Marcus Welby Speaks: Health Messages on TV

First there was Ben Casey. Then Marcus Welby and later the staff of General Hospital.

Almost from the beginning of network television, programmers knew instinctively that the public was hungry for information and images about what makes the human body function and how it affects our happiness.

In the health revolution of recent years that hunger has not abated. If anything, it has increased and the proliferation of media outlets — and new technology — feeds us a smorgasbord of opportunities to learn more about our bodies and our health.

There are two ways to look at health education via the media.

The wider view looks at modern media as a potential channel for all kinds of information and educational services. Looking closer, others view the content of these media messages as positive or negative, helpful or misleading. Sometimes it's not so easy to separate them but here are some directions and trends.

Specifically on the content side, a recent study reported in the New England Journal of Medicine proposes that viewers may be developing dangerous attitudes about their health from TV characters who eat and drink too much and live recklessly without suffering any ill effects.

An obvious example is obesity. The leads in such shows as Dallas and All My Children have their share of traumas, but getting fat is not one of them. Despite their svelte figures, these characters eat, drink or talk about eating and drinking nine times per hour.

On prime-time television 6% of men and 2% of women could be considered significantly overweight. In the real world obesity plagues well over a quarter of the population.

Coupled with the fact that television dramas tend to image medical personnel who "come to the rescue when life is at stake," the researchers at the Annenberg School of Communications (Pennsylvania) conclude that network television may contribute to a syndrome of "living for today," ignoring good health habits, especially nutrition and exercise. When, in later years, their doctors cannot provide the same "quick fix" imaged on television, there is sure to be frustration and disappointment.

Many in the medical profession already attribute the growing number of malpractice suits to unrealistic expectations of the "magic of medicine" created by popular TV medical dramas.

Similarly health practitioners worry about the runaway popularity of fad diet books fueled by exposure of their authors on nationally syndicated talk shows.

The real culprit in unhealthy television is not so much the information presented as the problem of entertainment. Dramatic story lines and interview questions are written to exploit the entertainment value of any subject matter — the better to capture, and hold, the viewing audience. Producers say people just don't tune in if the world presented is too realistic.

One person who has confronted the entertainment question head on is Dr. Art Ulene, founder of Cable Health Network (CHN). As physician-in-residence on a Los Angeles TV news show, Ulene became frustrated with the 2-3 minute time slots imposed on him by the producers. The fear was that people would tune out because health information could not possibly be entertaining — and still be good for you!

Ulene set out to prove otherwise. "Television is entertainment," he says. "It is synonymous with leisure. But a television diet must be good for you." The goal of CHN is to entertain, inform and motivate viewers to help themselves to good health.

Taking his cues from popular health specials where viewers were enticed to give up smoking or lose excess weight, Ulene proceeded to blend innovative program ideas with sound medical advice. He knew that to reach CHN's potential audience of 11.5 million cable households, he had to compete successfully with other programming — entertainment programming — and win.

A major shift was to change the style of presentation from a passive approach (talking-head doctor dispensing advice) to one in which viewers feel they are active participants. To do that, celebrity hosts, trained to be at ease on television, are coupled with guest experts on series with upbeat titles like The Do or Diet Show. On Crisis Counselor, actors dramatize problems experienced by families in trouble and a certified family counselor interacts with them as he would real patients.

The trend, therefore, is away from strictly medical discussions toward more general presentations dealing with people's well-being, human relationships and living in today's society. When specific medical information is covered, it is done in-depth like a recent four-hour special on diabetes.

"Our programming is designed," says Ulene, "to teach people how to practice more intelligent self care and to use the healthcare delivery system more effectively. Informed patients will also be better able to articulate questions and comprehend detailed answers."

His attitude signals the potential of television — or any medium — as a channel for the delivery of positive health information.

For example, both television and film have proved effective for patients in sickness situations. Children who watch a film showing the experiences they will encounter in surgery are markedly less anxious — and thus recover faster — than those who are not prepared.

In many hospitals, patient education is a growing field of nursing care with doctors 'prescribing' a videotape or slide show to accompany traditional medical treatment for heart attack, stroke or cancer. Nurse-teachers work one-on-one or with small groups and use a wide variety of professionally prepared media materials supported by take-home booklets. Often families participate as well, especially if diets or treatments must be continued at home.

While closed circuit television was originally installed to bring patients their accustomed entertainment, it is now possible to use the system in other ways. Healthstar, the first comprehensive entertainment and telecommunications system for hospitals, has just been put into operation by the Alexian Bros. of America Inc. in Elk Grove, IL in conjunction with Coaxial Communications of Columbus, Ohio.

HealthStar provides access to satellite-delivered pay-TV services (Home Box Office, ARTS, the Nickelodean channel for children, etc.) plus Cable Health Network, Cable News Network and other channels. But it can also be used for in-room monitoring and to link hospitals together for teleconferences.

In addition to entertainment and education, spiritual well being is another area that can be aided by media. Selected episodes from the Paulists' Insight TV series or programs from other religious producers are logical possibilities for a closed-circuit schedule.

One group, Crosspoint Communications in Pittsburgh, has developed a series of video programs to offer spiritual support to people — and their families — dealing specifically with medical crises. Towards Healing is a four-part documentary series focusing on the feelings of shock, disbelief and even anger at God when a sickness strikes.

But patients aren't the only ones to benefit from mediated health education.

Doctors and nurses and health practitioners in every field have numerous opportunities for continuing professional education through audio and video cassettes, video discs, closed-circuit telelectures from medical schools, telephone seminars and satellite teleconferencing of all kinds.

In fact, the health community has been one of the most aggressive developers of instructional technology and programming, perhaps because medical personnel place a high dollar value on their time and the cost of learning a new surgical technique via videotape or participating in a 3-hour teleconference on urological issues is far less than the cost of personal time and travel to a distant location.

Finally, the new media health channels have come full circle to the ordinary consumer. Ulene's utilization of cable is a prime example. Videotext information and referral services are already being planned.

Currently in operation in the meantime is Tel-Med, a program offering taped telephone mini-consultations on a range of medical topics. Begun in San Bernardino, CA the service is available to hospitals or health systems that offer it as a community service. Potential callers receive a "directory" of possible topics which they can request. For those who are embarrassed to ask questions especially on such topics as venereal disease, contraception or drug abuse, the message system provides access to clear facts and, perhaps, peace of mind.

But the most interesting phenomenon of consumer health media is the plethora of health-oriented magazines filling mailboxes and coffee tables around the country

Once found only in doctors' waiting rooms or perhaps health food stores, health-oriented magazines have come a long way from their origins as a kind of "healthy Good Housekeeping."

The trend to specialized magazines started with Psychology Today. As the health issue heightened in society, Runners' World and other sports magazines promoted exercise and awareness. More recently new titles like Executive Health, Healthline and Total Health have appeared, featuring articles like "Anatomy of a Backache" or "Preventing Blindness." Alternatives to surgery are often explored and the effects of stress are emphasized. The overall philosophy is generally a holistic integration of body, mind and spirit along with the promotion of health and well-being.

The market these publications have found indicates that the audience for them is there — and waiting to buy. Whether they, and other health media, are a passing consumer fad or a significant shift in health education remains to be seen.