Saturday, November 21, 2009

Language matters

And in my final post of a trifecta today, and to reassure those of you who worry that I buy too much into the Two Cultures phenomenon, I give you a prime example of the intersection of humanities and science.

Take medicine as art and distill it into a coding language. Politics as sausage is sterile by comparison.

Coding taxonomies seem dry until you recognize the magnitude of their influence in our current f**ked up healthcare system. John refers to them as deadweight. I prefer to think of them as red matter. I don't have the patience or aptitude to distill our healthcare dreck into a better future state. Thanks to John, I don't have to.

Albert Crewe obit

From the NYT obit for Albert Crewe, U Chicago Physicist who pushed electron microscopes to show atoms for the first time:

In a public lecture shortly after becoming the director of Argonne, Dr. Crewe bemoaned the growing gulf between scientists and laymen.

“There are too many people behaving like the proverbial ostrich and hoping that science will go away if they bury their heads in the sand,” he said, “and this in spite of the fact that the last few decades have indicated strongly that science will not go away.”
Say hi to Galileo for me Albert. RIP.

That's what I'm talkin about

I can't believe I missed Robbie Aronowitz' NYT mammogram editorial on Thursday!

THE United States Preventive Services Task Force’s recommendation this week that women begin regular breast cancer screening at age 50 rather than 40 is really nothing new. It’s almost identical to the position the group held in the 1990s.

Nor is the controversy that has flared since the announcement something new. It’s the same debate that’s gone on in medicine since 1971, when the very first large-scale, randomized trial of screening mammography found that it saved the lives only of women aged 50 or older. Despite the evidence, doctors continued to screen women in their 40s...
...Even though [the screen at 40] consensus was more asserted than definitively proved by experimental evidence or clinical observation, it soon became dogma...
...You need to screen 1,900 women in their 40s for 10 years in order to prevent one death from breast cancer, and in the process you will have generated more than 1,000 false-positive screens and all the overtreatment they entail. This doesn’t make sense. We could do more research and hold more consensus conferences. I suspect it would confirm the data we already have. But history suggests it would never be enough to convince many people that we are screening too much.
You've heard the rabble and the science. How many times will Galileo be tried before we get it right? Robbie's piece has, sadly, been written before. Different names, same ending.

[disclosure: I'm a proud faculty mate of Robbie's in Penn's Department of Family Medicine and Community Health.]

Monday, November 02, 2009

Has hell frozen over?

I work with many wonderful orthopedists who continue to see patients without regard to payor. That isn't true for most private orthopedics groups in town who continue to refuse medical assistance patients. Still, I wasn't expecting this... – orthopedists asking for my pay to be raised.

I'm gonna have to send them some link love.