Word: merenstein
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Consider the case of Dr. Daniel Merenstein, a family-medicine physician trained in evidence-based practice. In 1999 Merenstein examined a healthy 53-year-old man who showed no signs of prostate cancer. As he had been taught, Merenstein explained to his patient that there are advantages and disadvantages to having a blood test for prostate-specific antigen (PSA). The test can lead to early detection of prostate cancer but also to unnecessary biopsies and even treatment--with all its attendant risks of impotence and incontinence--for a cancer that might have grown so slowly that it didn't need...
Unfortunately, several years later, the patient was found to have a very aggressive and incurable prostate cancer. He sued Merenstein for not ordering a PSA test, and a jury agreed--despite the lack of evidence that it would have made a difference. Most doctors in the plaintiff's state, the lawyers showed, would have ignored the debate and simply ordered the test. Although Merenstein was found not liable, the residency program that trained him in evidence-based practice was--to the tune of $1 million...
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