Very insightful commentary.
Sincerely. Brooks Bradley.
jhi...@aol.com wrote:
> re: Dr. Heartless and Dr. Greed-
>
> Lemme get the big spoon and stir it up some more. I had a business for 10
> years doing consulting in electronic imaging and manufactured a high
> resolution laser scanner designed for genetic research. We became
> peripherally involved with the film business (Kodak, DuPont, Fuji) since our
> scanner scanned their films. The scanning approach was excellent for
> mammograms since it could quantitatively compare a prior year's cysts and
> calcifications for growth and movement.
>
> This was at a time when two things of major significance were happening
> in the film industry, a huge $ industry; 1) Chest X-Rays (14"x17") were
> being superceded by MRI's and CT's, both capable of filmless operation.
> 2)Technologies were being development for direct exposure filmless X-Ray by
> Fuji and DuPont themselves.
>
> Lo and behold, around this time, it suddenly(!) became essential for women
> to have mammograms (100% film-based) yearly after age 40. Hmmm. Well, OK,
> maybe it's not such a bad idea, even though there is a significant risk of
> developing cancer from the radiation, and/or aggravation (sp?) of an existing
> condition from compressing (really compressing) the breast to make it
> essentially of uniform thickness to be X-Rayable.
>
> So, we get the bright idea to market these scanners in Canada. Bad idea.
> Why? Because the Candian medical establishment/government had current
> studies on 20,000 (yes 20,000) women conclusively proving that there was no
> evidence that mammography screening increased the likelihood of early
> detection. They saw absolutely no value in it.
>
> Sooo, I start to call around here in the US to get a copy of this
> study...NIH (where we had some connections), NCI, ACS, etc. Can't be found
> anywhere, never heard of it, 'Canadian what?'. After a year I went directly
> to the Canadian government to get it, and it was for real. I looked for
> years for a review, statement, rebutal, comment, or even an acknowledgement
> of this major study in the US medical mainstream, but never found it. That
> there was never even a review concluding that the 'study was flawed' aroused
> my intense curiousity. Eventually it showed up 6 or 7 years later in some
> women's magazines.
>
> Now, I'm not Doctor bashing here, they work their asses off 20 hours a day
> doing everything in their power to help their patients. They simply do not
> have time while in practice to keep up with every new study and development
> that comes along, that's not their job and thats not what they spent 8-12
> years and $150K to do. They treat patients with the best medical knowledge
> available to them. (key phrase)
>
> But, you have to keep your eye on medical suppliers, pharmaceutical
> companies and big money establishments here, for they're the ones that plan
> and execute the studies and determine what knowledge gets distributed to whom
> and how, and what constitutes a 'cure'. I don't know a single person,
> doctors especially, who would knowingly ill-advise a patient, assuming they
> had the knowledge of a better way. But there's an awful lot going on in
> other countries that they don't know about and will never be exposed to,
> unless they do international internships, which was one of the amazing things
> about the Mayo Clinic. The Doc that did the laser excision on my sister was
> one of 100 docs in the US who know this procedure. They spent time in Germany
> learning the technique.
>
> Also, there is the issue of infrastructure, which is sort of
> double-edged sword. The long-term investment in education, literatre,
> methodology and hardware is enormous, and must be recouped, even if a more
> promising technique is developed in the interim. An imaging center with a 3
> million dollar investment in MRI and CT equipment, techs, nurses, facilities
> and radiologists sure as hell isn't going to recommend that you try a
> virologist instead, they're going to snap a picture and see what shows up.
> That's their business.
>
> Bottom line, US medicine is a business like any other, caveat emptor
> supercedes all. It's got it's share of foibles and the costlier and larger
> it gets, the slower it's able to move and adapt. It's up to the patient to
> take the time to verify, explore, and decide with the very best advice you
> can find. Don't expect the medical establishment to do it for you, they're
> on a mission that started 5, 10, 25 or 50 years ago for most Docs, and
> they've not had a minute since to reflect on what else might work better.
> -Jim
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