Today’s Advice: The Doctor Will Not See You Now

So what’s in my morning copy of the LA Times today? Let’s take a look.

Page A1: Stomach stapling is a crock. “A new study has found that the surgery does not reduce patients’ medical costs over the six years after they are wheeled out of the operating room.” Actually, it’s worse than that: according to the accompanying chart, medical costs were higher for patients who got bariatric surgery.

Page A7: A group of doctors has made a list of nearly 100 medical procedures that are overused in the United States. “The medical interventions — including early caesarean deliveries, CT scans for head injuries in children and annual Pap tests for middle-aged women — may be necessary in some cases, the physician groups said. But often they are not beneficial and may even cause harm.”

Page A17: Bullying women into getting routine, annual mammograms is a bad idea. “There’s no question that diagnostic mammograms should be performed on women who have discovered a lump. But a growing number of primary-care physicians, surgeons, epidemiologists and women affected by the process have begun to question the value of telling all women they need to be checked regularly with screening mammograms.” And just so you don’t think we’re picking on women here, the same is true for PSA tests for prostate cancer.

Maybe I can get better news elsewhere? Nope. My email this morning has a link to a recent article in Harvard Magazine, in which David Jones tells us that nearly all angioplasties and heart bypass surgeries are useless. “As Jones painstakingly explains, it took years to show whether the procedures prolonged lives; in both cases, subsequent research deflated those early hopes. The interventions—major procedures, with potentially significant side effects—provided little or no improvement in survival rates over standard medical and lifestyle treatment except in the very sickest patients.”

As near as I can tell, aspirin works. Blood pressure meds work. Beyond that, I’m beginning to wonder.


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