Dr. Kevin Pho offers the opinion that not all cancer screening tests lead to better cancer treatment:
Here's a excerpt: "As much as we'd like to believe that early detection automatically leads to better care, that is not always the case. There cannot be a one-size-fits-all approach. Persuasive arguments can be made for and against screening, and the decision is a highly personal one. But patients must be better informed of the potential consequences either choice can bring."
Your thoughts?
In my opinion, he is absolutely correct, but USA Today does not provide the page or two needed for an adequate explanation of his reasoning, nor, regrettably, does he do so on his blog.
ReplyDeleteThe take-home message is "there cannot be a one size fits all approach." Some screening tests will work well for certain subgroups of patients, and some screening tests are just not adequate yet. Both patients AND physicians (emphasis on the latter) need to educate themselves about this issue, for every test available
nonlocal MD
so are the doctors who take the time, educate their patients, engage in shared decision making, and try to reach a truly personlized and informed decision with the patient going to risk the label "poor quality physician" when their screening numbers are more "nuanced" under P4P ranking schemes?
ReplyDeleteSeems it's easier to be "high quality" and just scare every patient into getting every screening test being measured.
I wholeheartedly agree that more has to be done to educate the wider public on some of the basic concepts in epidemiology namely a better understanding of test specificity, sensitivity and the generation of false positive test results.
ReplyDeletePatients must learn to examine with their physicians, the benefits and risk for both (potential) disease and treatment to make choices consistent with their personal definition for quality of life.
I used a recent article in the Washington Post to explore this on my own blog, enBloom. I expanded the discussion to included genetic testing as well.
I believe that most patients do not understand this idea. They feel cheated if they are not given a test they have heard about. They assume you are cutting costs at the expense of their health. They figure a lot more people die from having no test. You're up against a big hill here. --But it has to be done!
ReplyDelete