Medi-tainment: Do TV patients get a bum deal?

'Medi-tainment' shows focusing on embarrassing ailments attract huge ratings. Meg Carter wonders if this is more exploitation than education

So, you're feeling under the weather. You're tired, your joints ache, and you've a bit of a rash. Do you a) soldier on, hoping it will soon pass, b) visit your pharmacist or c) call your local GP? If the team behind a groundbreaking new Channel 4 series starting this week is right, soon there'll be a fourth option; d) consult your TV.

Diagnosis Live from the Clinic, which starts a six-week run tomorrow night, is a medical TV show with a difference. Made by the team behind Embarrassing Bodies, it sets out to go further than just simply showcasing medical conditions. The aim is for doctors to diagnose ailments in front of the nation, live on TV. In each edition of the weekly, one-hour show doctors will offer instant diagnoses to people at home, using voice and video, over internet technology such as Skype.

The doctors will be in a futuristic TV studio dominated by two large screens – one showing the participant, the other an interactive touch screen used to call up extra images and facts, Minority Report-style. Off-air, a comprehensive website – including live web chats with doctors following each show – will offer further information. And the aim of all this? To make us better patients, the programme-makers explain. "It's about showcasing a way medicine can be offered that gives participants the immediacy of seeing a doctor, while helping viewers become better informed. The consumer element is key," according to Channel 4 commissioning editor Kate Teckman.

"The biggest take-out we want people to experience is deeper understanding of how to be a better patient," adds Dan Jones, head of new media at Maverick Television, which has developed the show and also makes a host of others, including Bizarre ER for BBC3 and Children's Hospital for ITV1. "The kind of advice offered will be along the lines of: yes, you should go to your doctor, or not. And if you do, this is what you should know and this is what to ask." Diagnosis Live from the Clinic is, without doubt, a bold idea, but one likely to divide opinion among health experts as the rise and rise of "medi-tainment" – the new generation of prime-time health TV shows that mix education with entertainment – has already done. "My concern is shows like these are more about entertainment than education," Dr Margaret McCartney, a GP based in Glasgow, observes. "Where's the evidence that viewers end up better informed? I'm not sure claiming something is educational is much of a defence – it depends on what you are learning."

Jules Hillier, deputy chief executive of young people's sexual health charity Brook, also has some concerns. "It is important to use the media to break down barriers that prevent young people accessing health services – the fear they won't be listened to or that they will be laughed at. And it is undoubtedly a positive when we get calls from people who tell us it's because of shows like Embarrassing Bodies that they've got in touch," she says. "But we also get calls from people unnecessarily worried that they have an unusual or a rare complaint because of a programme. Is live TV the right place for diagnosis? I'm not convinced."

Then there's the question of how baring all on national TV will affect participants. With its mission to break taboos, Embarrassing Bodies has found a steady stream of people brave enough to expose sometimes jaw-dropping complaints – from prolapsed rectums to testicular abnormalities – to almost four million people each week. But at what personal cost? Dr McCartney asks. "What will happen to the people diagnosed in this way – what's the follow-up? Medicine is confidential so patients can be sure things are dealt with in a proper manner," she says. "Which is why I think it's best done off camera."

Channel 4 and Maverick insist they take such concerns extremely seriously. "There's a Faustian pact, which means to educate you've got to entertain, too," Maverick creative director Alex Fraser admits. "A sense of humour is a part of the medical professional's uniform. When, in the last series of Embarrassing Bodies, a team of Coventry fire-fighters stripped off to examine their testicles, it was all the more memorable for being informative and fun.

"Undoubtedly there is a degree of voyeurism," she continues. "But so long as that is underpinned by support and advice then I'm comfortable with that."

The public, meanwhile, chooses to participate for mainly altruistic reasons, the producers say. And all are offered what Maverick and Channel 4 describe as "a comprehensive package" of support, Fraser insists. "Sometimes, the journey we go on with a participant can last months."

Those wanting to take part in Diagnosis Live from the Clinic will apply via an online application form, which will then be viewed alongside any available digital camera stills by a "casting team", including doctors. Cases will be pre-selected to ensure conditions are interesting – though someone applying as the show begins at 8pm still stands a chance of getting on air by 9pm.

Once shortlisted, the casting team will call the patient to check their condition, what friends and family know about it and what, if any, advice that person has received from a GP. This is to ensure the person understands the implications of "going public".

After the broadcast, all participants will be called back with further advice.

To what extent this new breed of health TV can make us a nation of better patients remains to be seen. But even if it isn't your cup of tea, it might still be worth a look. Because a form of "home triage", conducted via digital technology, could be the future of healthcare. "The way health TV is going is being shaped by our changing healthcare system, and the opportunities new technologies can offer," Fraser claims.

"Many agree the one-to-one doctor's consultation system is not sustainable. Meanwhile, access to experts varies according to your postcode. Diagnosis Live from the Clinic is experimental. But it is also, in effect, a pilot for what might soon happen to the NHS."



Diagnosis Live from the Clinic begins on Channel 4 tomorrow at 8pm

The rise and rise of 'medi-tainment'



The launch of Diagnosis Live from the Clinic will be followed by Embarrassing Fat Bodies in July, then Embarrassing Teen Bodies, before Embarrassing Bodies returns this autumn. Since first airing on Channel 4 in 2007, EB has been sold to 70+ countries, including Afghanistan, Cuba and Papua New Guinea. The team behind it is now planning local versions for Germany, Australia and the US.

Embarrassing Bodies' success stories include eight-year-old Charlotte Wilson, whose mother contacted the show in 2008 about her daughter's verrucas – a common viral infection that most people's immune systems defeat. EB doctors referred Charlotte to Great Ormond Street Hospital, where medical tests revealed her immune system was virtually non-existent and she needed a bone-marrow transplant. The operation was successful and the UK's largest bone marrow charity, the Anthony Nolan Trust, reported a 4,000 per cent rise in inquiries in the days following the broadcast of an EB "special" in April 2010, when viewers were asked to sign up for the Bone Marrow Register

My Healthchecker is an online "self diagnosis tool" to support Diagnosis Live from the Clinic, developed by the show's makers in partnership with NHS Direct. It has attracted 80,000 registered users since launching eight weeks ago who, in turn, have completed 575,000 online self-diagnosis questionnaires. So far the most popular tests are to calculate Body Mass Index and body fat, and for Type 2 diabetes. The site has attracted 11.3 million users and 95 million page-views.

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