July 29, 2012

WHEN CASH COWS MEET SHEEP RIPE FOR SHEARING:

Rethinking cancer : New studies show that aggressive measures aren't always best. What does this mean for healthcare? (LA Times, 7/29/12)

Most recently, a study published this month in the New England Journal of Medicine found that men whose early-stage prostate cancer is carefully monitored but not treated right away appear to live as long as men whose cancer is immediately operated on, and that they also avoid the troubling side effects of urinary problems and erectile dysfunction. The study isn't definitive, and its findings might not apply to all forms of prostate cancer or to younger men.

The public, though, seems a little doubtful about pronouncements that Americans are over-tested and over-treated, and it's easy to see why. Our very nature tells us that if there's a bad thing in us like cancer, we want it out. Also, insurance companies and the government have been warning that runaway increases in medical costs are unsustainable. This makes patients worry that important medical tests and treatments will be withheld for financial rather than health considerations. What many people fail to realize is that some unnecessary tests and treatments are currently being ordered for a different financial reason: in order to earn doctors money. Many procedures are profit centers for medical providers; in other cases, they are ordered to shield practitioners against possible malpractice suits, rather than because they are medically necessary and appropriate.

The sensitive new technologies that enable doctors to find and diagnose more medical problems have also led them to find, explore and treat things that never would have caused problems, according to Dr. H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice. "We now recognize that we all harbor abnormalities," Welch said in a Times story last year.

Posted by at July 29, 2012 10:31 AM
  

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