Every medical organization comes up with guidelines that benefits their members. The American Urological Association has more aggressive prostate cancer screening guidelines, resulting in increasing business for urologists in the form of prostate biopsies.
DrRich gives a pointed example with the American Heart Association’s ADHD recommendation:
In making this recommendation the cardiologists of the AHA have attempted to encroach upon the turf of the pediatricians, ostensibly to save the lives of innocent children, but in a manner that will inevitably increase business for cardiologists by a) generating hundreds of thousands of ECGs for them to interpret at $25 – $50 a pop, and b) generating tens of thousands of echocardiograms and other cardiac tests that will be necessary to evaluate all the equivocal (and to a very large extent false positive) ECGs that will result from this routine screening, while c) explicitly leaving the pediatricians themselves out of the process.
Guidelines from professional organizations generally should be viewed with a skeptical eye. Unbiased guidelines, like the USPSTF, should be the gold standard instead.
Related posts:
- Should children be screened with an EKG prior to starting stimulants for ADHD?
- Nancy Snyderman: Is she aware of any evidence-based guidelines?
- Will patients accept the new, evidence-based, breast cancer screening guidelines?
- Who’s not happy with the new prostate cancer screening recommendations?
- The drug industry and anti-smoking guidelines
- Who monitors clinical guidelines?
- Prostate cancer screening in blacks, and the lack of balanced information
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{ 7 comments }
So, why are so many physicians in lock step on proper cholesterol levels when the latest panel had serious conflicts of interest (i.e. 8 out of 9 had financial ties to the drug companies)?
It’s the same way with fire safety guidelines (firefighters just trying to protect their turf and make more money) or companies that provide instructions with their products (firms like Apple or Betty Crocker have a vested interest in making sure you know how to use your iPod or make a cake). You can’t trust anyone these days!
I strongly urge all doctors sued for malpractice to always sue the relevant guideline makers, the authors as individuals, and their academic employers for failure to supervise them and for negligent hiring.
1) The idea of cookbook medicine is wrongful on its face.
2) Guidelines reflect the medicine of 7 years ago, without providing adequate warning of such obsolescence.
3) Guideline makers have a duty to do no harm. They know they will be used as spears 90% of the time and as shield for defendant 10% of the time.
Deter these enemies of clinical care.
The AHA will next be recommendeing echo stress tests and angiograms on all ADHD kids.
Can’t be too careful you know. Its for the children.
Another example would be Eli Lilly’s hand in the whole “surviving sepsis” campaign. A proxy for their worthless expensive Xigris drug.
Or Genentech’s hand in the AHA as proxy to promote tpa for stroke.
My only question is how are you going to get those ADHD kids to sit still so you can get a good EKG tracing for the Peds Cardiologist to read. Perhaps give them a sedative first but before that there is probably some diagnostic test in a guideline somewhere to make sure they are healthy enough to receive the sedative.
Any possible crimes of urologists and cardiologists are more than fairly balanced by the sins of groups like the "preventive services" task force, an arm of the US Department of Health & Human Services. A list of its members can be found buried deep within the website of the Agency for Health Research & Quality (AHRQ): http://info.ahrq.gov/
Its members are dominated by so-called "primary care" MDs and shills for the HMO sector. They do not include a single cardiologist, oncologist, pulmonary medicine specialist or endocrinologist competent to compile guidelines on heart disease, cancer, COPD, diabetes and all the other common causes of chronic illness and death in the US.
Watch out for phony guidelines, wherever they come from, including the federal government in the Bush Administration.
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