Thanks, Its not only the drug co. that can be unscrupulous.
Regards Peter MacIsaac MacIsaac Informatics Consulting in Health Informatics, Terminology & Data management and Health Policy. [EMAIL PROTECTED] 0411403462 (mobile) 61611327 (office) peter_macisaac (skype) 8 Ewart St. Yarralumla 2600 "We trained hard, but it seemed every time we were beginning to form up into teams, we would be reorganised. I was to learn later in life that we tend to meet any new situation by reorganising, and a wonderful method it can be for creation the illusion of progress while producing confusion, inefficiency and demoralisation." - From Pertonii Arbitri AD 66, attributed to Gaius Petronus, a Roman General who later committed suicide. -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Ken Harvey Sent: Thursday, 9 March 2006 8:03 AM To: General Practice Computing Group Talk Cc: [EMAIL PROTECTED] Subject: Re: [GPCG_TALK] Increase in Pathology / Radiology ordering ABC Radio National Health Report, March 6, 2006, was the last of a 3-part series on, "Cancer Screening, Benefits and Harms", see: http://www.abc.net.au/rn/healthreport/stories/2006/1582008.htm# The following transcript extract adds an additional reason why pathology tests are increasing..... Alex Barratt: Dr Gil Welch, a physician with the US Department of Veterans Affairs. Today we're going to look at how you might make your own decision about which cancers, if any, you want to be screened for. Before that though let's take a look at the forces that drive cancer screening. As we've seen over the last two weeks, cancer screening has some pretty big downsides. Yet almost everyone's strongly in favour of it. So the question is why there's so much public and professional enthusiasm for it. Gilbert Welch: There's no single answer to that question. I think there are a number of explanations. Just the idea of early cancer detection is just so appealing. People are very genuinely scared by cancer and there's a widespread belief that gee there's no reason not to look for cancer early, and there's every reason to look for it early. And this is part of a broader culture that uncritically accepts medical testing is a good thing, without recognising that testing does have downsides, that it does find things that otherwise wouldn't bother you, and that it can start a chain of events that's very difficult to stop. Now I'd like to add a couple of other drivers, and it would not be correct not to bring up the topic of money. There are strong incentives. One of them is obviously for the test manufacturer or for the physicians that interpret them, whether they're mammographers or radiologists, they're good business right. Because they involve a lot of people, so they're big markets. It's also become in the interests of medical centres to find cancer early. I'd like to read a quote by Otis Brawley, a urologist who went on to be a director of the Georgia Cancer Centre and worked at Emory University. He wrote that 'We at Emory had figured out that if we screen a thousand men at the North Lake Mall this coming Saturday we could bill Medicare and insurance companies for about 4.9 million dollars in health care costs'. But he goes on to write that the real money comes later from the medical care that the wife will get in the next three years because Emory cares about her man, and from the money we'll get when he comes to Emory's emergency room when he gets chest pain. I think there's a lot of interest in garnishing patients, and one way to get patients is to offer free screenings. Alex Barratt: Dr Gil Welch. One current example of a significant commercial opportunity is the test for human papilloma virus, the virus that causes cervical cancer. Not surprisingly the test is being strongly promoted by its makers, Digene who think it should be incorporated into cervical cancer screening because they argue it's good for women. But there's a lot of dispute about whether it would actually add anything to screening other than a lot of anxiety and cost. Dr Angela Raffle is a world leader in research on cervical cancer screening, and she's had a close look at what Digene's been up to in promoting the HPV test. Angela Raffle: The British medical Journal carried an article saying that perhaps we should solve all the problems in cervical screening by using HPV testing. And our newspapers are full of photographs of very well known celebrity women who apparently were campaigning for all 15 European nation states to introduce HPV testing into the cervical screening program right away, Carol Smiley, Honour Blackman, Jilly Cooper. I think they would be the most prominent. Well fortunately a very astute investigation of a journalist spotted that something strange seemed to be happening. And he contacted all the celebrities who were named on the website for the group. None of them knew that they had anything to do with the campaign. He managed to track down who'd set up the campaign which wasn't easy because it all traced back to a PO Box in Brussels. Nobody was allowed to divulge who'd set it up. But it turned out to be Burson-Marsteller which is a big PR company who were working on behalf of Digene, and they'd completely manufactured the whole celebrity group. Alex Barratt: And they had done it to put pressure on governments in Europe and the UK, to include HPV testing as part of the screening program? Angela Raffle: They'd done it precisely for that. And it creates the impression that oh well HPV testing must be a good thing because all these very high profile women must have independently looked at the evidence and made their minds up. Alex Barratt: Dr Angela Raffle runs the NHS Breast and Cervical Cancer Screening Programs in Bristol, England. Research in the prestigious journal of the National Cancer Institute found that 70% of US women and 60% of men had seen celebrity endorsements in the past year. About a quarter said the endorsements made them more likely to be screened. -- Dr. Ken Harvey Adjunct Senior Research Fellow School of Public Health, La Trobe University http://www.medreach.com.au VOIP: +61 (03) 9029 0634; Mobile +61 (04) 1918 1910 _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
