nearby drugstore and, at a lower cost, with brief waits, see a doctor or a nurse and then fill a prescription on the spot.”

It’s a nationwide phenomenon. But in New York City, Duane Reade has a corner on this new market. Don’t get me wrong, Duane Reade is my first choice for mascara, but I think I’ll take my sprained ankle to a specialist or an accredited imaging center. The AMA is afraid these new drugstore physicians might have consumers sacrificing quality for convenience (and price), and they’re proposing a series of guidelines, including a requirement that the clinics have “a well-defined and limited scope.”

Too much choice may be too much of a good thing. It was 1974 when Burger King whipped up that memorable line, “Have it your way.” Americans did. And look what’s happened to Americans’ waistlines.

Marianne Matthews, editor