Not to mention that few docs are going to correct the patient who says “doc, thanks for ordering that (unneccessary) test, you saved my life!”

I have a very hard time convincing women they don’t need yearly pap smears. Doesn’t help that many gyn’s still do them yearly, despite clear evidence and recommendations that you are more likely to cause harm doing that.

agree. When I was in medical school, I was taught by definition, carcinoma in situ, was not “cancer”. Not cancer until in penetrates the basement membrane

yes and no. Majority of cancer is found by woman herself. However, and this is an important distinction, a well designed study showed no benefit to routine self exam. Women did just as well picking up lumps from randomly feeling them in the shower, etc. as they did when doing the old fashioned monthly regular self…

obviously great it turned out to be nothing, but imagine a different scenerio. Say you could a significant infection, requiring drainage and IV antibiotics. You have now incurred all that pain, risk and cost for “nothing”. This is the issue with false positives. One thing can lead to another

difference between a screening test and a diagnostic test. If you “flunk” your mammogram, you are by definition in a higher risk group, and we are will to accept a much higher false positive rate. We feel confident if ultrasound is negative, end of story. However, if positive, you need more invasive testing. For a…

actually pretty good evidence and data on colonoscopy. Benefits and risks much better elucidated. There are fewer “flavors” of colon cancer, and pretty much all are bad and inevitably grow (unlike breast cancer where many do not). Talk to your doc about colonoscopy. the general rule is 50 for average, 40 if a first…

classic story. Every one knows a woman whose “life was saved by a mammogram because cancer was caught early.” The problem is we often don’t know that at all Recent study on DCIS, the most common type of early cancer picked up by mammogram in young women showed NO BENEFIT TO TREATMENT. That’s right, with that type of…

huge (much higher than mammogram) false positive rate to both of those tests. There is a huge increase in biopsy rates, without any proven benefit when they are used for screening. That leaves aside probably 10-20 x increased cost per test

Great article! The effects of false positives and overscreening are poorly understood by physicians, and even more so by the public. Any decision for a test or treatment that affects very large populations needs to be taken VERY seriously. Asprin for all, mammograms, etc. have huge effects. Pretty much by definition,…

Oh, I was just kidding. However, by the “logic” of groups like this, which frequently push “listening to the real expert on the kid, the parent” they should take note of the fact that a majority of their “experts” don’t think it is related to vaccines. I won’t hold my breath waiting for that though

Maybe that’s what we should start to push? 60% of parents of kids with autism DON’T think it was related to vaccines. Why aren’t we listening to the parents? University of Mom. Mom knowledge, etc. etc. Why listen to the (dumb) minority of parents?

locker rooms have been designed in recent years to accomodate the idea that press will be there. Also important to note, given the size of a team, and the number of coaches, aides, owners, owner’s friends, various jack off VIP’s etc. there are already 100’s of people walking around that locker room. It’s not like if…

I was really psyched because I thought amber was wearing blue nylon Nike cortez, my shoe choice for 35 years. However, I realized it was someone else’s leg. I’ll never match her (or anyone really) for style.

read even a bit more about her, and your position will quickly sour. She’s been voting pretty straight line Republican. Given next years election, she just wants to position herself as a moderate, but she really ain’t.

Unlike solid red states, she needs to get votes from people who understand that the goverment does do real stuff like run the parks, the VA’s, national defense, etc. Thus she can’t throw in with the total batshits.

Vast majority of insurances do not allow waiver of copay. You can not charge for the visit totally, but contractually, if you bill the insurance company for the visit, you MUST take a copay from the patient. I know many docs do it, but it is pretty explicitly against the contract with the insurance company.

As a family doc who delivers babies and does plenty of paps/ “gyn” exams, we always have women wear a (nondisposable, cloth) gown, open to the back, with a drape over them. Reason being both the reast exam, and that I do a full skin exam as part of the annual. I don’t (and doc’s shouldn’t) do a annual pap smear.…

couldn’t believe nobody said Mosi before you!. Great name drop from the simpsons. Tried to find a video link of it, but couldn’t

Brother of Mortimer and Randolph Duke. They founded Duke and Duke investment house.