Here it is. Excerpts:
Lenox Hill Hospital, part of the North Shore-LIJ Health System, is offering a free informative evening on Thursday, January 8th from 6-7:30 p.m. with David Samadi, MD, chair of urology and chief of robotic surgery, about what women can do to help keep the men in their lives healthy and happy. The presentation will be followed by a question-and-answer period, and everyone is the audience will be receiving a free T-shirt.
“Woman are the most proactive healthcare champions in the family and are the driving force in men’s health,” said Dr. Samadi. “We want women to promote men’s health issues with a particular focus on those associated with the prostate and sexual function so they can encourage healthy lifestyle choices for the men in their lives.”
Dr. Samadi will be challenging the audience to participate in “The Samadi Challenge.” Created as a way to promote the importance of prostate health, the Samadi Challenge has gone viral over Facebook. "I asked women who have a man in their lives to get his PSA (prostate specific antigen) and testosterone levels checked," Dr. Samadi said. "They then had to record a message that challenged three women they know to do the same and post the video.”
I'm not going to go through all the recent studies about PSA and testosterone tests. You can do that on your own. What I am going to say is that in neither case is there reason to believe that an unselected population of normal men should have these tests.
This doctor and through him this health system are engaged in advocacy that will cause overuse of the health care system. Add to that the inevitability of a number false positives from the PSA tests, leading to an unnecessary number of biopsies, some of which will cause harm to patients.
So, we have to ask, is this a doctor doing this on his own, or does it have the support of the health system's administration? Is this a scientifically based clinical program or a business development program?
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Addendum: Dear readers, after reviewing the extensive and thoughtful comments below, please turn to the follow-up post on this topic, in which NS-LIJ Health System responds.
25 comments:
This doctor is clearly trying to imitate the success of the ALS ice bucket challenge. I wonder how many other shysters are doing the same thing.
From Twitter:
It is indeed very wrong. Oz-like.
From Twitter:
Agree. Especially with the current push for thoughtful PSA testing to diminish overdx & tx
From Twitter:
Those 4 more impt than PSA. What is most important male prev health issue: BP smoking diet exercise
From Twitter:
Free t-shirt? Good grief.
It appears people are becoming inured to brazen (false) 'infomercials' by medical professionals. I guess I am idealistic enough to still find it highly offensive. Do we really want to be members of yet another 'let the buyer beware' vendor group?
When I visit doctors (I rarely) I now cross out "Patient" and put "Customer." I encourage everyone to do the same and explain why.
Same hospital system, different hosp: med director is nephrologist who owns (for profit) dialysis center across the street. Fed regs require pts to be informed of other treatment options including transplantation, but in fact this center tells pts to accept dialysis as their only option, dismisses the possibility a pet can find a donor. This is like a methadone clinic not encouraging addicts to get clean, clearly profit driven.
Wait, that's the guy who wants women to stop hogging all the health care. Yikes.
http://youtu.be/MyqQj4ReZHk
People on dialysis die much earlier than people with transplants.
Looks to me like this is all marketing and fools are falling for it. I found this earlier blog piece about his marketing behaviour. He must have a very organized marketing team.
http://surgicalopinion.blogspot.com.au/2014/02/be-smart-about-how-you-read-marketing.html
Lee, a fascinating link. In my opinion, here is the problem (quote from the link):
"I am currently registered as a medical practitioner with the Australian Health Practitioners Regulatory Authority. AHPRA has strict advertising guidelines. There is also a code of conduct published by the Royal Australasian College of Surgeons (and endorsed by the Urological Society of Australia and New Zealand) that dictates my appropriate behavior as a surgeon. If I were to have written such an advertisement, I would unquestionably be investigated by AHPRA and run risk of punitive actions and I would also stand a significant chance of being stripped of my surgical diploma from the RACS for breaches to our code of conduct. Dr Samadi is not required to adhere to Australian licencing regulations or code of conduct but in my opinion, there appears to be a lower bar for this behaviour in the United States."
Great photo, too. The banner reads "Wormwood Motors" in apparent reference to the apprentice demon of the same name in the CSLewis satire "The Screwtape Letters"
Isn't this a bit like saying let's stop teaching (and performing) CPR because it only works sometimes? Sorry Paul, I agree with this doctor,and I can't fault his marketing strategy either. The PSA pendulum has swung too far in the opposite direction. Because of this trend, my urologist now only wants to check mine twice yearly, and I have prior PC diagnosis and treatment. Let's forget what's fashionable, let's forget the politics, and let's get real!
Paul,
I couldn't disagree more strongly. It is insulting to suggest that everything physicians do is financially self-serving. Men are recognized to be poor advocates for their own health, so many of us that deal with men's health enlist the help of their female partners. With regard to PSA and testosterone testing, there are strong arguments for testing, despite public pronouncements to the contrary. Here is my question to you, and your readers:What should an MD do if asked how to help men with their health, if he has opinions on the topic based on experience and evidence? Every suggestion leaves someone vulnerable to attack. I urge you to avoid ad hominem attacks. Men need a lot of help!
Disclosure: I have received payments for consulting and research grants from companies producing testosterone products.
"Chair of urology and chief of robotic surgery" = Cha-ching!
Like the best of deceptive practices, it mixes in 90% good advice with 10% questionable. It is true that women (mothers in particular) are the health champions in most households. It is also true that men are reluctant to discuss "sensitive" health issues.
It most likely very good and sound advice right up to the point where the instructor advocates "and therefore you should convince someone else to get this diagnostic intervention."
To readers, please make sure to read the comments on the follow-up blog post, here: http://www.runningahospital.blogspot.co.uk/2015/01/oh-ns-lij-we-hardly-knew-ye.html
Abe asks the straw man question: "What should an MD do if asked how to help men with their health, if he has opinions on the topic based on experience and evidence?" Of course, that's not the situation here, is it? Peter has it just right. Most MDs would not consider it appropriate to give generalized advice regarding diagnostic tests to a broad population of men (or women).
Abe also overstates the point of this blog post by creating another straw man: "It is insulting to suggest that everything physicians do is financially self-serving."
As to scientific disagreements over the value of such testing, they certainly exist. Given those disagreements, is it appropriate for one physician who believes one way to, in essence, encourage a man to bypass his own MD who might believe the other way--and to do so in a public campaign enlisting the help of the man's mate? How could we consider that kind of approach to giving medical advice to be ethical, even just considering relationships within the profession? "Oh, your doctor is too stupid or ill-informed to properly advise you, so I'll get your mate to convince you to go down this diagnostic path." That's a lot different from suggesting to a single patient that he get a second opinion.
In addition to Paul's extremely cogent response above, I would like to add as both a physician and a woman, the idea of a "Facebook challenge" directed to women in an attempt to multiply the screening and a "free t-shirt" is offensive and, IMO, unprofessional. How can one regard that as other than brazen advertising? Lots of hospitals offer 'education seminars' on various subjects like hip replacement, cancer etc. which no doubt are subtle attempts to drum up business too, but I have seen none so openly hucksterish.
Also, just because men don't want to discuss sensitive health subjects is no reason to ignore them and treat their wives as their mothers and themselves as babies. How are you ever going to have an educated patient otherwise? It's patronizing and demeaning.
In general, screening tests are fraught with complications. They often have poor specificity (lots of false positives) and are associated with substantial harm. They cost money, cause anxiety and often have no effect on all-cause mortality, and minimal effects on disease-specific mortality. For this reason, I find campaigns to generate mass screenings (mammograms, PSAs, etc) to be deeply flawed. Any conversation re: screening should take place between a patient and their primary care doctor who knows them best AFTER other high impact interventions such as smoking cessation and diet/exercise. Not between a patient and a radiologist or breast surgeon (who benefit from mammographies) or between a patient and a urologist (who benefit from mass PSAs). The science behind screening is far too nuanced (as is the epidemiology) to be applied en masse. For this reason, the USPSTF continues to refine its screening guidelines. Here is a breakdown of the PSA screening data by the wonderful site NNT.
http://t.co/FreRv2pTDm
Jonathan is exactly right; in fact screening tests are deliberately designed for high sensitivity at the cost of specificity, because the idea is to cast a wide net to detect the abnormality. Their accuracy also declines with a lower prevalence of the abnormality in the population - which is precisely why an unselected population in this case should not be screened.
It is no surprise that radiation therapists think the best treatment for prostate cancer is radiation, and urologists think the best treatment is surgery. Patients, unfortunately, now can no longer trust a doctor with a stake in the treatment.
Is there really any wonder why physician public opinion polls have been steadily dropping for the last several decades? It's sad so many well-intended physicians get branded by charlatan quacks like this in their never ending quest to dial for dollars.
Hey nolocal MD, agree with you about context. What Samadi does is indeed legal but in poor taste and with a behavior less than I would expect from a senior doctor. I forgot to mention the other great blog from that Australian MD on disclosure. To me it sounds there is some deal between the Forbes writer and Samadi. I think they both work at the same hospital and the writer does publicity work for his hospital. http://surgicalopinion.blogspot.com.au/2014/09/dr-glatter-and-dr-samadi-together-in.html
That's begging the question if I've ever seen it, and down right disrespectful. Health issues affect everyone and stats indicate that most people walking around deal with some sort of ailment day to day. It costs everyone: time, mental / physical health, and money.
To suggest one demographic is the driving force behind intelligent health decisions cannot be seriously backed up by data.
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