Early Steps to Find Cancer Are Often Hit or Miss
Advances in mammography and other imaging technology over the past 30 years have meant that pathologists must render opinions on ever smaller breast lesions, some the size of a few grains of salt… As it turns out, diagnosing the earliest stage of breast cancer can be surprisingly difficult, prone to both outright error and case-by-case disagreement over whether a cluster of cells is benign or malignant…
“There are studies that show that diagnosing these borderline breast lesions occasionally comes down to the flip of a coin,”…said Dr. Shahla Masood, the head of pathology at the University of Florida College of Medicine in Jacksonville.
Full article on mistakes made in early cancer detection.
This doesn’t give me a lot of confidence in the health care system.
I agree with Vicki. Sounds horrible.
Whoops, another thing you need to know to make consumer directed healthcare work. Is your pathologist board certified? Is he certified in D.C.I.S? How many does he read a year? How about getting bids from a number of pathologists and you pick the best one or the cheapest one. All those decisions while you think you have this ticking time bomb that might kill you. People can’t be rational economic actors when life and death is involved.
artk, no matter what I know or don’t know, there is no argument whatsoever for surrendering the authority to make decisions to some impersonal bureaucracy. With consumer directed care, I can always ask the bureaucrats what they think. And if I don’t like the answer, I can ask someone else.
The issue is not about knowledge. It is about power.
All this says is that the imaging quality is ahead of the biology. Same is true in the ability to detect hazardous substances in water or food. We can see the thing but we have no idea what it means.
As Tom says, somebody has to decide what to do. What I don’t understand is why artk thinks that some bureaucrat somewhere will make a better decision.
“Whoops, another thing you need to know to make consumer directed healthcare work. Is your pathologist board certified?”
Uncle Miltie said docs should not have to be licensed or certified. Could he have ben wrong?
Steve
I can see how this would be a problem. Why don’t doctors say “We’ll check in again in a few weeks?” That sounds like a rather simple solution.
Not quite right, Steve. Milton Friedman said the government should certify the skills and knowledge of doctors, and perhaps other professionals. But there is no need to license them.
The article says that the expert diagnosis of this type of lesion is about as good as a coin flip. Yet several commentators proceed to claim that the inaccurate diagnosis in these cases demonstrates that consumer directed care, and free market economics in general, will not work in health care.
The logic escapes me. I figure that I can flip a coin about as well as the experts.