Dangers of "entertainment" medicine

I found this article interesting, and very telling of the risks parents and others run when using medicine for personal gain or entertainment rather than what it's true purpose is:

The latest concern comes from a study that suggests, in mice at least, that ultrasound can affect the development of the fetal brain.

Even so, researchers say the findings should not keep pregnant women from having ultrasound scans when needed for medical reasons.

When pregnant mice were exposed to ultrasound, a small number of nerve cells in the developing brains of their fetuses failed to extend correctly in the cerebral cortex.

"Our study in mice does not mean that use of ultrasound on human fetuses for appropriate diagnostic and medical purposes should be abandoned," said Dr. Pasko Rakic, lead researcher and chairman of the neurobiology department at Yale University School of Medicine.

However, he added in a telephone interview, women should avoid unnecessary ultrasound scans until more research has been done.

www.cnn.com...

Interesting, no? Obviously, as the doctors state in the article, there is no reason for an expecting mother to avoid her necessary sonograms, but they need to avoid frivolous sonograms outside of their scheduled appointments. Perhaps this is a fault of the private medical system, no? If a patient comes to a private OB/Gyn practice and asks for an extra, several thousand dollar, sonogram, I'm sure many doctors would oblige. I'm curious, though, if in a public health setting, where money is a little tighter, these extra "entertainment" ultrasounds are still being performed?

Mariella

Its an interesting thought. A few years ago, an U/S tech mentioned a large number of fellow techs that were having difficulty hearing and that hers has started to slip. Given the amount of time they are in and around the machine, I wonder of further study of this group is warrented as well.

Edit: I remember being offered this '3-D" ultrasound that would give us a computer generated image of what our kid would look like. We declined, but this certainly would be a frivilous use

[edit on 8/9/06 by FredT]

It's called an "appeasement study" and it's not confined to sonograms of fetuses, but runs the entire gamut of diagnostic medicine. Countless times I've seen a patient badger a physician with little more than idle curiosity until an exam is ordered (the worse case I ever saw was an MRI of a patient's brain because she saw a show on Discovery Channel and thought it would be "neat" to have one). Or a patient has a particular "symptom' that won't go away until some form of diagnostic study "proves" there's nothing wrong. Finally, I have even seen a couple of cases of "appeasement surgery," one of which actually involved the amputation of a foot.

The problem with these practices is twofold, first and foremost, it's unnecessary, and in some cases dangerous, second... Someone has to pay for it.

That brings to mind the proliferation a few years ago of the drop in MRI / CT / US clinics where they would scan you head to toe and a radiologist would then read it on what for the most part were healthy patients. People would pay out of pocket for the test.

The treatment by apeasement syndrom is all to well. We recently spent 10K plus on a helichopter transport for a child that was going to a regular care area because the oncology doctor caved in to the parents demands to do so. Nevermind that the ground transport would have taken about the same amount of time (no helipad at the refering hospital so we had to take a regular ambulance from the airport to the hospital and back), and the unpresurized chopter put the already hypoxic patient further at risk

Originally posted by FredT
That brings to mind the proliferation a few years ago of the drop in MRI / CT / US clinics where they would scan you head to toe and a radiologist would then read it on what for the most part were healthy patients. People would pay out of pocket for the test.

It's flat out quackery... The so called "screening MRI/CT" is nothing but a cash money grab by unscrupulous providers. There's insufficient resolution to adequate delineate pathologies, and any "real positives" are anecdotal at best.

Here's what Canada thinks.

As long as we are talking about unnecessary medical proceedures we might as well toss in "Defensive Medicine". By Defensive Medicine I mean a doctor ordering an expensive test just to cover his a$$ against a medical liability lawsuit. It has been estimated that as much as 40% of diagnostic testing is done as Defensive Medicine.

I would agree but the medical staff has to CYA cause of the litigous environment. thats why medical liability reform is needed.

*loam puts on his raincoat, 'cause he's certain with this crowd, he's gonna get wet*

I can't help but bristle at the "blame the patient" tone found in this thread. While I'm sure such ridiculous examples exist, they hardly compare to the slew of significant problems easily found in the medical profession- whether privately or publicly funded.

Medication Errors Hit 1.5 Million Americans Annually

Malpractice Insurers Inflated Losses, Study Finds

U.S. Health Care Most Expensive & Most Error Prone

In the Hospital, a Degrading Shift From Person to Patient

Medical errors go unreported

There is no shortage of material concerning what is broken in the health care industry...

I'm sorry, but terms like "appeasement study" and "entertainment medicine" are nothing more than blaming the "patient" for the medical establishment's exploitation of the patient's ignorance. The vast majority of these incidents happen because there is financial interest involved...not because the patient held a gun to the physician's head.



[edit on 9-8-2006 by loam]

Originally posted by loam
not because the patient held a gun to the physician's head.

It's because they hold a lawyer to physician's wallets...

Originally posted by Mirthful Me
It's because they hold a lawyer to physician's wallets...

I don't think this article is helpful to that argument.

Malpractice Insurers Inflated Losses, Study Finds

In official documents filed with state regulators and in statements to public officials, medical malpractice insurance companies consistently inflated the amount they estimated they would pay out in claims, according to a study released by the nonprofit Foundation for Taxpayer and Consumer Rights (FTCR).

Insurers then used the overstated figures to justify enormous increases in doctors' premiums and pressure legislators to enact lawsuit restrictions, the study concludes.

Malpractice insurers inflated their losses by an average 46% each year between 1986 and 1994, the study found. During that period, insurers reported $39 billion in losses to regulators, but actually paid out only $27 billion in claims.

More...

Once again, let's blame the patient...



[edit on 9-8-2006 by loam]

Originally posted by loam
I don't think this article is helpful to that argument.

I don't think this article is helpful to yours.

It's hard to believe that physicians, with so much invested in their education and careers would just quit, unless there was some overwhelming factor. That factor is litigation and malpractice insurance costs.

I don't blame patients... I blame patients and lawyers.

I'll see your tit and raise you a few tats!

The Medical Malpractice Myth

Medical malpractice premiums are skyrocketing. “Closed” signs are sprouting on health clinic doors. Doctors are leaving the field of medicine, and those who remain are practicing in fear and silence. Pregnant women cannot find obstetricians. Billions of dollars are wasted on defensive medicine. And angry doctors are marching on state capitols across the country.

All this is because medical malpractice litigation is exploding. Egged on by greedy lawyers, plaintiffs sue at the drop of a hat. Juries award eye-popping sums to undeserving claimants, leaving doctors, hospitals, and their insurance companies no choice but to pay huge ransoms for release from the clutches of the so-called “civil justice” system. Medical malpractice litigation is a sick joke, a roulette game rigged so that plaintiffs and their lawyers’ numbers come up all too often, and doctors and the honest people who pay in the end always lose.

This is the medical malpractice myth.

Built on a foundation of urban legend mixed with the occasional true story, supported by selective references to academic studies, and repeated so often that even the mythmakers forget the exaggeration, half truth, and outright misinformation employed in the service of their greater good, the medical malpractice myth has filled doctors, patients, legislators, and voters with the kind of fear that short circuits critical thinking.

More...

See also:

MEDICAL MALPRACTICE: MYTH VS. REALITY

And take a look at this example:

Survey: D.C. Medical Society Fabricated Obstetrician Shortage

The D.C. Medical Society (MSDC) has grossly understated the number of obstetricians practicing in the District, according to a survey released by Public Citizen.

The survey, which sought to identify and determine the status of all District obstetricians, found that obstetric services are readily available and dozens more obstetricians are delivering babies in the District than MSDC claims.

"This study unmasks the D.C. Medical Society as a cynical fear-monger, willing to go so far as to exploit the anxieties of expectant mothers to push its political agenda," said Jillian Aldebron, civil justice counsel for Public Citizen's Congress Watch division, which conducted the survey.

"These are the same scare tactics used by medical groups across the country: Create the perception of a doctor shortage then assert that it can be cured only by changes in the law that would shield negligent doctors from accountability when they injure patients and deprive victims of the compensation they deserve," Aldebron said.

More...

Sorry, I'm not buying the evils of frivolous medical malpractice suits as the bulk of the problem.


[edit on 9-8-2006 by loam]

People have to be intelligent consumers and intelligent patients. Many people hear about a thing on the news as the "newest and best way" when the product or service has not been fully tested or used for any significant period of time. Even on this site you have to be careful of ads-- regarding the topic -- the danger of ultrasounds to babies in the womb an ad came up on the side

Welcome to 3D Baby Fetal Imaging
3D BABY Fetal Imaging is a fetal imaging centre that offers parents-to-be an opportunity to view their baby using the exciting technology of 3D and 4D ultrasound.

Advancements in ultrasound technology now allow parents, family and friends to watch with incredible real-time clarity as the unborn baby moves in the mother's womb.

Imaging is performed by a skilled ultrasonographer with General Electric's state-of-the-art Voluson 730 Pro®, in a comfortable and relaxed setting. Parents are welcome to invite family and friends to share in the joyous experience!

The ultrasound images are viewed on a 42" plasma screen, and are accompanied by the sounds of the baby's beating heart. Parents-to-be receive keepsake 3D photos and a DVD capturing their baby's ultrasound forever.

source www.3dbaby.ca...

Like most ads that appear it is keyed to the content of the message. After reading the article would you submit your unborn child to this test? Some would and some wouldn't depending on their level of understanding and research. Who do you believe and who do you trust? A company that says its equipment is licenced to be safe or a study that brings up questions of safety of these devices. Most will probably go on the advice of their doctor --if the doctor feels the test is harmless and the customer is willing to pay for it for peace of mind??? Most doctors would probably not object unless they felt the test was harmful or unnecessary.

Would I go for it? as a person without children I don't truly know.
Most of the time I rely on my Doctor's opinion, so it depends on how up to date with these studies the doctor is, though I will discuss treatment options, and we decide on a strategy, usually brought on by what I have read, and if I am told it is hogwash by my doctor, we don't do it.

Mod Edit: Fixed Link.

[edit on 9/8/2006 by Mirthful Me]

Loam,

Having been in the healthcare field all my adult life, malpractice is a huge issue and it drives treatment etc that patient do not need. While like in every field mistakes are made, the simple fact is the amount of time and energy and resources spent because of it is staggering.

The number of people related to auditing, checking compliance with arcane and often bizzare rules (many as the result of suits) coupled with the HUGE Risk management departments majopr facilities sport actually in some cases OUTNUMBERS the number of nurses on staff.

Here is one such example: Because a nurse forgot to set monitors on a patient and the facility fears a suit this is SOP now:
1) The nurse has to check the alarms and sign a sheet.

2) Another nurse has to verify that the alarms are on and set to the stated orders and sign a sheet.

3) The Charge nurse then has to go bedside to bedside and do the same.

4) Then the nursing supervisor has the charge nurse sign a sheet and is also supposed to check as well (nevermind the fact that we have 200+ beds)

5) The assistant managers then audit for compliance at all of these steps. The Director of nursing audits the nursing supervisors.

While it seems trivial this eats up a huge amount of time. While its fun to point out all the mistakes, the consumer ie. the patient also has to take some ownership for what he/she allows people to do.

It is hardly a myth, I am in the middle of what can only be described as a frivilous suit regarding a transport years back. Seems like a money grab to me.

Originally posted by FredT
...malpractice is a huge issue and it drives treatment etc that patient do not need.

FredT, if by "malpractice" you mean frivolous law suits, I don't see the evidence for it...only anecdotal "that's ridiculous" stories... If by "malpractice" you mean medical mistakes, then yes...the errors of the few have burdened the many. But let's not also forget the role the insurance carriers cited above play. Regardless, patients and their lawyers are small fry in this situation. They merely serve as a convenient target of deflection from the real issue- the medical community needs to clean up its own act and the insurance carriers need to be brought under control.

Originally posted by FredT
While like in every field mistakes are made, the simple fact is the amount of time and energy and resources spent because of it is staggering.

The number of people related to auditing, checking compliance with arcane and often bizzare rules (many as the result of suits) coupled with the HUGE Risk management departments majopr facilities sport actually in some cases OUTNUMBERS the number of nurses on staff.

Here is one such example: Because a nurse forgot to set monitors on a patient and the facility fears a suit this is SOP now:
1) The nurse has to check the alarms and sign a sheet.

2) Another nurse has to verify that the alarms are on and set to the stated orders and sign a sheet.

3) The Charge nurse then has to go bedside to bedside and do the same.

4) Then the nursing supervisor has the charge nurse sign a sheet and is also supposed to check as well (nevermind the fact that we have 200+ beds)

5) The assistant managers then audit for compliance at all of these steps. The Director of nursing audits the nursing supervisors.

While it seems trivial this eats up a huge amount of time.

Again you attribute the symptom to the wrong disease. I am hardly persuaded that patients and their attorneys are predominately to blame for such nonsense. Incompetent self-regulation led to the lunacy you describe.

EDIT: BTW, it just so happens that while I have been participating in this thread today, I myself just learned ten minutes ago of a potentially dangerous situation where I was proscribed by my physician a medication that can "cause dangerous side effects when taken" with another medication I am on that he is aware of... Luckily, I looked the stuff up before taking it...

Pleeezzzz....

[edit on 9-8-2006 by loam]