Why Doctors Hate Science

Scaremongers warn that 'effectiveness research' threatens the lives of Americans.

By Sharon Begley | NEWSWEEK
Published Feb 28, 2009
From the magazine issue dated Mar 9, 2009

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  • Posted By: dhrtx @ 10/13/2009 12:17:41 PM

    I doubt that any doctors hate science or CER. My concern is that insurance companies will use it to pay for or allow only the cheapest treatment or to deny treatment rather than to pay for the most effective treatment or the appropriate effective treatment for each patient. Conservatives opposing socialized medicine may include doctors, but insurance companies are the primary beneficiaries of the high cost of medicine. Look at how they are squealing about the President's plan now.

  • Posted By: sjar @ 10/08/2009 11:06:51 AM

    As a retired cytotech ( screener of pap smears), I have seen many women with hysterectomies who still had vaginal cancer. The Pap is not only to detect Cerivcal cancer, but all types of female genital tract cancer which includes squamous cell cancer - the cells lining the vagina. To say a Pap smear for a woman with a hysterectomy is unnecessary is misleading.

  • Posted By: medstudent17 @ 03/12/2009 11:52:17 PM

    Though its certainly sexy to blame everybody's favorite whipping boy these days, those rich, greedy, ignoramus doctors, I think that it goes much deeper than that. How about that patient who comes in with back pain and DEMANDS an MRI, and who will sue the physician if he doesn't get one? Over and over, patients demand (rightly so) to be the decision makers in their own health care, then turn around and blame anyone who happened to be there when things don't go well. I can say unequivocally that, although doctors want to be paid, (as may I add, do congressmen, nurses, and writers), they are most certainly, with few exceptions, trying to do right by their patients. But without serious tort reform, change of legislation, and a radical revamping of the system of physician reimbursement, poorly supported medical practices will continue.

    • Posted By: bobnotrob @ 04/15/2009 3:28:42 PM

      While I see your point, and I agree that the majority of physicians are TRYING to do right by their patients and TRYING to survive in this "medical milieu" I must contend, though, that every person has to take responsibility for their actions. Giving in to a pt, as in your example, because they are demanding specific treatment that isn't warranted is irresponsible; better to take the time to educate the pt with best available evidence and a mature, compassionate communication style first. Then if litigation is the concern there are legal indemnification on the MD's side. But this takes time and the physician who is unwilling to operate in this manner is not doing the best for their patient.

  • Posted By: dan59 @ 03/14/2009 6:40:54 AM

    Not biased? CER, with its 1 billion government funding is most definitely biased. I???m sure Obama expects CER to come up with cost cutting ???data??? for his investment. The bias will manifest itself in how and where CER chooses to look for cost savings. What if you end up needing bypass surgery? Are you ready to accept denial of it because statistically not as many people need it in Pueblo Co.? How foolish and wicked, the notion, that individuals should be treated based on statistics of occurrence. I would rather have an imperfect system of doctors consulting each other, than a prejudiced government agency of numbers crunchers deciding what medical procedures I may receive. Educating the population about healthcare would go a long way in making people educated consumers of healthcare. Insisting on second opinions for major procedures is another. Defining the line between truly needed health care and frivolous comfort care is way overdue too

    • Posted By: bobnotrob @ 04/15/2009 3:20:08 PM

      To your point we should all read "Worried Sick" by Nortin Hadler, MD. CABG's are only good on 3% of pts operated on who happen to have Left Main Disease, yet CABG's and stents are severly over-utilized with abysmal outcomes. There can be only one reason for this--greed. Hadler's done his research to support his contentions, where is the counter-argument?

  • Posted By: jbz7879 @ 03/05/2009 6:33:09 AM

    i think as a consultant physician in uk i feel american medicine treats not the patient but the possibility of avoiding litigation and they still get it all wrong
    america has a very poor medical milieu with low clinical acumen .a greedy medical community and an awfully defficient emergency room which leads to completely in sufficient and inefficient practice .
    i see records of people treated on holidays in america -i am a neurologist and they happen to miss basic components while doing the most unnecessary complex procedures .
    it is appalling and i wonder how you guys train your juniors as medicine is an art and a science where you treat an indiavidual rather then a disease or a symptom .
    regards

    • Posted By: A Concerned Physician @ 03/13/2009 12:45:52 AM

      For a neurologist from the United Kingdom, your appear to have a poor grasp on the English language. We generally use capitalization and punctuation, unless we are under the age of 12 or have a different primary language.

      • Posted By: bobnotrob @ 04/15/2009 3:15:10 PM

        shouldn't that be "poor grasp OF the English language"? ... oh my, I forgot to capitalize ... off with my head!

    • Posted By: sherrycnm @ 03/12/2009 4:11:58 AM

      Thank You! Your insight is right on the mark and we (Americans) can only hope that our leadership, in reforming the system, will seek guidance from other countries actually getting it right!

      • Posted By: A Concerned Physician @ 03/13/2009 12:48:29 AM

        How can we lead and follow at the same time? Please elaborate.

        • Posted By: sherrycnm @ 03/13/2009 3:11:42 AM

          So typical...I'm sure I just paged someone with an arrogance titer to match yours. "our leadership" as in US policy makers-President, congress, labor leader, insurance leaders, nursing, and...of course, the all powerful AMA that has a major share of the blame for this mess even if unwilling to admit it. I hear all around me that changing things scares my physician colleagues-too bad, it is way past time. As far as the reply beating up the entry for puctuation...again...so typical and your arrogance is completely underwhelming.

          • Posted By: A Concerned Physician @ 03/14/2009 1:24:12 PM

            They point that Nurse Sherry completely missed here has nothing to do with arrogance. I was raising the possibility that the neurologist from the UK was likely not who they say they are because my 5 year-old can write better.

            As for the authenticity of Nurse Sherry's claims, I am entirely convinced she's legitimate because only years of patient care could have jaded someone to the point of blaming physicians for everything that ails the US health care system. I have seen my fair share of nursing incompetence and laziness in my time, yet I still realize that the majority of nurses are just trying to earn a good living for their families while helping people in the process. Health care in this country and most others is overwhelmed by skilled labor shortages from physicians, to nurses, to radiology and lab workers. Yet as the population ages and demands increase, we are all expected to work harder, longer and for less reimbursement. Something has to give and Nationalization/Socialism are not the answer.

  • Posted By: CharlieWP @ 03/14/2009 6:21:32 PM

    Dear Ms Begley,

    I usually enjoy your writing and think most of your ideas are good, but your, On Science, article in Newsweek, March 9, 2009, bothered me. It took until now to figure out what???s wrong with it. It certainly seems logical that women with hysterectomies don???t need pap smears, except for the few who???s cancer was invasive. In those cases it is not possible to be sure every last cancer cell was removed and pap smears, at least for the first few years after surgery, would seem helpful in finding recurrences.

    So, why do so many women who don???t need them get pap smears? One reason is that they have been indoctrinated for so many years that they need them, they never get over this indoctrination. But with this issue over-indoctrination is better than under. But, the more fundamental reason is that when a woman gets a pap smear she is saying to herself, ???I???m still young. I???m still like the other women who need pap smears. My reproductive ability wasn???t taken from me, the surgery was a convenience because I already have all the children I wanted, it didn???t make me different. I???m not different. I???m not old.??? In addition, going to the doctor for a regular pap smear provides an opportunity to screen for diabetes, hypertension and other diseases that become common with aging, and it may enable a woman to maintain a relationship with a doctor that provides her with a significant sense of security.

    • Posted By: bobnotrob @ 04/15/2009 3:08:42 PM

      What you are describing is more of a result of an inefficient system of wellness prevention and health maintenance than of the need to continue with costly, irresponsible medical practices for which we all pay the price down the road. Screening for DM and HTN don't need to have a Pap associated with them; should be more prevalent as routine care. Medicine needs to ascribe to higher principles of ethical care than just looking at the bottom line or the party line (I'll do it because that's what has always been done). How much do you think a doctor makes on running an essentially impertinent test? Multiply that times the number of impertinent tests run.

  • Posted By: Ariafya @ 03/18/2009 3:37:44 PM

    Dear Ms. Begley,

    The problem is 2 fold. The science market is a "tournament market" a published by Science Magazine. The best person with a profitable idea wins, just like any other tournament. That means the science of medicine suffers. So, erroneously, laypeople think that the ROI is higher with a MD/PhD including MD from unverifiable source who "discover" a scientific process without the critical interrogation required to solve humanity's serious medical problems. When was the last time you have seen a cure for a heinous, life costly disease? I have seen all kinds of drugs to treat the symptoms of an array of diseases, but I have not seen the effective cures made by the likes of Dr. Jonas Salk. The reason, you do not get funded if you cure the illness.

    The other issue is physicians need to treat patients, that is what they were trained to do. Doctorates (Ph.D.'s) do the science. That is what they have labored for years to do. But since Ph.D.'s have not treated patients (outside their training), their education advancement is diminished by many research facilities because they either choose NOT to treat patients or choose NOT to pursue that opportunity.

    I did not want to treat patients, so, I became a research scientist with a Ph.D. Now I don't have a job because I do not have that MD degree. And if I did have a clinical degree, I will be dealing with patient cases, which is not what I wanted to do. The esoteric nature of illnesses are what brought me to molecular genetics, not healing patients.

    The fact is you can have the hottest treatment out there, latest research report to treat patients, and inform your patients with the best of intentions, but if your patients fail to adhere to your medical school training, knowledge and license directives, it all does not matter in the end-game. Many people are going contrary to their physician's, health websites, etc. goals, waiting for that miracle of science...

    • Posted By: bobnotrob @ 04/15/2009 2:59:26 PM

      The incentive to do good will always be undermined by the incentive to do as little as possible. But that shouldn't preclude the opportunity and effort to continue trying. One never always knows when a connection is made and, thus, makes a difference.

  • Posted By: dugmaze @ 03/27/2009 10:38:42 PM

    Funny how you embrace science for everything but autism.

  • Posted By: restored386 @ 03/24/2009 7:11:32 PM

    what about male circumcision, no medical benefits have been conclusively proven, most benefits are based on claims from studies that occured before modern scientific methods were used. no country other then america does it for health reasons.

    doctors make a quick $300-$400 on a patient that can't sue, and if the infant patient dies of mrsa or other means then it can easily be blamed on the birthing process and not pinpointed as the result of circumcision. In addition problems with circumcision are rarely recorded unless they need immediate treatment, many complications won't become apparent till puberty

  • Posted By: JAFJ2009 @ 03/18/2009 3:08:22 PM

    This is imprinting. Remember "imprinting" from psych 101 ? Health care providers (MDs and others) are also imprinted from their early endeavors in their role -- and for most that was ages ago!

    Imprinting
    If newly-hatched geese are exposed to a moving object of reasonable size and emitting reasonable sounds, they will begin to follow it just as they would normally follow their mother.
    This is called imprinting.

    The time of exposure is quite critical. A few days after hatching, imprinting no longer occurs. Prior to this time, though, the results can be quite remarkable. A gosling imprinted to a moving box or clucking person will try to follow this object for the rest of its life. In fact, when the gosling reaches sexual maturity, it will make the imprinted object ??? rather than a member of its own species ??? the goal of its sexual drive.

    Much of our knowledge of imprinting was learned from the research of Konrad Lorenz, shown here with some of his imprinted goslings. Lorenz shared a Nobel Prize in 1973 for his discoveries. (Photo by Tom McAvoy; courtesy of LIFE Magazine, ©1955, Time, Inc.) Secondary source again: http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/L/LearnedBehavior.html accessed March 18, 2009.

  • Posted By: JAFJ2009 @ 03/18/2009 11:54:54 AM

    What we are seeing right now is imprinting. Remember "imprinting" from psych 101 ? Our doctors (mostly MDs) are also imprinted from their early endeavors in their role -- and for most that was ages ago! IMy spouse and I have been in the health care arena from several venues (both public, military, academic and private practice). Read the imprinting definition below and see what you think!

    Imprinting
    If newly-hatched geese are exposed to a moving object of reasonable size and emitting reasonable sounds, they will begin to follow it just as they would normally follow their mother.
    This is called imprinting.

    The time of exposure is quite critical. A few days after hatching, imprinting no longer occurs. Prior to this time, though, the results can be quite remarkable. A gosling imprinted to a moving box or clucking person will try to follow this object for the rest of its life. In fact, when the gosling reaches sexual maturity, it will make the imprinted object ??? rather than a member of its own species ??? the goal of its sexual drive.

    Much of our knowledge of imprinting was learned from the research of Konrad Lorenz, shown here with some of his imprinted goslings. Lorenz shared a Nobel Prize in 1973 for his discoveries. (Photo by Tom McAvoy; courtesy of LIFE Magazine, ©1955, Time, Inc.) Secondary source again: http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/L/LearnedBehavior.html accessed March 18, 2009.

  • Posted By: AmericanMedicalAssociation @ 03/13/2009 1:36:26 PM

    The AMA and many other health care groups support comparative effectiveness research that provides physicians with information on which medical treatment options works best. Physicians and their patients both can benefit from research that demonstrates whether a particular treatment option results in better outcomes. The AMA has stressed that research findings should be driven by clinical evidence and not be used to identify and promote the cheapest treatment option. The CER provisions in the recent economic stimulus bill make clear that the advisory council has no authority to restrict payments or make coverage decisions, or establish national practice guidelines and it does not grant Medicare officials new authority to impose a cost-effectiveness standard.



    J. James Rohack, M.D.

    President-elect, American Medical Association

  • Posted By: AmericanMedicalAssociation @ 03/13/2009 1:35:49 PM

    The AMA and many other health care groups support comparative effectiveness research that provides physicians with information on which medical treatment options works best. Physicians and their patients both can benefit from research that demonstrates whether a particular treatment option results in better outcomes. The AMA has stressed that research findings should be driven by clinical evidence and not be used to identify and promote the cheapest treatment option. The CER provisions in the recent economic stimulus bill make clear that the advisory council has no authority to restrict payments or make coverage decisions, or establish national practice guidelines and it does not grant Medicare officials new authority to impose a cost-effectiveness standard.



    J. James Rohack, M.D.

    President-elect, American Medical Association

  • Posted By: Babe's Ghost @ 03/03/2009 10:05:55 PM

    Seriously, what is with Yalies? They all think that their BA degree entitles them to BS about subjects they are manifestly unqualified to discuss. Sharon Begely is just the latest example of someone with an English degree who thinks they should start interpreting the technical literature. (The other classic is Amity Shlaes who despite not having any economic training decided that she could 'prove' that FDR and the new deal actually caused the Great Depression)

    Hint to Newsweek, instead of hiriing Ivy league BS artists, why not hire subject matter experts? Then they would at least have a clue when it came to what they were talking about. At the very least hire someone who has actually published a scientific paper to discuss science. Or an actual doctor to discuss medicine. Otherwise you risk more shameful pieces like this article.

    • Posted By: sherrycnm @ 03/12/2009 4:47:32 AM

      Really? So ordinary citizens don't have a right to question our system even though...In 1999 the prestigious Institute of Medicine (IOM) shook the medical community to its foundation. The IOM estimated that almost 100,000 Americans die in hospitals every year as a consequence of errors.

      People were outraged. If a similar number of deaths were caused by airplane crashes or terrorist attacks there would be general panic.

      Hospital administrators and health policy wonks placated the public by promising to find ways to avoid many of these preventable mistakes.

      Now, five years later, a new report suggests that the IOM estimates were wrong. Instead of 98,000 deaths annually, the number may actually be twice that. The up-to-date analysis suggests that almost 200,000 people die each year from medical mistakes in hospitals and "that there is little evidence that patient safety has improved in the last five years."

      Imagine 390 jumbo jets full of people crashing each year. Or consider that the U.S. loses more lives every six months to medical mistakes than it lost in the entire Vietnam War.

      How is it possible that so many errors are being committed? Despite all the high-tech equipment in hospitals, such as CT scans, MRI machinery and cardiac monitors, there is a woeful lack of practical problem solving.

      As a RN CNM MSN do I have the right to ask why the US is in a tie for 29 th place (with Slovakia) in infant mortality?

      If we uncover 100 more cases of this..Doctor Admits Pain Studies Were Frauds, Hospital Says - Mar 10, 2009
      ???He was one of the most prolific investigators in the area of postoperative pain management,??? Dr. Shafer said. His fraud ???sets back our knowledge in the ...New York Times then can we question???

  • Posted By: meltoncn @ 03/04/2009 7:05:41 PM

    A non-doctor, second guessing a doctor. Makes sense to me.

    • Posted By: sherrycnm @ 03/12/2009 4:31:19 AM

      Someone has to...
      http://www.peoplespharmacy.com/archives/editorial/medical_mistakes_still_take_too_many_lives.php

  • Posted By: jjxelumich @ 03/11/2009 11:29:05 AM

    For every single example of a fraud doing dastardly deeds, such as in that nytimes article, there are literally thousands of examples of doctors who are doing the right thing and honestly publishing their findings for the sake of helping their patients.
    Consider for example:
    HIV ???In 1982, a deadly new immune disease ravages young gay communities in San Francisco. It is alarmingly infectious and universally deadly. A few years later Gallo et. Al reported a major finding that could be considered to be seminal to our understanding of how HIV works. That same year , 1984, an in-house compound was screened for fighting HIV, a compound first developed in Detroit at the Michigan Cancer Foundation in 1964. Turns out this compound was AZT and by 1985 the gov???t in partnership with pharma cos. developed AZT for the treatment of AIDS patients. Since then the understanding of HIV and its mechanism of infection has been elaborated on by over 195,859 original research articles. There are now as a result of these efforts, 5 distinct classes (Integrase , Fusion, Protease, NNRTI, and NRTI) of drugs that work synergistically to turn this deadly virus into a chronic but manageable infection, a virus that now plagues much of Africa, India, and minority populations in US.
    So yes, let???s be wary of frauds but don???t for a minute paint the whole biomedical research community including physicians with the same brush. By and large doctors are doing the right thing every day going to work with nothing more than wanting to do a good job for their patients both in the lab and in the clinic.

  • Posted By: voyager5 @ 03/04/2009 8:38:42 PM

    Journalistic malpractice has been running rampant for years, Sadly, we cannot sue these people because there is no money in it for the attorneys. It is however taking its toll, as evidenced by the decline of newspapers and news magazines. Fortunately for the American public, physicians are the most competent professionals we have. We can do without newspapers, but not health care.

    • Posted By: sherrycnm @ 03/11/2009 6:25:56 AM

      Right so this latest example is nothing to worry about?
      http://www.nytimes.com/2009/03/11/health/research/11pain.html?ref=health

  • Posted By: sherrycnm @ 03/10/2009 2:15:18 AM

    I am an RN and I've worked in almost every setting. In my twenty plus years as a nurse and a midwife I have seen a lot. This author is absolutely right in her tone and accusations. I had two major surgeries and my mother is currently being treated for cancer so I'm no stranger to either side. I have seen patients mistreated-one was struck by a resident. I've seen doctors hold pain relief because they were mad. I've gathered data for studies that were flawed from the beginning and everyone knew it. I've seen pregnant women get insulin because of a study even when they didn't need it. I watched a 14 year old be pulled off a table during forceps. To anyone who thinks "tried to kill me" is an overstatement You Are Wrong! No one really tries to kill they just don't try hard enough not to! I laid in a bed so anemic I was barely able to remain conscious and the nurse (non-English) was having trouble with the IV. I kept waking back up to ask "what unit is that?" I don't think she understood my fear but that unit hung for about five hours before I threatened to take it down myself-clots you know are somewhat of a problem and I didn't need anymore! It is not safe to be in a hospital in this country without a sitter (paid or family.) I feel terrible to admit it but it is true. I will eventually write a book but I'll have to get further away from my 12 year stint in a big county facility because it is just to awful to process this soon.

    • Posted By: jjxelumich @ 03/10/2009 5:28:44 PM

      If things were really that awful the expectation would have been for you to say so at the time to the people that needed most to know. I don't see the point in waiting for all these years after the fact to write a tell all that doesn't really help anyone.

      • Posted By: sherrycnm @ 03/11/2009 5:48:50 AM

        I did tell-you don't get it do you? The system is a mess and very little if anything is working the way it is supposed to. I have the forms where I wrote up part of this stuff-Nobody wants to hear it. They want their re-imbursement, their perfect baby, the accreditation... The day I write all this down is the day I forfeit 10 plus years of education and work-if it were easy the system wouldn't be so broken.

    • Posted By: Country Doc @ 03/10/2009 3:26:06 PM

      "Big County Facility" means public or socialized medicine folks. You can see how well that works.

  • Posted By: EmilyLK @ 03/10/2009 5:15:49 PM

    My experience with doctors and their interest to current-evidence based science is "it depends on the doctor." As a patient, it's very hard to know which physician is up to speed on the research and which physician is prescribing something that is outdated or new and not as good as something older. One of the best doctors I ever worked with actually sent me a letter citing some of the research he read in medical journals on my particular problem. What a relief to work with someone of that caliber. He was also a professor which, in my opinion, is a pretty good way to assure that your provider is up to date on the science.

    I don't think this problem is unique to the medical profession. As a teacher, I saw wide variations in skill as well. Unfortunately, as with all things, it's a bit of "buyer beware." It's very important to ask good questions of doctors, verify their qualifications, and talk to other people that are in a position to help you. Nurses and nurse practitioners can be a great help and I wish they were encouraged to speak up more when they thought that something was being overlooked or mishandled. I also think it's important to go back to doctors that have really been helpful and thank them for their good work.

    I don't think effectiveness research should worry any effective doctor.

    • Posted By: jjxelumich @ 03/10/2009 5:35:58 PM

      But therein lies the problem in part of the reasoning about "it depends". You can't take anectodtal evidence and apply it to an entire profession , as you plainly point out. Indeed every physician is required to have continuous medical education to maintain their licence to pracitice in any given state.The problems I think are not so much that physicians are not keeping abreast of the research but rather intepretation of the research itself. Science can be very tricky thing especially when it comes to ppl. I mean people still debate evolution for crying out loud. So, just because a study is published with a particular finding does not preclude it's conclusions as universally true. It takes time, trial, and yes error before the studies work there way through to the "best clinical practices". Don't forget these points either.

  • Posted By: A Concerned Physician @ 03/09/2009 2:29:59 AM

    I'm not sure why doctor bashing has become such a popular sport nowadays. But I can tell you this... It was rather foolish for Newsweek to send me a free evaluation copy for my waiting room containing this article. I believe that handing out "free samples" puts you in the same category as Big Pharma. Quid Pro quo?

    • Posted By: LangDoc @ 03/09/2009 11:59:34 AM

      Dear Concerned Physician, The reason that there is such a backlash for your profession is that so many of us on the receiving end have too many horror stories to tell about fatal and near-fatal experiences with your kind. For example, my husband is deathly afraid to see a doctor for any reason after a couple of surgeons almost killed me. I had a female gynocologist (wouldn't a woman be more sensitive to another woman's problems?) who, after years of severe problems, performed a surgery. After the surgery, she reported to my husband that I must have really been in severe pain for quite a while because it was "really bad in there" - she had assumed, for some reason, that I had been exaggerating reports of excessive bleeding and pain. Then, before I even got out of recovery, she left on vacation (which we didn't know was planned). Her partner signed the release papers for me without seeing me, and before I had held down any liquids or solids and while I still had a fever two days later. I was at home a week, with infection draining from holes which had broken open in the skin around the incision, and when the doctors office was called, the doctor had the nurse tell us that this was "normal". When I could no longer maintain conciousness and I was turning yellow, my husband took me the morning of the fifth day to the emergency room - after calling our insurance company and getting clearance. When the doctor's office was called, the partner (my surgeon was still on vacation) reported to the attending in the ER that I was a trouble-maker and that I should have called for an appointment at the office later in the week, so the attending refused to treat me and lectured my husband that it was slackers like us who were raising insurance rates through the roof. Considering I could not maintain consciousness lying down much less sitting up, plus the yellow hue indicating liver failure, a nurse took my husband aside and explained that, by law, he could insist on me staying until the doctor saw me. I was put in a room to hallucinate in a fever, shiver, and drain out pus from an abnominal incision, becoming more dehydrated, for the rest of the day. The doctor left the office at the end of the day, went home and dressed to go out, then stopped by the hospital. I came to briefly when he took the sheet down and said "My God." I was in the hospital for 2 weeks with rounds of antibiotics. All over the country people have their own stories to share.
      When the only people who have seriously tried to kill you - and almost succeeded - and could simply bury their mistake with no fear of consequences - and still get compensated big bucks for doing so - are doctors, there are going to be people that start questioning your ablities.
      Still wonder why some of us perceive you and your kind as necessary evils and one step above voodoo doctors? Embrace evidence-based practice and develop some empathy.

      • Posted By: A Concerned Physician @ 03/10/2009 1:00:50 AM

        First off, assuming that because I disagree with the obviously inflammatory tone of this article that I dismiss science and have no empathy is quite a stretch. "You and your kind" is an extremely prejudiced statement. Would you say that if you knew I was a black, or Jewish, or female?

        Second, I find it highly implausible that any ER physician in their right mind would discharge a septic and jaundiced patient, regardless of what a gynecologist said over the phone. Laboratory tests and physical examinations are objective, not subjective. Pain is subjective based on a variety of factors. Everyone interprets what they feel differently. No surgeon wants to operate without a very good reason to do so because even when performed 100% correctly and by the book, complications still occur. There are risk/benefit ratios to consider (how's that for evidence-based?). You obviously developed a complication, But nobody "seriously tried to kill you". That part of your story is clearly embellished for effect.

      • Posted By: jdcheng @ 03/09/2009 11:38:32 PM

        Just a thought:

        a) I'd bet your doc wasn't being paid "big bucks" for your case. Most surgeries are paid lump-sum, with its inherent (not explicit, anyway) dis-incentive to follow-up on complications.

        b) A bigger focus is being made on work-hours limitations on trainees, and physicians in general. Without a significantly larger pool of physicians, what happened to you will be a matter of course - discharge over the phone, delays,etc.

        c) it's just as problematic IMHO that you decided to go to the ER "after calling our insurance company and getting clearance". That and statements after make me wonder who was really in control of your care - your doctor or the insurance companies.

        Did your doctors provide problematic care? It sure sounds like it. But perhaps this is a symptom of an overall problem (e.g. the way healthcare is provided in America), rather than the problem itsellf

      • Posted By: jjxelumich @ 03/09/2009 6:56:40 PM

        You are right there are too many horror studies. Physician do need to constantly evaluate what is working and what is not and to improve outcomes for their patients. But you can't take the horror studies as representative of all the work that physicians do everyday. For example, take breast cancer, it wasn't long ago when this may have been considered a very deadly diagnosis. In the 1980s the mortality rate (per 100k) in white women was just under 35%. As of 2005 that same mortality rate has dropped to about 24%. That is a nearly 10% reduction in the death rate of white women from breast cancer, in spite of the fact, that incidenc of breast cancer in that group has remained relatively the same. (Source: http://planning.cancer.gov/disease/Breast-Snapshot.pdf). That my friends is just one example of success we have had from early detection and better treatments. All of which is built on good science.

        • Posted By: jjxelumich @ 03/09/2009 7:08:55 PM

          studies should say stories (sorry i wrote in the heat of the moment)

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