Favorite Quotes
"For every complex problem, there is a solution that is simple, neat, and wrong." - HL Mencken
====
"I hear and I forget. I see and I remember. I do and I understand." - Confucius
====
"The good physician treats the disease; the great physician treats the patient who has the disease" - Sir William Osler
====
" The best test of a person's character is how he or she treats those with less power." - Bob Sutton
====
"Those are my principles, and if you don't like them - well, I have others." - Groucho Marx
====
"The difference between genius and stupidity is that genius has its limits." - Albert Einstein
====
"It is hard enough to remember my opinions, without also remembering my reasons for them" - Friedrich Nietzsche
====
"Anyone can make the simple complicated. Creativity is making the complicated simple." - Charles Mingus
====
"Not everything that can be counted counts, and not everything that counts can be counted." - Albert Einstein
====
"A foolish consistency is the hobgoblin of little minds, adored by little statesman and philosophers and divines. With consistency a great soul has simply nothing to do." - Ralph Waldo Emerson
====
"This ain't no party, this ain't no disco, this ain't no fooling around." - Talking Heads, Life During Wartime
====
"What is hateful to you, do not do to your neighbour. This is the whole Torah; all the rest is commentary. Go and learn it." - Hillel, Talmud, Shabbath 31a
====
"You will never understand bureaucracies until you understand that for bureaucrats procedure is everything and outcomes are nothing." - Thomas Sowell
====
"An idealist is one who, on noticing that a rose smells better than a cabbage, concludes that it will also make better soup." - HL Mencken
====
"If you only have a hammer, you tend to see every problem as a nail." - Abraham Maslow
====
"A great teacher is one who realizes that he himself is also a student and whose goal is not to dictate the answers, but to stimulate his students creativity enough so that they go out and find the answers themselves." - Herbie Hancock
====
"There are no facts, only interpretations." - Nietzsche
====
"An education isn't how much you have committed to memory, or even how much you know. It's being able to differentiate between what you do know and what you don't." - Anatole France
====
"In character, in manner, in style, in all things, the supreme excellence is simplicity." - Henry Wadsworth Longfellow ====
Nov - 15
Dec - 19
Jan - 21
Feb - 7
Mar -
Not all screening helps patients
21 Oct2009
Bravo to the American Cancer Society! (Disclosure – my daughter worked there for several years)
In Shift, Cancer Society Has Concerns on Screenings
It is quietly working on a message, to put on its Web site early next year, to emphasize that screening for breast and prostate cancer and certain other cancers can come with a real risk of overtreating many small cancers while missing cancers that are deadly.
“We don’t want people to panic,” said Dr. Otis Brawley, chief medical officer of the cancer society. “But I’m admitting that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated.”
This piece in the NY Times is thoughtful and balanced. Whenever we discuss diagnostic testing, we must understand both the benefits and the risks. The American Cancer Society has stepped up to the plate and recognized that we need to understand both benefits and risks.
Yesterday I gave a talk on guidelines, which I will give again tomorrow. In that talk I make a major point in emphasizing competing guidelines. We have had competing guidelines concerning cancer screening. The American Cancer Society is showing leadership and courage in this new direction.
If breast and prostate cancer screening really fulfilled their promise, the researchers note, cancers that once were found late, when they were often incurable, would now be found early, when they could be cured. A large increase in early cancers would be balanced by a commensurate decline in late-stage cancers. That is what happened with screening for colon and cervical cancers. But not with breast and prostate cancer.
Still, the researchers and others say, they do not think all screening will — or should — go away. Instead, they say that when people make a decision about being screened, they should understand what is known about the risks and benefits.
This discussion is healthy for physicians. It should remind us all that medical decision making is rarely black and white. Politicians would like to simplify the complexity of improving medical care. Insurance companies (including Medicine) want to make rules about testing and treatment. Lawyers want excuses to sue physicians about missing diagnoses.
We must always balance errors of omission and errors of commission. This article should inform those who think medicine is really easy.
Related posts:
- Prostate cancer screening
- Mammograms and cost containment
- Politics and mammograms – I am disgusted and disappointed
- More on screening for cancer
- When guidelines differ – prostate cancer
Related posts brought to you by Yet Another Related Posts Plugin.
- In: Medical Rants
1 Response to Not all screening helps patients
Michael Kirsch, M.D.
October 21st, 2009 at 7:23 am
Vindication for the Whistleblower? http://bit.ly/OVzkj