I'm not suggesting that there are physicians who would operate to remove a perfectly healthy kidney just to make a buck. My reference is to those who perform procedures that haven't been proven to improve outcomes.
I don't believe for a microsecond that you would want to take that flexibility away from the physician. If the decision rests not with him, with whom then? I know you and I agree it shouldn't be a government committee somewhere. But if there are three or four articles questioning the outcomes of a particular procedure, should that make it off-limits?
The one that comes to mind is C-Sections. There are tons of articles purportedly proving that a C-Section does not improve outcomes in a given set of circumstances.
However, does that mean that a physician should abandon his judgment and stop doing them in those circumstances? Not necessarily. There are a lot of reasons a physician might different with the study -- it may be that in HIS opinion, the study doesn't reflect his own personal results. The particular case might be just sufficiently different from the typical case that he believes the C-Section affords some better opportunity. The physician might just be more "comfortable" with the C-section in this situation over a vag delivery.
Or it could be he's trying collect an addition $300 (here, the charge for the global OB care including vag delivery is about $2,800 versus $3,100 with a C-sec).
I just don't buy it. I'm not saying it NEVER happens, but I think for the most part there are legitimate reasons for physicians to make the decisions they do in this respect.
I have high lp(a), fibrinogen, and homocysteine. Those are all risk factors for heart disease. My lp(a) is off the charts--ten times the top of the reference range. I changed my diet dramatically to try to reduce my risk. How could testing those markers after a year on the new regime possibly not be medically useful? My diet is now very low cal, virtually no sugar or starch, very high fat. How could testing my lipids, metabolism, and blood sugar after a year of that not be medically useful?
Maybe you've got the wrong physician. I can't imagine going in for an annual physical and my physician not checking my lipids or sugar. |
