1) The JAMA-inspired uproar du jour is industry-sponsored CME.
My take: Without industry sponsorship, very few physicians will attend any full-price CME meetings. You may not like or accept it, but that’s the reality.
In any case, I get most of my CME from UptoDate and don’t worry about whether a CME meeting is “tainted” by the industry or not. Reading an article a day gets me all the CME hours I need.
2) The American Cancer Society approves virtual colonoscopy as an acceptable method for colon cancer screening.
My take: As I mentioned yesterday, I think it’s premature.
One obvious winner here would be the radiologists. The majority of the public prefers CT over endoscopic colonoscopy. What a windfall it would be for radiologists if/when insurance companies start paying for these studies.
Some caveats. If anything was found on the imaging study, a real colonoscopy will have to be performed to biopsy any suspicious lesion. Also, I’m not convinced that the data supports virtual colonoscopy being as comprehensive as the endoscopic approach.
Part of me wonders if the radiologists have the ACS in their back pockets, or if the gastroenterologists did anything to piss them off.
3) I read another article today suggesting how easy it is to “Google” your diagnosis.
My take: When physicians Googled diagnoses, they were right only 58% of the time. Are these articles saying that the public is happy with that kind of accuracy?
I don’t think search engines will be replacing physicians anytime soon.
Related posts:
- Virtual colonoscopy
- Medicare will not cover virtual colonoscopies, gastroenterologists breathe a sigh of relief
- Virtual colonoscopy
- Covering a virtual colonoscopy, or not, will test the cost-cutting will of Medicare
- Should Medicare cover a virtual colonoscopy?
- How accurate is a colonoscopy to screen for colon cancer?
- Virtual colonoscopy
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Googling diagnosis – People will be happy with a 58% accuracy if the Googled diagnosis errs on the bad side. In other words, I’d be happier if my Google diagnosis tells me I have pancreatic cancer, but a visit to the doctor proves that I just have a bad cold. (Yes, this is hyperbole.)
A bad google diagnosis, I think, helps people that are looking for an excuse to take the time to go see a doctor.
From a traditional-role-of-doctors point of view, this is a response to the problem that many patients cannot just call their doctor in the middle of the day and ask if their symptoms are something serious. Do doctors take out-of-the-blue direct calls from patients? Or does an administrator answer the phone and schedule an appointment sometime next month?
I think you have it right, that-xmas. There are many times in which I’ve wished to ask a physician before potentially wasting both my and his time.
Case in point: a relative of mine presented with three fixed, nontender, swollen posterior cervical nodes and one enormous suboccipital node. No infection, cat exposure, night sweats or fever. Possible fatigue, possible 5 lb weight loss, both unsure because he works a high stress job. Late 20s.
Google says he has Hodgkins. Except because they’re hard, he has non-Hodgkins. Or AIDS.
Since less than <1% of enlarged lymph nodes turn up malignant, he would have loved to know if he should go to the doctor quickly, or in a couple of months. The GP ran a normal CBC and referred him to an ENT, which has left him even more unsure of whether or not he's wasting the doctor's time or if there might be something serious.
When I was a kid I still remember the nurse reassuring my mother over the phone that such-and-such was unlikely to be serious and not to come in unless Y, Z and Q happened. My guess is that modern liability has destroyed that option.
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