Linkdump for February 24th through March 5th


Comments

Written by michael -

Dear Ms. Begley_ Wow! Somebody must have put a hit job out on medical doctors. Your recent article was linked on a blog I read and I couldn't help but notice the hostility of the article. It seems to me it was an unabashed knock at an entire swath of the medical community and the entire medical profession. It didn't even have a single sourced fact to support (or allow for rigorous analysis) the whimsical claim that doctors hate science. Example_ "Yet a 2004 study found that some 10 million women lacking a cervix were still getting Pap tests." This claim deserves further scrutiny and I am sure that a study of 10 million women cannot be summarized in a single sentence. Indeed, I'll be the first to concede to the author that there are unneeded treatments being prescribed and that disparities exist not only in treatments, but also in diagnosis and outcomes. Furthermore, disparities are not just limited to geographical locales, but also along racial lines. There is no doubt that culture plays a role too. Also in contrast to the crux of your article, I also suggest that medical doctors are not all against science. The comparative effectiveness research is indeed supported by the largest doctor's organization, the AMA, (http://www.ama-assn.org/ama/no-index/news-events/rhetoric-reality-stimulus-package.shtml). Also, Senator Coburn is a politician first and foremost and using his conservative opposition to CER as a example of a "doctor" in opposition to CER is a stretch. In your article you wrote, "Doctors have long resisted having science guide their practice. That's obvious from the disparity in clinical practices from one region of the U.S. to another, as The Dartmouth Atlas of Health Care has been finding since the early 1990s." This conjectured link between doctors resisting science and regional disparities in clinical practice is more obtuse than it is obvious. Nonetheless, these issues are real and do merit discourse. However they are a result of a combination of factors that go far deeper than how doctors feel about science. Plainly speaking I reject the idea and the title of the article that medical doctors hate science. In point of fact, the foundations of medical education and training are rooted in science. I just wanted to make sure that we all agree on that because this fact is simply beyond debate. There are a whole littany of issues (other than hate of science) at play here which include_ HMO influence, malpractice lawsuits, hospitals and clinics for-profit, medicare and medicaid, the under- and un-insured, rapidly growing technology, patient compliance and preferences, and the ever aged-patient population. So let's try to have a little more fairness about these issues, aside from a token mention at the end of a "younger generation". Sincerely, Michael A. Lopez

Written by michael -

also there are different kinds of hysterectomies some of which preserve the cervix

Written by Chris -

Haha - nice rebuttal. For the record, I agree with some of her overarching themes, but not necessarily with all of the details. For example, I don't necessarily believe that there's actually a pervasive anti-science sentiment among all MDs. I think that rapidly changing technologies and information leave many doctors unable to keep up, through no fault of their own. In an ideal world, they'd have time to keep up on the literature. There are all sorts of barriers to that, though, in our clusterfuck of a health-care system.. I threw it up as something to think about, and I see you thought about it plenty - nice.

Written by Michael -

you created a firestorm of comments over at the original newsweek story. these ppl don't give up.

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