MOVIE: Knock (1951): Foreshadowing Medicalization

A first for Less is More!

No, we are not making a movie. It's the first "pop culture" feature of the problem of medicalization, where healthy people get labeled as sick.

Those of you who know I speak a bit of rusty, fragmented french will be aware of the page of French-language resources [français] on this site. I would love for the entire site to be better organized and to have the whole thing translated. But with a budget consisting of the coins I find in my couch, that is unlikely to happen soon.

In the meantime, I am proud to tell you about this french film.

"Dr Knock," is a french comedy film from 1951 in which a physician who, in need of work, convinces an entire healthy village that they are all ill so that he can treat them. Originally a play in 1923 by Jules Romains, called Knock ou le Triomphe de la médecine (The triumph of medicine), this film had some kind of foreshadowing!

Theatre 625 (BBC) did an English adaptation in 1966 but I have not been able to find a video of it.

 The full film is available (legally, I believe) on YouTube. French speakers, enjoy!

Source: https://www.youtube.com/watch?v=OVBnhTEoiv...

French/français ressources; Moins est Mieux Médecine/#surdiagnostic

Mon français est pauvre, mais je suis ravi d'offrir quelques «Less is more» ressources dans la langue française. Vous pouvez les trouver ici: Page française

Le site a besoin de beaucoup plus de travail bien sûr, et donc je me réjouis de vos contributions.

Il ya beaucoup de controverse entourant les soins primaires au Québec en ce moment, et la gestion de surdiagnostic est une partie du changement qui vient.

Merci: Dr Isabelle Leblanc (@leblanc_isa) pour fournir des ressources et l'édition. Aussi, merci à Drs Simon-Pierre Landry (@SimonPiLandry) [voir son article sur le sujet dans Santé, Viser Juste), Éric Contant (@EContantMD), Yves Lambert (@docLambertY), et L'AMQ (@AMQuebec) pour montrant que les médecins du Québec sont très contraints de se attaquer surdiagnostic et les problèmes associés.

Viser Juste: Shoot Straight (kind of)

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It's tough to translate. Viser Juste. Not exactly "Shoot Straight" or "Get it Right," it's really about getting as close to the target as we can, hitting that bull's eye. In this case, hitting the sweet spot of 'Right Care.' Not too much or too little.

Training together during Family Practice Residency in Nanaimo, Simon-Pierre Landry and I shared a few things: an appreciation for the kind of jaded medical humour and cynicism in The House of God, love of the hits of the 90s, an eagerness to debate the fundamentals of Canadian culture, and a taste for fancy cheese. We both also had a curiousity about why we practice medicine the way we do and how we can do it better.

"Laws of the House of God, #13:  The delivery of good medical care is to do as much nothing as possible." — Samuel Shem, House of God

Dr Landry is now an Emergency Physician and Intensivist in Sainte-Agathe-des-Monts, QC. He writes a regular Méditorial column for Santé, a publication of the Canadian Medical Association. He interviewed me while I was in Yellowknife for part of his article about Appropriateness in Medicine.

In Viser Juste, Dr Landry brilliantly weaves together House of God, the Choosing Wisely (Canada) campaign, and Ken Murray's How Doctors Die to make the case for a "Less is More" approach to medicine.

As physicians, we know that advances in medical technology are undeniable progress. At the same time, we also understand that these technological advances are not without flaws, and the possible consequences must be analyzed by an objective expert who is skilled at dissecting complex situations, for example, the clinician. We also understand that these technologies have a cost and do not always offer value for money. Sometimes, investing in other types of medical care or improving the social determinants of health (eg. guaranteed minimum income, early childhood services, mold-free schools) would be a wiser use of public funds. (translated roughly by Google & I)

Read a translated version of the Viser Juste ["Shoot Straight"] article (in Google Translated English-ish).

Read the Viser Juste article (in French) and don't miss Dr Landry's other articles at Santé Inc.