Thursday, March 05, 2009

Socialism's Scientific Method

Thank God journalists in the United States can spew forth opinion in the name of self-righteousness and indignation free from interference from faceless bureaucrats. If bureaucrats were in charge, they might require that journalists make generalizations about a profession they know nothing about to push their socialist-leaning agenda in the name of readership. Oh wait, they are. I am so relieved that journalists can still breathlessly demonstrate why doctors hate science after never spending a day at a patient’s bedside.

Welcome to socialism’s scientific method.

Doctors, you see, make more money than journalists. Therefore, they are inherently evil since everything they do is about money.


For example, doctors use expensive hypertensive agents because all patients can be treated with simpler, much less expensive agents that have been “definitely shown” to be more effective. Why? Because they are easily corruptible by evil pharmaceutical and device companies that have added nothing to our pharmaceutical or therapeutic armamentarium in the last ten years.

And doctors get MRI’s in patients with back pain when cheaper CT scans are just as effective because… well, I’m not sure, but I know there’s a reason. Oh, I know, to make money! (What’s that you say? The hospital owns the machine and the doctor doesn’t get paid the technical fee that covers the cost of the MRI – oh, come on now, don’t bore me with the details!)

It’s hard not to scream when journalists make such sweeping generalizations about doctors without any attempt at identifying the potential problems inherent to surrendering individualized care to a central governmental Politburo in the name of the “efficiencies and cost savings” of comparative effectiveness research. After all, what's $1.1 billion when we're talking trillions in government bailout?

But where has this $1.1 billion in your tax dollars already gone? Well, much of it has gone to the very “efficient” and “non-biased” bureaucratic Agency for Healthcare Research and Quality (AHRQ) or the National Insitute of Health. Please recall that it was the AHRQ that helped fund the “non-biased” research that advocated for adding cardiac resynchronization therapy (CRT) to hospital guidelines for the treatment of heart failure with barely acknowledging the investigators’ and the American Heart Association's deep ties to the device industry. (Hey, it was a sound scientific study based on chart reviews!) And of course, we can still thank the NIH for their bloated and hightly efficient National Center of Comparative and Alternative Medicine! Where would we be without their ongoing work on echinacea that showed it was worthless for the common cold? I feel relieved (don't you?) that because some critized their study that the echinacea dose was "too low" that they still accept proposals for continued work in this area!

And when the journalist needs a pacemaker, what does she say?

"You're not going to give me one of those old, recalled ones, are you? I want the best!"

Thank God the government and their left-leaning journalistic sycophants can provide us with all the answers. Certainly, us “doctor-scaremongers” and our patients have nothing to fear now that they’re in charge.


Addendum: Also republished at MedPageToday. (Additional commentary there).

1 comment:

Jay said...


Overall I agree with you, but you've got to admit there is a ton of crap going on in medicine.

I see suboptimal care outside of accepted guidelines all the time. I see industry influence in the presciption of meds and devices all of the time as well. I see doctors ordering unneccessary tests because they are too lazy to seek out old records.

The main problem, as I see it, is that doctors rarely are truly accountable for their actions. Privacy laws prevent easy oversight and patients aren't capable of evaluating the quality of the care given. Even when shoddy care is given and everyone knows it, only rarely does someone speak up.

I, for the most part, try to practice fairly strict evidence based medicine. I strive for cost effectiveness. I'm happy to have someone look over my shoulder. I'm not really thrilled with interruptions, but I should be able to defend any of my actions. Can you think of any other job with this degree of responsibility with less checks and balances??

We've gotten ourselves into this mess. You have to agree that doctor's decisions in delivering care are strongly influenced by money. I realized a long time ago, that I'd know I was a good doctor if my care would be the same in a capitated versus a fee for service environment. Do you think most doctors live up to this ideal?

I don't want to become a robot following someone else's rules any more than you. I do think so degree of oversight would have it's benefits.

Rant complete.