Why are cancer organizations waiting until it starts to rain before they suggest buying an umbrella?“Join my Medicare Advantage plan and get free membership to a local health club, free glasses and dental care.” This time of year, during Medicare Advantage Annual Enrollment period, the only TV commercials that annoy us more often are for lawyers who want to help us if we were injured at work or in a ...
Richard Leff, MD
How generational changes of physicians will affect oncology
Nothing makes a physician feel older (or should) than realizing that he/she just started a discussion with a younger colleague, fellow, resident or student with the sentence "When I was in training ... "In a recent article in the health section of the New York Times, Gardiner Harris skillfully depicts the culture gap between younger and older generations of physicians. Using a ...
Unrealistic optimism in early phase new drug studies
In a thoughtful posting in the New York Times, Dr. Pauline Chen, a well respected observer of the doctor-patient relationship, points out an ethical dilemma that faces cancer researchers working in drug development conducting early phase (I) new drug studies. Ethicists have identified that patients in these studies often have unrealistic optimism about their personal outcomes despite ...
Radiation treatment errors with Intensity-Modulated Radiation Therapy (IMRT)
In a recent series of articles in the New York Times, Walt Bogdanich uncovered an alarming series of radiation treatment errors associated with implementation of new computerized treatment technologies such as Intensity-Modulated Radiation Therapy (IMRT).Based on this article, reporting hundreds of cases, some of them fatal, it appears that a variety of causes are associated with errors, including inadequate training of physicists and radiation therapists, difficulty physically validating ...
Early detection and improving cancer cure rates
Reading the newspapers and watching the news lately would lead you to believe that screening for cancer is largely a waste of time.Yet, in the same week that the NEJM published Norwegian data showing a remarkably small survival benefit of 2% associated with screening mammography, HealthDay reported a decrease in cancer incidence of almost 1% per year from 1999 to 2006 and a decrease in cancer deaths ...
Should OSHA create work rules for physicians in training?
Recent rules issued by the Accreditation Council for Graduate Medical Education (ACGME) for resident work hours have further limited the consecutive and total number of hours that medical trainees may work. These measures, originally created because of safety concerns, are intended to decrease the number of fatigue-related errors made by physicians in training. They have received broad support within the medical community.A recent story published by Mike Lillis in The ...
Comparative effectiveness could impede cancer therapy progress
In an editorial published the New York Times, a strong argument was made for studying the relative effectiveness of screening colonoscopy and sigmoidoscopy. Based on a review in JAMA of three studies conducted outside the US that showed no difference in colon cancer mortality or incidence when the two procedures were compared, the Times proposed a US study to answer this question.Comparative effectiveness (CE) research, a relatively new concept in ...
