u*******2
发帖数: 287 | 1 *************“If your income is dependent on you not understanding
something, it is very easy not to understand something.”***********
LOL
Originally Posted by NYT
“All of us take extraordinary issue with both the methodology and
conclusion of that report,” said Dr. Deepak Kapoor, chairman and chief
executive of Integrated Medical Professionals, a group that includes the
nation’s largest urology practice. “We will not allow patients to die,
which is what will happen if this recommendation is accepted.” He and other
urologists said that the P.S.A. test is just one part of an overall
strategy that, in the hands of well-trained doctors, can help prevent death
and other consequences of cancer.
Treating patients with prostate cancer is a highly profitable business in
the United States, and much of the practice of urology is dedicated to this
fight. If men no longer get screened routinely, urologists will see a steep
decline in patient visits and income. But Dr. Kapoor rejected the notion
that profit plays any role in his defense of screening.
“That I’m going to treat patients that don’t need therapy is morally
repugnant,” he said.
But Dr. Otis Brawley, chief medical officer of the American Cancer Society,
suggested that is what doctors like Dr. Kapoor are doing. “We in medicine
need to look into our soul and we need to learn the truth,” he said.“If
your income is dependent on you not understanding
something, it is very easy not to understand something.” | A*******s
发帖数: 9638 | 2 It is especially true for the pain medicine service. | A*******s
发帖数: 9638 | 3 这就是evidence based medicine和经验医学的区别， 我觉得这是一个很好的topic。
医生治疗疾病， 都是为了防止病人死亡， 这个前提没错。 可是具体的做法并不是都
合情合理的。 PSA screen就是一个例子， 因为背后的商业利益实在太多了， family
medicine， 实验室， 病理， 放射， 泌尿科，OR，etc， 一个假阳性就可能牵涉到这
么多的程序， 不光给病人带来烦恼， 经济上的花销也是非常可观。 而前提是为了病
人的健康， 一旦有个家庭医生没有screen， 而病人恰恰得了cancer， 可能又是legal
的问题， 花费更大。
carotid U/S是另一个例子， 有一段时间在大的shopping mall就有这样的screening
service， 发现有问题， 不管有没有症状就做手术， 结果一些出了并发症的病人就不
买账。 还有一些imaging中心， 给没有症状的人做CT体检， 全身扫一个遍， 看到东西
就去看surgeon， 搞得大家一头雾水。
不得不承认， 经济利益在medicalpractice扮演着一个极其重要的角色， 而为病人服
务这个幌子下很容易在经济利益下走上歧途。
所以说 If your income is dependent on you not understanding
something, it is very easy not to understand something |
|
