Furst, now a spokesman for the American Diabetes Foundation, is best known for his roles as Flounder in the movie, “Animal House” and Vir in the television series “Babylon 5.” He told audience members he had narrowly avoided having his foot amputated a few years earlier, and about the changes he then made to his diet and lifestyle.

“Probably because he’s an actor, he was very eloquent,” recalls Pearson, founder of the family and sports medicine practice Medicine in Motion in San Marcos, California. “He was diabetic, had been obese, and could talk about what it was like growing up like that. He had been there and done that.”

Drawing a crowd

When it comes to drawing a crowd, attracting media attention or raising money, few tools are more useful than the presence of an actor, athlete, prominent author, or other public figure. The Yul Brynner Head and Neck Cancer Foundation uses actress Brett Butler and former Notre Dame University football coach Lou Holtz, among others, to draw attention to Oral, Head and Neck Cancer Week (OHANCAW), which takes place every year at the end of April.

“If I call a reporter or editor to pitch a story on OHANCAW, they’ll treat it as just another disease of the week,” notes Jeff Hoyak, president of MCS Public Relations in Bedminster, New Jersey, which frequently works with organizations seeking to raise public awareness of diseases. “If I call that editor with a Lou Holtz or Brett Butler for that same story, suddenly they’re paying attention. Celebrity involvement really enhances media interest.”

Experience with diseases

The American Academy of Family Physician’s 2008 Scientific Assembly – the academy’s annual meeting – featured as part of its keynote session the actresses Sally Field and Patty Duke; Grace Anne Koppel, wife of TV journalist Ted Koppel; and former Miss America Nicole Johnson, MA, MPH.

Field, who appears in advertisements for the drug Boniva, spoke about her experiences with osteoporosis; Koppel, a spokeswoman for the National Heart, Lung & Blood Institute’s “Learn More, Breathe Better” campaign discussed chronic obstructive pulmonary disease; Duke spoke about bipolar disorder; and Johnson, a former board member of the American Diabetes Association, spoke on her experiences as a patient with Type 1 diabetes.

The speakers were chosen to reflect the assembly’s annual clinical focus, which for 2008-09 is chronic disease management. Brad Fox, MD, chair of the 2008 assembly and a family practitioner in Erie, Pennsylvania, said, “We asked them (the guest speakers) just to tell us who they are, what their experience has been with diagnosis and treatment, what their physicians did that was right or not right, and what advice they would give to doctors taking care of patients in their situation.” All speakers received an honorarium.

Fox adds that audience feedback was overwhelmingly positive. “Everyone who spoke to me afterwards thought it (having the speakers) was a great idea,” he recalls. “They really liked hearing Nicole Johnson’s story about being told she would not be able to do anything because she was diabetic, and passing out during the Miss America pageant. Her experience really seemed to make people think.”

Johnson, winner of the 1999 Miss America pageant, speaks frequently about her experiences with diabetes treatment and management. She advised audience members to work on their communications skills. “Healthcare professionals need to understand and get training in different communication styles so they can be sure their patients will hear them,” she said. “And they need to understand the psychology of a disease that is never going away, and what it’s like to grapple with it multiple times each day.”

Thaddeus Bort, MD, chairman of The Family Medical Group in Cincinnati, was impressed with Duke’s account of her struggle with bipolar disorder. “She wasn’t just a talking head. She had lived this, and was communicating the message, ‘Hey, docs, this is something you’re seeing in your office and you may be missing it.’ I thought that was very helpful,” Bort says.

Role of the family doctor

Richard Roberts MD, JD, pondered the family doctor’s role in helping victims of bipolar disorder after hearing Margaret Trudeau, wife of former Canadian prime minister Pierre Trudeau, speak at the College of Family Physicians of Canada’s 2008 Family Medicine Forum. Trudeau was diagnosed with the disease in 2000.

“It was almost painful to hear what she went through,” says Roberts, a family physician in Belleville, Wisconsin, and professor of family medicine at the University of Wisconsin School of Medicine and Public Health. “It was powerful stuff, and it changed a little bit my sense of how helpful or unhelpful the health care system is for people who are struggling with difficult issues.

“She said the one person in her life who kept her afloat was her family doctor, even though he wasn’t directly involved in her bipolar management. So there was a message that it’s really important to have someone you know and trust as a health care professional who hangs in there with you,” Roberts adds.

Motivating patients

While Tim Martindale MD, a family practitioner in Waco, Texas did not attend the AAFP assembly, he welcomes patients who want to discuss osteoporosis after hearing Field talk about it in other venues or on television. “Anything that motivates people to become interested in their health and take action is worthwhile,” he says. “I think celebrity spokespeople can start the process. It lets me say, ‘I’m so glad you’re interested in taking charge of your health. What that celebrity said is a start, now let me show how what they said affects you’.”

Martindale knows some doctors worry that patients will act on the advice of celebrities rather than the doctor’s professional opinion, but he thinks such an attitude is short-sighted. “I don’t think we should be threatened by celebrities’ influence,” he says. “When the patient comes in and is thinking I’ve got to do something about this symptom we should grab hold of that energy and point them in the right direction.” Among the conditions Martindale’s patients have asked about as a result of hearing celebrities advertising a drug or discussing their own conditions are benign prostatic hypotrophy, erectile dysfunction, and high blood pressure.

Sal Volpe, an internal medicine practitioner in New York, better understood the challenges of making health records universally available after hearing a speech by Newt Gingrich, former Speaker of the U.S. House of Representatives, at a meeting of the Health Information Management and Systems Society.

Gingrich, Volpe recalls, contrasted the difficulty of obtaining health information with the ease of getting cash from ATMs anywhere in the country. That access came about because banks everywhere saw it was in their interest to share information about customers so that they could withdraw cash. But doctors, hospitals, and insurance companies have yet to develop a similar common interest that would permit sharing of health information. “It made the situation a lot more understandable, and gave me a concrete example I could share with patients who aren’t sure how easy this should be,” Volpe says.

Potential for harm

While celebrities can bring attention to diseases and improving patient care, the flip side is their potential to cause harm, even unwittingly. “Celebrities are skilled communicators and can command a large audience, which is potentially a good thing,” notes Roberts. “The downside is that sometimes they are not sophisticated consumers of medical information. They can get it wrong.” He cites as an example the actress Jenny McCarthy’s outspoken opposition to some types of vaccination due to her belief that they cause autism.

Moreover, unlike doctors, celebrities can’t be held legally responsible for the results of stating their opinion on a health or medical topic. “If I say something stupid and a patient does something stupid as a result, I can be held accountable for professional negligence,” Roberts points out. “The difficulty for someone who follows a celebrity’s advice is they don’t have any legal recourse.

“I think most celebrities try to get good information and approach it (being a spokesperson) in a way intended to do good,” Roberts adds. “But they have to be mindful that when you’re trying to communicate a message harm could come of it. And if new evidence comes in, they have to be willing to say ‘I was wrong about what I was saying before.’”

Frederick Sherman, MD, MSc, clinical professor of geriatrics and medicine in the Mount Sinai School of Medicine’s Brookdale Department of Geriatrics and Adult Development and medical editor of Geriatrics, calls the use of celebrities to bring attention to medical causes and diseases “a very loaded phenomenon.”

“The power of their influence affects people’s perceptions of how much whatever they are talking about should mean,” says Sherman. Nor are physicians immune to the phenomenon. “We doctors are human too. If we see a celebrity with an illness it has an effect on us. We’re going to pay more attention to it.”

Roberts believes it is important to provide some medical perspective to the celebrity’s situation. Referring to Margaret Trudeau’s experience, he says, “At times you could sense her frustration (with the psychiatrists who treated her). Ideally, you would have liked someone who could provide some context to what she was saying, to say ‘the reason Margaret got this treatment at this time was A, B and C.’”

Similarly, physicians and lay people alike need to know if the celebrity is being paid for their appearance, says Roberts. “You always have to ask yourself if you’re in the audience, ‘why is this person here and what are they asking me to do?’ If they’re here just to draw a crowd it’s one thing, but if they’re trying to persuade you to give money or buy a product or see a doctor, that’s quite another. It may put a different cast on what you’re hearing.”

Bringing the message home

At the AAFP assembly, guest celebrities were paired with doctors for just that reason, says Fox. “We treated these like case studies, except that instead of having the physician present the case, go over diagnosis and treatment, we were having the patient present their story, then have the physician talk about disease state and the treatment of it. It provides a fuller perspective than hearing just one or other. People in the audience told us they were happy to hear it presented that way, and that it was great way to bring home what we were teaching.”

Johnson thinks the physician-patient format is effective, in that it provides doctors with a more complete picture of how they are viewed. “They work hard at analyzing the numbers and meeting guidelines, which is completely understandable,” she says. “But it’s always good to have someone out there to remind them of the people aspect of what they do.”

As for Pearson, after hearing Furst speak he added a link to the actor’s web site on Medicine in Motion’s web site, and more information about the importance of weight loss and exercise. He also began telling his diabetic patients about Furst’s experiences. “Furst was very motivational for getting us to get on our patients about dealing with their diabetes,” he says.