Even in those stories constructed around a single participant, one never gets the feeling that the patient on a reality show has all that much input into the treatment plan. It is unsettling to watch a patient undergo nine hours of surgery that includes procedures she did not ask for. It is equally dismaying to watch the even more common scenario in which the patient relinquishes her autonomy and the doctor accepts, often without batting an eye, the unshared role of decision maker. The viewer can sense the nervous excitement of the patient who says, after listening to the doctor explain what is to happen, “Whatever you say doctor; I am in your hands.” It is hard to image a worse message to send to potential patients in the viewing audience. (When I hear those words in my practice, I always feel that the patient may not really understand what is proposed and that we need to back up a bit.) Yet this message of blind faith and miracles has sent many a customer to the local cosmetic surgeon’s door. Read the rest of this entry »