Here is something that would be great to hear as a patient, but, as a doctor, I would be very hesitant to say about a patient, any patient:
WH Physician: Trump “in very good health… will remain so for the duration of his Presidency, and beyond.” pic.twitter.com/iudGrh8LdF
— Jim Acosta (@Acosta) February 8, 2019
Sean Patrick Conley, DO, made this statement. Conley has been the Physician to the President ever since Ronny Jackson, MD, stepped down in the Spring of 2018 after being nominated by President Donald Trump to become the next Secretary of Veterans Affairs. Jackson never actually became the Secretary, but that’s a different story. Conley completed his Doctor of Osteopathic Medicine degree at the Philadelphia College of Osteopathic Medicine in 2006 and his Emergency Medicine Residency at the Naval Medical Center Portsmouth in 2013. Prior to joining the White House Medical Unit, he had been the research director at Portsmouth Navy Department of Emergency Medicine.
The interesting thing about Dr. Conley’s statement are the words “will remain so for the duration of his Presidency, and beyond.” This isn’t quite Buzz Lightyear saying “to infinity and beyond” in the movie Toy Story, but let’s take a closer look at what exactly this statement may imply.
President Trump has at least 710 days remaining in his Presidency, in case you haven’t been counting. You can always check the countdown clock in Seattle, Washington, that has an accompanying Instagram account. If you want to get the count right down to the second, the web sites “How long until Trump leaves” and “Time left until Trump leaves office” offer such services. All of these counts, of course, assume that Trump won’t be re-elected. If Trump is indeed re-elected then you can add another 1,460 days to each of these counts.
Therefore, Conley’s statement suggests that Trump will remain “in very good health” for the next 710 days to 2,170 days, “and beyond.” That’s quite a lot to say, because a lot can happen in 710 days.
The character Dr. Leonard McCoy of Star Trek was known for saying things such as “I’m a doctor, not a bricklayer”, “I’m a doctor, not a coal miner,” or “I’m a doctor, not a torpedo technician!” Well, you can add fortune teller to that list. After all, while immunology, biochemistry, and surgery are part of the standard medical school curriculum, crystal ball reading is not.
As a doctor you can try to assess a patient’s health at the moment, right then and there. Notice the emphasis on the word “try”, because tests and examination techniques are never 100% accurate. Yes, in this case, Yoda was wrong. Try there is. Exams and tests are also quite limited in what they can find. Many examination techniques and tests offer only indirect evidence of how your body is functioning. Moreover, you cannot tell specifically with 100% certainty what will happen to the patient one year, one month, one week, or even one hour after the exam is completed. At most, you can get a sense of the patient’s risks of developing different particular diseases and medical problems.
Most of these risk assessments are based on studies of various populations. So depending on the patient’s background, experiences, and surrounding factors, such risk assessment may apply with varying degrees to a particular patient. For example, such studies may not include enough female, minority, immigrant, and low income populations to represent a given patient’s particular experiences and exposures. Plus, Elmo was right. Everyone is special. Everyone is unique and can “defy the odds” in either direction. In any case, you can never say for sure what will happen in the future even if the patient is a completely healthy baby. This is especially true for Trump since he is not a baby in chronological age.
Additionally, risk assessments assume that you, your behaviors, or your life won’t change. If, for example, Trump were to start playing for the New England Patriots as a tight end, his concussion risk could potentially rise. On the flip side, improving your diet and exercise habits (e.g., running alongside golf carts) could improve one’s chances.
All of this needs to be clear. A physical exam that didn’t find any problems is not a ticket to forget about your health and do whatever you want to do until the next exam. If you’ve had a “clean” physical exam, congratulations, feel good about yourself, but don’t rest on your laurels. Laurels can scratch your behind and lull you into a false sense of security. Instead, use the physical exam as a reminder to be vigilant about potential risk factors and do what you can to maintain a healthy lifestyle. Moreover, a “clean” physical exam doesn’t mean that you should go without health insurance coverage because disaster could happen at any time.
Very definitive statements can create the false narrative that doctors are all-seeing, all-knowing, perfect, and infallible. Sure, it may be nice and encouraging for a patient to get strong reassurances. There are certainly emotional and mental health benefits of positive reassurance, which can then lead to physical health benefits. But doctors need to be careful. Going overboard and offering overly definitive reassurance can lead to unrealistic expectations and severe disappointment, confusion, and even lawsuits when things don’t go as predicted. Your physician cannot really predict the future with much certainty, even if your physician is Dr. Lightyear. In general, be wary of anyone who uses very exaggerated and super-definitive statements. Science and life don’t work that way.
Without access to the specific medical reports and test results from Trump’s annual physical exam, I can only go by what was said in the letter posted on Jim Acosta’s Tweet, which is not much. That means, it is difficult to tell how well the specific exam and test findings correlate with Dr. Conley’s statement. The suggestion is that Trump doesn’t currently have any significant health concerns, which would be very positive news for the 72-year old President.