There is nothing like getting up in the morning and reading the latest medical pronouncements from a government bureaucrat whose greatest accomplishment in life is deciding between Lucky Charms or Coco Puffs for breakfast. That is how I felt the other morning when I read about the government's new "suggestions" regarding mammograms and Pap smears. As a service to patients and friends, I am putting out this special edition of the newsletter to address these important issues and allow me to vent so my head won't explode!
Let me say at the outset that I think these new recommendations are at best horrible and at worst dangerous. Just so there is no confusion about where I stand on this, let me reiterate my position: you can take these recommendations and make Origami giraffes out of the paper they are printed on because it will be worth more (I've heard there is quite the market for Origami giraffes) and at least you won't die from folding paper; whereas you might from these guidelines.
I could spend the next few thousand words giving you example after example of patients in my own practice who are alive today because of screening mammograms and timely Pap smears, but that would only prove my point too easily, so let me opine on a deeper level and dissect not only the recommendations but also the not so subtle reasons behind them.
First, the mammogram controversy. In a world besieged with pink ribbons and "Save the Ta Ta s" bumper stickers, you would think that anything we could do to lesson the impact of breast cancer would be a good thing. A survey a few years back listed the fear of breast cancer as the greatest health concern of women over 40. The controversy surrounding when to begin mammograms and how often to follow up has raged for years, but now the government appointed Preventive Services Task Force has said that those low risk women under 50 should simply bury their heads in the sand and not only not get mammograms but forget about doing self breast exams. Why, you ask? It's all about the money! Doing early routine mammograms are not cost effective they profess, which is a fancy way of saying the accounting wonks have determined that saving the life of 5 women per 5000 is not worth the expense of early detection. Try telling that to those 5. The arrogance of this group is astounding. Dr. Otis Brawly of the American Cancer Society said it well, "The task force advice is based on its conclusion that screening 1,300 women in their 50s to save one life is worth it, but that screening 1,900 women in their 40s to save a life is not. That stance is essentially telling women that mammography at age 40 to 49 saves lives, just not enough of them."
What you have here is a government controlled group of statisticians, ivory tower research doctors, and scientists who have rarely cared for patients making "recommendations" based on population statistics and cost analysis. Interestingly, this same Preventive Services Task Force is given frightful influence in the new "health care reform" legislation slithering through Congress. This is simply a blatant attempt to ration care. Essentially the government is saying that you may have this screening but your younger sister may not. Supporters clamor that these are simply suggestions and that the final decision is between you and your doctor. Whereas this is exactly where the choice should rest, the real world dictates that as soon as insurance companies adopt these guidelines as the "standard of care" (and history proves that is exactly what happens) then even if your doctor thinks a screening mammogram is a good idea, if you don't fit into one of the categories designated by this powerful task force, your insurance company may not pay for the procedure. They will quote the oft spoken diatribe, "We are not saying you can't have the test, we are just saying we are not going to pay for it."
The bottom line is that science, good medicine, and common sense dictates that low risk women get screened by age 40, every 2 years until 50, and then yearly after that. And for goodness sakes (and your sake) do your self breast exams! They actually save more lives than mammograms.
It is embarrassing as a member of the American College of Ob-Gyn to hear of their latest dictates surrounding Pap smear frequency. As a clinician for the past 21 years, I have treated numerous young women with pre-cancer changes of the cervix that, if they had abided by the new Pap guidelines, would have been subjected to hysterectomies, radiation and even death from missed cervical cancer. We are living in a time of epidemic infections of the Human Papilloma Virus (HPV) the causative agent of cervical cancer. We have never seen the volume of infections nor the mass of girls under 21 infected with the virus as we are documenting now, and we have no clue as to the long term impact of these infections. The rate of cervical cancer has plummeted over the past several decades due solely to early detection ( by means of regular Paps) of changes that are easily and completely curable. To revert back to a time when women walked into my office with large cancer lesions on their cervix from neglect and a lack of detection seems ludicrous. What the American College of Ob-Gyn won't say is that the biggest risks for these infections are early onset sexual activity and multiple sexual partners. The liberal leaning political hacks that make up the leadership of this organization will support your 15 year old getting an abortion but will never promote an abstinence program, and they now say young women don't need the "stigma" of being labeled as having a sexually transmitted infection. It is hard for me to take the advice of a group that is supposedly championing women's health when I see them making recommendations that hurt women.
The bottom line for Paps: get them yearly and begin when you become sexually active (not like the woman who answered my question, "Are you sexually active? with, "No, I just usually lie there!").
Folks, if you want a taste of what government run health care will be like, check out the rationing in these guidelines. After all, they did such a great job in getting plenty of H1N1 vaccines distributed, didn't they!
Blessings,
Ron
P.S. address hate mail and dissenting opinions to obamacare@stayoutofmyhealthcare.com
Let me say at the outset that I think these new recommendations are at best horrible and at worst dangerous. Just so there is no confusion about where I stand on this, let me reiterate my position: you can take these recommendations and make Origami giraffes out of the paper they are printed on because it will be worth more (I've heard there is quite the market for Origami giraffes) and at least you won't die from folding paper; whereas you might from these guidelines.
I could spend the next few thousand words giving you example after example of patients in my own practice who are alive today because of screening mammograms and timely Pap smears, but that would only prove my point too easily, so let me opine on a deeper level and dissect not only the recommendations but also the not so subtle reasons behind them.
First, the mammogram controversy. In a world besieged with pink ribbons and "Save the Ta Ta s" bumper stickers, you would think that anything we could do to lesson the impact of breast cancer would be a good thing. A survey a few years back listed the fear of breast cancer as the greatest health concern of women over 40. The controversy surrounding when to begin mammograms and how often to follow up has raged for years, but now the government appointed Preventive Services Task Force has said that those low risk women under 50 should simply bury their heads in the sand and not only not get mammograms but forget about doing self breast exams. Why, you ask? It's all about the money! Doing early routine mammograms are not cost effective they profess, which is a fancy way of saying the accounting wonks have determined that saving the life of 5 women per 5000 is not worth the expense of early detection. Try telling that to those 5. The arrogance of this group is astounding. Dr. Otis Brawly of the American Cancer Society said it well, "The task force advice is based on its conclusion that screening 1,300 women in their 50s to save one life is worth it, but that screening 1,900 women in their 40s to save a life is not. That stance is essentially telling women that mammography at age 40 to 49 saves lives, just not enough of them."
What you have here is a government controlled group of statisticians, ivory tower research doctors, and scientists who have rarely cared for patients making "recommendations" based on population statistics and cost analysis. Interestingly, this same Preventive Services Task Force is given frightful influence in the new "health care reform" legislation slithering through Congress. This is simply a blatant attempt to ration care. Essentially the government is saying that you may have this screening but your younger sister may not. Supporters clamor that these are simply suggestions and that the final decision is between you and your doctor. Whereas this is exactly where the choice should rest, the real world dictates that as soon as insurance companies adopt these guidelines as the "standard of care" (and history proves that is exactly what happens) then even if your doctor thinks a screening mammogram is a good idea, if you don't fit into one of the categories designated by this powerful task force, your insurance company may not pay for the procedure. They will quote the oft spoken diatribe, "We are not saying you can't have the test, we are just saying we are not going to pay for it."
The bottom line is that science, good medicine, and common sense dictates that low risk women get screened by age 40, every 2 years until 50, and then yearly after that. And for goodness sakes (and your sake) do your self breast exams! They actually save more lives than mammograms.
It is embarrassing as a member of the American College of Ob-Gyn to hear of their latest dictates surrounding Pap smear frequency. As a clinician for the past 21 years, I have treated numerous young women with pre-cancer changes of the cervix that, if they had abided by the new Pap guidelines, would have been subjected to hysterectomies, radiation and even death from missed cervical cancer. We are living in a time of epidemic infections of the Human Papilloma Virus (HPV) the causative agent of cervical cancer. We have never seen the volume of infections nor the mass of girls under 21 infected with the virus as we are documenting now, and we have no clue as to the long term impact of these infections. The rate of cervical cancer has plummeted over the past several decades due solely to early detection ( by means of regular Paps) of changes that are easily and completely curable. To revert back to a time when women walked into my office with large cancer lesions on their cervix from neglect and a lack of detection seems ludicrous. What the American College of Ob-Gyn won't say is that the biggest risks for these infections are early onset sexual activity and multiple sexual partners. The liberal leaning political hacks that make up the leadership of this organization will support your 15 year old getting an abortion but will never promote an abstinence program, and they now say young women don't need the "stigma" of being labeled as having a sexually transmitted infection. It is hard for me to take the advice of a group that is supposedly championing women's health when I see them making recommendations that hurt women.
The bottom line for Paps: get them yearly and begin when you become sexually active (not like the woman who answered my question, "Are you sexually active? with, "No, I just usually lie there!").
Folks, if you want a taste of what government run health care will be like, check out the rationing in these guidelines. After all, they did such a great job in getting plenty of H1N1 vaccines distributed, didn't they!
Blessings,
Ron
P.S. address hate mail and dissenting opinions to obamacare@stayoutofmyhealthcare.com
