KevinMD's Take, May 29, 2013

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How effective are screening tests?

It depends on the population being screened.  Too often, doctors screen healthy populations, which is ineffective, says internist Albert Fuchs: "... testing patients that are almost certainly healthy raises the possibility of false positives due to test errors. That won’t reassure anyone and will likely lead to more tests to pursue the spurious abnormal result."

Doctors need a health system that reimburses discussions with patients about these issues. 

Patients need to understand that sometimes more tests doesn't necessarily equate to better health care.


We are training doctors to treat the 1%.

That's the conclusion from primary care doctor Andrew Morris-Singer.  Most physicians train in hospital-based settings, where medical technology is promoted.

"Only 1% of American patients will be treated in super-specialized institutions in any 3-month period," Dr. Morris-Singer writes.  "The vast majority of us have a set of healthcare needs requiring treatment approaches that can’t be found within most of these institutions."

We often blame our culture, which obsesses about the latest medical marvel.  But we should also point a finger towards how doctors are trained.  Rarely do they learn in a true primary care setting.  A cutting-edge academic medical center, where most physicians are trained, isn't representative of the way in which many primary care doctors will be practicing during their careers.