I have a confession to make. I've never watched an episode of "Keeping Up With the Kardashians." And while many of the Kardashians appear in my Instagram or TikTok feeds, I've scrolled on by. But Kim Kardashian's recent Instagram post extolling the benefits of elective, comprehensive MRI scans made me stop scrolling. After seeing her post, it reinforced my belief that celebrity endorsements of unproven healthcare trends need scrutiny. Maybe it's time to hit the unfollow button.
While preventive care saves lives and improves health, Kardashian's post highlights the problem of consumerism and celebrity influencers in healthcare. Americans should be looking to their own physicians and practitioners for advice about the need for and reliability of these scans -- not celebrity influencers.
Why? Because Kardashian is not sharing all the facts.
What Kim Kardashian Didn't Say
The healthcare community has been debating elective full-body MRI screenings for years. A central concern has been whether these scans will actually enhance care and the quality of it -- or whether they'll just inflate prices.
Many of the companies selling scans argue their scans can identify numerous medical conditions, including cancers in their early stages.
Kardashian clearly agrees, but her Instagram post offered no evidence to back up this claim. She certainly did not explain that data thus far is agnostic about whether elective, full-body CT scans and MRIs are worth it, especially for the broad population. Kardashian also didn't offer information from the American College of Radiology (ACR), which has said there is not "sufficient evidence to justify recommending total body screening for patients with no clinical symptoms, risk factors or a family history suggesting underlying disease or serious injury." (If she doesn't believe the ACR, Kardashian might want to talk to her fans. Several people commenting on her post said these scans simply are not worth the cost.)
Kardashian also neglected to mention exactly how pricey these scans are. Generally, they come with price tags ranging from $500 to $2,500. That may be a small sum to a Hollywood influencer, but most Americans cannot afford an unforeseen trip to the emergency department, much less an elective full-body MRI.
Finally, Kardashian failed to note these scans can be unreliable. A 2019 study concluded that a substantial proportion of critical and indeterminate incidental whole‐body MRI findings resulted in false positives. The American Academy of Family Physicians (AAFP) has said these scans should not be used for asymptomatic cases.
In fact, the AAFP concluded, "Whole-body scanning has a risk of false-positive findings that can result in unnecessary testing and procedures with additional risks, including considerable exposure to radiation with positron emission tomography and CT, a very small increase in the possibility of developing cancer later in life, and accruing additional medical costs as a result of these procedures."
While the lack of information in Kardashian's post was problematic, what is more nefarious is the broader movement her Instagram story represents. Influencers, often for personal gain and fortune, push unproven medical treatments and interventions. Other influential celebrities like Gwyneth Paltrow have faced heavy criticism for extolling the health benefits of the jade egg and candles. While these wellness products are not on par with costly MRIs, celebrities have significant influence yet lack the accountability and responsibility to share accurate information with their followers.
The Side Effects of Healthcare Influencing
A proliferation of posts like Kardashian's can have at least five negative effects on the healthcare marketplace.
First, it risks leaving the public believing that complex medical issues can be solved with simple solutions. We've seen how political oversimplification has degraded our public policy discussions. In healthcare, the effects will be worse. Healthcare is a realm of intricate medical knowledge, where symptoms are often elusive and diagnoses intricate. Encouraging patients to "Google" their symptoms can lead to misinformation and misguided self-diagnoses. Additionally, offering "solutions" to complex or perceived problems using celebrity influencers may lead to overuse and potential harm. Medicine demands a blend of medical training and experience, a combination not easily encapsulated in a quick internet search.
Second, excessive consumerism can inadvertently strain the delicate fabric of the physician-patient relationship. Patients with self-diagnoses and preconceived notions can steer consultations in directions that may not be clinically relevant. A harmonious partnership between patients and physicians must be nurtured and founded on trust, open communication, and the physician's expertise. Influencers can interrupt this sacred relationship.
Third, influencers can skew healthcare priorities. The alluring appeal of consumerism can misguide patients into prioritizing convenience or anxiety over necessity. Patients might be swayed to seek quick fixes rather than comprehensive solutions. Medicine's intricacies demand thorough assessments and evidence-based approaches, not hasty remedies. Medical decisions must be grounded in the sound principles of clinical judgment, avoiding the pitfalls of superficial solutions.
Fourth, influencers can enhance the mirage of price transparency. Price transparency is often offered as a solution to rising healthcare costs. While transparency is valuable, we must also recognize the complexities of healthcare billing. The interplay between insurance, complex procedures, and dynamic healthcare systems can render "transparent" pricing bewilderingly opaque. The cost of care transcends the simple sticker price, encompassing a myriad of variables that need careful consideration. Kardashian could not explain these intricacies in a social post.
Finally, influencers can spread misinformation. Our experiences during the COVID-19 pandemic provide vivid illustrations of how consumerism and misinformation influenced vaccine adoption. Leveraging influential figures, including politicians and celebrities, to sow discord and mistrust in the healthcare system has led to substantial consequences.
Getting Healthcare Consumerism Right
While I wouldn't follow Kardashian's medical advice, her post has allowed the medical community to consider how consumerism, influencers, and social media are steering the trajectory of healthcare.
Consumerism can be an important force in healthcare. The Biden administration used influencers to try to convince reluctant Americans to take the COVID vaccine, for example. On top of that, patients should demand better access to care, inventive innovations, better engagement, and enhanced choice.
But healthcare companies need to be careful not to prey on patients' worst fears and certainly should avoid appealing to vanity. On the surface, consumerism is an enticing proposition, but beneath this glossy exterior lies a labyrinth of challenges.
While elective full-body scans are not immediately life threatening, we simply cannot treat healthcare innovations as trends. We must demand greater responsibility and accountability by platforms and companies using influencers to drive healthcare businesses. In addition, policymakers should examine how social media influences patient demands, healthcare decision-making, and behaviors. Further, platforms should use disclaimers and make design and development decisions prioritizing safety and health. Finally, lawmakers, healthcare companies, and social platforms should use this research to set standards and best practices.
Full-body MRIs are not the same as vegan shoes or the latest vitamin C facial serum. Patient engagement and feedback are assets, but healthcare consumerism's true potential will be found in fostering collaboration between patients and physicians, not in driving social media engagement and profits.
N. Adam Brown, MD, MBA, is a practicing emergency medicine physician, founder of ABIG Health, and a professor at the University of North Carolina's Kenan-Flagler Business School. Previously he served as president of emergency medicine and chief impact officer for one of the nation's largest national medical groups.