Tuesday, November 24, 2009

How outrage over new cancer screening recommendations might positively impact health care reform

Opponents of health care reform have used the new recommendations for breast and cervical cancer screening as a weapon to derail health care reform. The argument is that a "government run system" will deny you the necessary services you need. I am sure that the Obama administration is not happy with the timing of these controversial recommendations, which is likely why Health and Human Services Secretary Kathleen Sebelius came out immediately and distanced the administration from supporting these new recommendations.

Over at Kevinmd.com cardiologist and blogger Dr. Joel Sherman posted an excellent piece called Informed consent is missing from Pap smears and cervical cancer screening. His post points out that many women were simply told to have a pap without discussing the potential pros and cons of doing the test or not doing the test. I was impressed, though not entirely surprised by the many comments of frustrated and angry women who felt like they have been forced to have cervical cancer screening unnecessarily, especially when the doctor mandates this as a pre-requisite to refilling birth control prescriptions. Below is the comment I posted, which I decided to put on my own blog:

"Screening for any disease, whether a pap smear for cervical cancer, rectal exam for prostate cancer, mammogram, colonoscopy etc. is a complicated decision. With the recent release of changed guidelines for cervical cancer and breast cancer, the public is now becoming more aware of this issue. The best thing for both patient and doctor is a conversation about the risk and benefits for both screening and not screening. This is now more important than ever since now there are several guidelines with very conflicting recommendations. The problem is that our current health care system reimburses quite well for procedures and diagnostic tests. It does not reimburse well for important conversations. This is why patients who use their health insurance to see their primary care physician (as most people in the US do) have only brief and what must seem like rushed visits with their doctor. True informed consent about these important matters will only happen if we change the current structure of our reimbursement system. Paying doctors to discuss the pros and cons of screening, testing, and treatment will actually save money because (especially as evident by many of the comments already posted by women angered by likely unnecessary pap smears), it will likely lead to fewer tests and procedures."

I am hopeful that the screening controversy is in the public domain, the public will start to place more value on having these conversations with their health care providers. Once people realize that the reason why these conversations are lacking is because of our broken health care system, this will move more people to help support health care reform.

1 comment:

Joel Sherman said...

Thanks for the praise.
If you really want to see what women think about all this, go to my blog and read the 350 comments (if you have a week). Most are on cervical cancer, but also other issues are hit on.
It is full of intelligent angry women who feel abused by the system. This wasn't a topic I knew much about until the women convinced me by giving bountiful references.