I recently published my nominees for best health care-themed film of 2013. The nominees were: Blue Jasmine (for depression), Nebraska (for dementia), Dallas Buyers Club (for access to life-saving medicines and FDA regulations), Hours (for disaster effects on health care), and Love is All You Need (for recovery from stress of chemotherapy). Which is the best?
My choice is Dallas Buyers Club. The issue of what to do when you receive a life-threatening, possibly fatal diagnosis (HIV positivity) is well-illustrated in the movie. Matthew McConaughey's character at first denies the diagnosis, then seeks out all information he can get, first looking at Internet sites. My patients do the same thing.
• My tip: Get a second test and a second opinion.
The next theme represented in the film is to find a good doctor. The lead character turns to a research study expert who is investigating a new drug and also to a compassionate younger doctor (well-acted by Jennifer Garner) who communicates better.
• My tip: Find an expert doctor who communicates well and answers all of your questions. And ask about clinical trials and if you can get a promising new therapy with possibly better results. Tips about clinical trials can be found at clinicaltrials.gov.
An additional theme well-described in the movie is the strict FDA regulation of access to drugs. The FDA makes sure investigational drugs are not indiscriminately available to just anyone, but only to those who qualify for a study. And the issue of availability of new drugs from foreign countries is also illustrated.
•My tip: First see if you can get on a clinical trial. If that is not possible, see if the FDA has an expanded access program that permits you to receive an experimental drug outside of a trial. Also check on availability of drugs from foreign countries if you cannot access them in the United States. Some drugs are already approved in some other countries but are not yet available here. However, there can be problems with foreign drugs in terms of quality and reliability. So always discuss with your physician if you are considering acquiring drugs from foreign sources, and have your doctor monitor you for side effects and improvement with treatments.
Unfortunately, many drugs have serious side effects. This theme is portrayed in the movie and the relationship to drug dosing is covered. The way in which a support group (in the movie the informal group of patients facing the same diagnosis, as well-portrayed by supporting actor Jared Leto) can help each other in finding out about care for a serious condition is illustrated as well.
•My tip: Always research the side effects of drugs in the drug company website as well as in the experience of others who have received the drug or participated in a clinical trial. Find a support group preferably through a treatment center, research facility, support organization for example, the American Cancer Society or Cancer Support Community), or even online through Yahoo. Share your experiences and find out how others have coped and solved problems.
This film was entertaining. More importantly, many movie-goers, including my wife and me, have spent hours discussing the issues from the film, at times being angry at the regulations and restrictions of drug access, and at other times admiring the ingenuity of the characters in facing serious health problems, finding solutions that were so well described and acted.
Never let important messages in films go overlooked by your admiration for the acting and writing. Let films such as these be a gateway for helping us all to live healthier and more enjoyable lives. Congratulations to Dallas Buyers Club writers Craig Borten and Melisa Wallack, director Jean-Marc Vallee, and all the cast and crew.
See my book Surviving American Medicine about second opinions and where to get them.