How doctors do harm
http://www.cnn.com/2012/01/30/health/how-we-do-harm-brawley/index.html?hpt=hp_c2
Astounding:
American medicine is big business. It is about 18% of the U.S. economy and growing. The average cost of a health insurance policy for a family of four is $19,400 per year. The expense of our inefficient health care system is a major drain on the economy. It is a major reason why employers are hesitant to hire and a reason why many employers cannot provide health insurance to employees.
Assuming there are 300 million of us and rounding up to $20K a pop, that comes out to one and a half trillion bucks. It is more impressive with all the zeros: $1,500,000,000,000.00 That is enough green to corrupt anyone! (According to Wikipedia, the US economy is around $14.5 trillion; 18% should translate to $2,610,000,000.00.)
I have always complained that most doctors are about as far removed from science as the average member of the Shakespearean repertoire and the author supports my contention:
Doctors deserve some blame for this mess. Appreciation of the science of medicine and the scientific method is often lacking.
It is amazing the number of health care professionals who seemingly reject the scientific method. They prescribe treatments they believe to be appropriate as opposed to therapies that are known to be appropriate based on objective scientific evidence. This form of ignorance is a root cause of much of the overuse of medical therapy.
Too often, doctors fail to distinguish what is scientifically known from what is unknown, from what is believed. This is beyond mere disagreement about interpretation of the science. There is often selective reading of the science, especially by those trained in a specialty wanting to advocate for it.
An old girlfriend’s father had cancer (late stage, but he got some 5 years from the original diagnosis) and since she and I were biochemist we invested a lot of time researching the state-of-the-art and developed a pretty decent knowledge base in a short time. Interestingly (and quite frustratingly) the doctor treated us with thinly veiled contempt (maybe he didn’t think so, but we sure did) and basically totally ignored anything we had to say. Why that matters to me is the treatments he recommended were based on perusing single paragraph abstracts in a non-peer reviewed document that simply reported what different doctors did and what the results were (I am sure there was huge bias against reporting things that _failed_ to work) and thus proved to my satisfaction that he didn’t know a damn thing about cancer biochemistry (the specific treatment he was recommending at the time was _specifically_ targeted toward a small percentage of breast cancer tumors, this for a man with throat cancer). Conversations I have had with people in the medical community that I otherwise respect as individuals nevertheless convinces me that there is no training in science in the world of medicine. Even those tiny number that pursue the MD/PhD route, they are not really likely to become scientists (or even grok the scientific method) because they are coddled because they must be super smart because they are dual doctorate students.
The most critical missing element in our dysfunctional health care system is any sort of evidence based decision making. The drug/equipment companies should never be allowed to market directly to the end consumer (sheeple), indeed, I don’t think they should be allowed to market directly to doctors or hospitals either. Of course, if we have a centralized approval process (more of that damn dreaded socialism raising its ugly head!) that makes for highly targeted corruption, but at least it would be centralized and easier to see. I firmly believe that no new drug/procedure/product should be approved for use unless it is has passed a cost/benefit analysis showing it provides a better benefit per dollar spent than the previous best choice(s). Of course, in our current society going that direction has about as much chance of happening as my being elected dictator this fall.
Like everything else, we are on a wide highway to hell and the momentum for the apocalypse is so high that the chance of avoiding the looming crash is only a wee bit greater than my chance of being elected dictator.
Interestingly enough, there’s a joke amongst the gun community that doctors cause 120,000 deaths per year. Given 700,000 physicians, that’s .171 per doctor. Guns, on the other hand, are responsible for 1500 accidental deaths per year (this doesn’t count the 18,000 suicide deaths by firearm or the 14,000 murders by firearm). Given 80 million firearm owners, that’s .000188 per firearm owner.
Statistically, doctors kill more people than guns. Not everyone has a gun, but almost everyone has a doctor. Where’s the Doctor Control Legislation?
That’s great! Thanks!