Dr. Otis Brawley has taken the gloves off on prostate cancer screening.
Brawley, chief medical officer of the American Cancer Society (ACS), makes some powerful statements about controversies in prostate cancer screening in a new YouTube video that is billed as the first of a series that the ACS will post on discussions with its officials.
Key nuggets from this video — not surprising to anyone who has followed this debate or Brawley’s past comments — include these quotes:
“I’m very concerned. There’s a lot of publicity out there – some of it by people who want to make money by recruiting patients – that oversimplifies this – that says that ‘prostate cancer screening clearly saves lives.’ That is a lie. We don’t know that for sure…
…We’re very concerned about a number of clinics that are offering mass screening where informed decision making – where a man gets told the truth about screening and is allowed without pressure to make a decision – that’s not happening. Many of these free screening things, by the way, are designed more to get patients for hospitals and clinics and doctors than they are to benefit the patients. That’s a huge ethical issue that needs to be addressed.
We’re not against prostate cancer screening. We’re against a man being duped and deceived into getting prostate cancer screening.”
You can’t be well-empowered if you hear advice wrong. That’s why in a participatory relationship, an essential skill is accurate handoff of information.
The Foundation for Informed Medical Decision Making (FIMDM), catchily pronounced “fimdim,” has been working for years to improve patients’ knowledge of options and alternatives. In [the September 20th] Boston Globe Liz Cooney talks with people from FIMDM about the issue. An excerpt:
What doctors explain and what patients understand might be two very different things, recent research suggests.
Ideally, patients talk with their doctors about the pros and cons of a particular treatment, weighing the risks and benefits, exploring alternatives — including doing nothing — and then come to a conclusion. That’s the goal of the informed consent process, best known by the paperwork patients sign at the end saying they heard doctors describe what they may be getting into.
A Boston non-profit, FIMDM is the force behind Gary Schwitzer’s excellent Health News Review service, which analyzes health news in the media, teaching e-patients and policy people to sift the gold from the garbage.
*This blog post was originally published at e-Patients.net*
One part of the health care law that took effect this week is widely reported as “establishing a menu of preventive procedures, such as colonoscopies, mammograms and cholesterol screening, that must be covered without co-payments.” For example, one of my local papers, the [St. Paul, Minnesota] Star Tribune, wrote: “Some people will no longer have to pay for copays, coinsurance or meet their deductibles for preventive care that’s backed up by the best scientific evidence.” (emphasis added)
That phrase should always include a huge asterisk, like the one hung on Roger Maris’ 61st home run. The best scientific evidence according to whom?
Time magazine reports, “Procedures, screenings and tests that are considered ‘preventive’ will be determined by the U.S. Preventive Services Task Force, the Centers for Disease Control (for vaccines) and the Health Resources and Services Administration.” As written, that is incorrect and inaccurate at worst and misleading at best. Read more »
I have a lot of catching up to do after being in Europe for just 4 days. But I can’t let this one go by without comment. In fact, this issue was one of the first ones raised by German journalists I met with in Dortmund this week. Don’t think people around the world don’t notice the good AND the bad in American health/medical/science journalism — especially by The New York Times.
The Times took a long time (five weeks) to comment on what critics — including me, Paul Raeburn, Charlie Petit and many other journalists (including Times’ ombudsman Arthur Brisbane) — wrote about Gina Kolata’s August 10 piece on a “100% accurate” Alzheimer’s test. But [on September 16th] the paper published a correction. Read more »
It is so important to keep this discussion alive. The miscommunication that took place last November of what the U.S. Preventive Services Task Force tried to convey, and the complicity of some news organizations in adding to that confusion, provide lessons from which we simply must learn to do better.
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