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Diagnosis (1)

“Diagnosis” is a Netflix reality show first, a comment on American healthcare second, and Lisa Sanders’ medical show on crowdsourcing the diagnostic process a distant third. If you wanted to see more of what made her book and column great, like I did, well, tough luck: this ain’t it. Because — and this isn’t a surprise — most people with access to a tertiary medical center do get an adequate diagnosis. Those who are undiagnosed either lack access, or have a functional-slash-undiagnosable condition that ultimately doesn’t change much in their management.

Realizing this, the producers add a spin: the crowdsourcing they bring is also there for emotional support, connecting with people, getting different treatment recommendations. As if Facebook didn’t exist. If this show were a clinical trial, it would be a phase II with an unimpressive response rate but hey look at those bio markers we hadn’t initially planned on doing!

Warning: spoilers for Episode 1 ahead. I may get to the other ones, eventually.

Only the first episode half-lives up to its promise. A young woman from Las Vegas has a problem. Her local doctors don’t know the cause; I certainly didn’t, but could make a ballpark guess as to which type of a disorder it was and which subspecialist she should see. However, instead of giving her a referral to the nearest university medical center, the doctors flood her medical bills, and sue her for non-payment to boot. Only in America!

Enter Sanders: her NYT article gets a bunch of people across the world sending video suggestions as to the possible diagnosis. A medical student from Turin, Italy, offers a free work-up. Netflix, bless their hearts, films the patient and her partner flying to Italy to get it done, marveling at the wonders of a single payer system. I can only presume travel and boarding were paid for by the production team. But why not pay for a trip to San Francisco instead? Well, the skyline isn’t as dramatic as that of Turin; and it would rob Dr. Sanders of the opportunity to marvel how crowdsourcing brought the answer from half way across the world, literally.

In a nutshell: Because of No Insurance and TV Drama Makes Better Ratings, woman from Nevada flies to Italy — instead of driving to California — to get diagnosed with a rare medical condition.

To be continued…

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