1 Boring Old Man

Dr. Roy Poses of Healthcare Renewal frequently mentions what he calls the anechoic effect in covering healthcare issues. It means exactly what you’d think it means parsing the word – no echo. He’s referring to the fact that big healthcare stories have a short shelf life – coming into the media, then quickly disappearing from sight. In this age of information overload, it happens everywhere – but it’s particularly noticeable in matters medical. Interestingly, Dr. Poses seems intent on keeping the term itself [anechoic] from suffering the same fate it defines by mentioning it 93 times since beginning to use it eight years ago [to his credit]. He also sends out periodic summaries of important issues covered by his blog. Certainly, you can’t follow these issues without noticing how all this works, watching scandalous stories just disappear as quickly as they arose. It’s pretty frustrating. I was commenting on Dr. Frances’ and his associates’ effectiveness in the campaign to bring the DSM-5 up to snuff [two lessons…], and one of the obvious reasons for that success has been recurrent articles, widely placed, that never allow the DSM-5 slink into the shadows while the revision is still underway.

I’m reminded of an old psychotherapy technique called flooding. When a patient is avoiding looking at something that badly needs looking at, they often bring up something else, some "shiny object" that tempts the therapist to skip merrily down another path. Such maneuvers are often unconscious – the mind can drift from potentially painful topics all by itself. So simply saying something like, "Are you trying to change the subject?" doesn’t meet the challenge because many times, the patient isn’t aware of their diversion. When flooding, the therapist acknowledges the new topic, but immediately returns. "I think <the new topic> is something important for us to look at down the line, but for the moment, let’s stick to <the topic being ‘left’>." I’ve never been much of a technique therapist [too artificial for my tastes], but this one has become an almost automatic response to a common defensive maneuver. So back to the anechoic effect, I do find myself reposting and reminding about issues here, like study 15 below [so maybe I’m more of a technique guy than I know]. I know I often sit down and remind myself what’s on the table that might get lost and Google® the news.

What’s in need of echoing just now? in danger of becoming another lost story? One thing is that trial I went to in Texas with some incredibly incriminating documents shown in open court. I’ve posted the testimony, but I’m still hoping to see a public source for the primary documents like after other trials. The recent flap over Dr. Ian Hickie’s review in the Lancet about Agomelatine has gone silent in the blogs and in the Australian news [a changing…]. It’s sure not ready to end. The data that goes with Dr. Gibbon’s assertion that the SSRIs are safe to use in children and adolescents is scheduled to be posted later this week [watchful waiting…]. And Dr. Healy’s book, Pharmageddon, is now being joined by his frequent blog postings that are pertinent to all of these topics. The one today is particularly enlighteninging [Mystery in Leeds] about the antidepressants and akathisia. Then there’s always the DSM-5 Task Force goings on, though Dr. Frances et al do a fine job of keeping that one front and center.