In a compelling article called Are Some Diseases More Prestigious Than Others? the always-interesting medical historian Dr. Jan Henderson ran an overview ranking the prestige of a number of medical diseases. And WOOOO HOOOO, my heart sisters! We won! Those of us who have survived a myocardial infarction (heart attack) are right up there at the top. Studies from Norway report that the more highly ranked medical specialties and diseases all involve vital organs, and, let’s face it – what organ is more vital than our hearts?
So why don’t I feel even a tiny bit better about “beating out” 37 other important diagnoses? On this, my 300th posting here on Heart Sisters, let’s check out what Dr. Jan had to say about this Norwegian research:
“Among medical specialties, some are more prestigious than others. You can generally tell which ones are more prestigious by how well they pay. Surgery and cardiology, for example, rank at the top of the prestige scale. Psychiatry and dermatology are near the bottom.
“One can also ask if some diseases are considered more prestigious than others, in the opinion of doctors.
“A Norwegian physician, Dr. Dag Album, has been investigating the prestige of both diseases and medical specialties for many years. In one study, he asked a cross-section of physicians and med students to rank the prestige of 38 specific diseases, as well as medical specialties. He found that certain diseases consistently ranked at the top (myocardial infarction, leukemia, brain tumors) and others at the bottom (fibromyalgia, anxiety neurosis).
“Among medical specialties, neurosurgery and thoracic surgery ranked highest. At the bottom were geriatrics and dermatovenerology (the treatment of skin diseases associated with venereal diseases).
“What makes a disease or specialty more prestigious?
“One relatively objective way to view the ranking of specialties is to consider their urgency.
“The aim of primary care physicians, pediatricians, and psychiatrists is to keep their patients healthy. Although some of their patient encounters surely do make the difference between life and death, those are generally the exception. On the other hand, a patient only sees a brain or heart surgeon when his or her life depends on undergoing a successful operation.
“Dr. Album draws a similar conclusion from his study. Specialties and diseases ranked lower involve chronic conditions. But he also points out that age and the bodily location of disease contribute to high and low prestige:
“Our interpretation of the data is that diseases and specialties associated with technologically sophisticated, immediate and invasive procedures in vital organs located in the upper parts of the body are given high prestige scores, especially where the typical patient is young or middle-aged.
“At the other end, low prestige scores are given to diseases and specialties associated with chronic conditions located in the lower parts of the body or having no specific bodily location, with less visible treatment procedures, and with elderly patients.”
“Here’s the complete list of diseases, ranked from most prestigious to least. (Note that 38 is a small number of diseases, so there are conspicuous omissions, such as breast cancer):
- Myocardial infarction [heart attack]
- Spleen rupture
- Brain tumour
- Testicular cancer
- Pulmonary embolism [usually a blood clot in main artery of lung]
- Angina pectoris
- Extra-uterine pregnancy
- Thyroid cancer
- Meniscus rupture [knee cartilage tear]
- Colon cancer
- Ovarian cancer
- Kidney stone
- Ulcerative colitis [type of inflammatory bowel disease]
- Kidney failure
- Duodenal ulcer [ulcer in upper part of small intestine]
- Pancreatic cancer
- Ankle fracture
- Lung cancer
- Sciatica [injury or compression of sciatic nerve]
- Bechterew’s disease [ankylosing spondylitis, spinal arthritis]
- Femoral neck fracture [top of the thigh bone]
- Multiple sclerosis
- Inguinal hernia [abdominal protrusion through inguinal canal]
- Apoplexy [bleeding of internal organ]
- Cerebral palsy
- Depressive neurosis
- Hepatocirrhosis [cirrhosis of the liver]
- Anxiety neurosis
Dr. Jan Henderson is a historian of medicine who blogs at The Health Culture. By the way, if you object to Dr. Album’s disease ranking order here, don’t get mad at Dr. Henderson or me. We’re simply the messengers . . .
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Well, there’s heart disease, and then there’s heart disease. Learn more about where your own diagnosis sits on my very unofficial and subjective Seven Levels in the Hierarchy of Heart Disease list.