You know that feeling of frustration you get when something that should work—computers, airline schedules—just doesn't? Here's something new to add to that list: prostate cancer screenings.
Bob Wachter, MD, professor and chief of the division of hospital medicine at the University of California at San Francisco and author of Wachter’s World, sums up the findings of two recent New England Journal of Medicine studies in a recent post.
“One, a European study, found that PSA screening led to little benefit. The American study found that, after seven years of followup, the unscreened group had a 13% lower mortality rate than the screened group, with not a whiff of benefit.”
Dr. Wachter describes how his own father chose not to act on a PSA that came back in the 8 ng/mL range in the late 1990s. His father recently turned 79 and is healthy. “A heartfelt thanks to my dad’s urologists, who gave him what proved to be sage advice when all of the pressures—social, psychological, and financial—might have steered them toward more aggressive recommendations,” Dr. Wachter writes.
A Smarter Investment?
The Happy Hospitalist ponders what would happen if the $8,760 a year his patient and her husband spent on cigarettes was invested in the stock market. “Let’s say that the price of a pack of cigarettes only rises 5% a year (a conservative estimate). How much money could you save up by not spending $8,760 on cigarettes and instead investing it with a post-inflation return on average of 7%?”
The answer? After 10 years, the total would be $153,716; after 50 years, it would be $5.8 million.
“My, how foolish we are as a nation,” The Happy Hospitalist writes. “Looking for ways to pay for the healthcare of its citizenry, when the answers are staring us in the face.”
Brave New Hospitalist
HM welcomes a rookie to the ranks this week. Spiffer, an internist from California who doesn’t mince words on her blog, explains her new gig as a hospitalist to patients. “This is the doctor that will come and ask you about 700 annoying questions while you lay, uncomfortably, in the overcrowded emergency room. And this person will, ideally, follow you for much, if not all, of your stay in the hospital.
“I love my patients and will miss them,” she says. “But here I go, into a brave new world.”