The Gandolfini Effect

     The James Gandolfini death is big news around the New York area. Everyone is still talking about it. A few days ago, while driving home from work, I was listening to the local sports talk radio show.  The afternoon host is a powerful voice in local sports and heads up a top rated show. I always enjoy listening to his opinions, even when it veers into non-sports related topics, such as the death of James Gandolfini. On this particular show, the host invited his own renowned cardiologist to discuss this event. The premise of this segment was benevolent. The host thought that by bringing attention to cardiovascular disease and sudden death, some lives could be saved.
     Now when you discuss medical news on a public stage, the effects are wide and far reaching. Sure, by discussing this tragic death with millions of listeners, hopefully a few people will learn not to ignore their health and get the help they need to save their life. But by also bringing such massive media attention to what is unfortunately a relatively common occurrence in health care (cardiovascular disease, heart attacks and death) it will undoubtedly create extra panic and fear.
      Diagnosing cardiovascular disease is anything but an exact science. There are numerous subtleties and considerations when it comes to deciding if symptoms are cardiac or not. But these subtleties are not considered in the panic and fear world of mainstream media that is trying to do good in the realm of public health. So yes, talking about James Gandolfini will lead to a few more over weight middle aged guys to get the appropriate work up and diagnosis for their cardiovascular disease. But what about the thousands who don’t have any disease, and may never, who will undoubtedly walk into their doctor’s office wanting to be “tested.” Many will get a bevy of testing done, even when it’s not appropriate. The Gandolfini effect will result in hundreds and thousands, if not millions of wasted healthcare dollars. In this view, I can argue, those wasted dollars, if spent properly may have saved lives. It’s just as possible,that the net effect of this radio hosts public service attempt will be more lives lost than saved.
      As I was listening to this famous cardiologist implore the audience to get “checked out” I was frustrated. There was not a single mention of the preventable factors that could’ve saved James Gandolfini’s life. It was all about getting tested and “fixed,” Although this cardiologist didn’t say it directly, to a lay person, his message almost sounded like he was advocating screening for cardiovascular disease with testing, such as stress tests. There is absolutely no scientific basis for this. 
     The whole conversation was infuriating. The final minutes of this segment went from being public service to live advertisement for this cardiologists practice and hospital. Normally I admire this host, when he leaves his comfort zone of sports to discuss topics he is less familiar with. But this was just awful. Thanks to him, the Gandolfini effect will be multiplied in my practice.
    By the time I got home on this particular day, I started to experience severe chest pain. But that’s not because of the segment on James Gandolfini. It’s because finally after 15 infuriating minutes, this host finally started talking about sports and my New York Mets. I don’t need a stress test. I don’t need a cardiologist. What I really need is a power hitting outfielder.


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