Yes. This.

Read this excellent post on Science & Sensibility in reaction to this already excellent article in the New Yorker about health care costs and outcomes. I had the same reaction as Amy Romano when I read Atul Gawande’s article:yes yes, but what about obstetrics? If you need an example of costs and procedures run wild at the expense of outcomes, there you go.

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5 Comments

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5 responses to “Yes. This.

  1. Read it. Agree. Why is a surgeon commenting on the state of obstetrics anyway? Makes no sense.

  2. Christopher

    I was a bit shocked to read that cardiac catheterization is employed so casually. It’s great as a treatment, but as a testing method it’s massive overkill. When I was treated for WPW, I received about 30 rems during the procedure. I wasn’t informed how much it would be in advance, and I had to specifically ask the RSO to calculate how much I had been irradiated afterward. (30 rems is nothing to sneeze at either, it’s a third of a lifetime worth of exposure.) Anyway, I think it would be great if risk/benefit analysis was used more often so that interventions are only deployed when they are clearly beneficial.

    This also reminds me of another article about unnecessary treatment:
    http://www.doctorsopposingcircumcision.org/info/info-forcedretraction.html

    • MomTFH

      The only physician I have talked to about this is very opposed to any governmental intervention in physicians deciding what tests and procedures to run. Her father happens to be head of the AOA.

      I can see how this can be a slippery slope into excessive control of doctors in some far fetched worse case scenario. possibly, and necessary items are denied, but I don’t want to err only in the direction of all technology and procedures being fine, either. Right now technology run rampant without evidence based, outcome guided reins isn’t helping patients, either. And, somewhere deep in my heart, I really think most doctors want to do the best care for their patients, not just prove they can fly by the seat of their pants because they’re so gosh darned knowledgeable.

      Anyone in the medical field should realize that information is always changing. I would think anyone would want to know what practices are going to make their patients healthier and provide better results. Looking at statistics on iatrogenic morbidity and mortality should make most health care pracitioners cringe, I would hope.

      I think non profit, doctor run boards who analyze outcomes and use of best practices should be supported by the government financially but not run by them. I think this will support cost cutting in most areas and improve outcomes.

  3. I don’t think circumcision is unnecessary. In fact, many of the uncircumcised males in my family have had countless issues related to being uncircumcised. I believe that the choice for circumcision is the families choice and that people who choose to circumcise be respected for their family decision.

    • MomTFH

      I interpret the available to research that routine circumcision is unnecessary. The number of circumcisions needed to prevent even the most minor of issues (urinary infection in the first year) outweighs the benefits. If you want to talk about family members, both of my sons are intact and have never had an issue, and neither did my father for 84 years.

      It is an elective surgery on the genitalia of the newborn. If I were a parent, (and I am), I would want a good justification for that. Since it is fairly common, I try not to make a big deal about it to parents who do choose it and can hardly be accused of disrespect, but it is hardly “necessary” on a physiologically normal penis.

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