Word: patients
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...doesn't guarantee that the desired effect--a healthier heart and a longer life--will follow. Often your doctor is left to make prescription decisions based at least in part on faith, bias or even an educated guess. That ought to be enough to spook even the least jumpy patient, but the fact is, recognizing just what a roll of the dice medicine can be may be a good thing...
...such certainty possible--or even desirable? Medicine, after all, is a personalized service, one built around the uniqueness of each patient and the skilled physician's ability to design care accordingly. "I'm worried about training a generation of physicians who don't have the other skills they need for the optimal practice of medicine," says Dr. Mark Tonelli, a pulmonary-care specialist at the University of Washington in Seattle. "They can read the scientific literature, understand the statistics, but they don't understand how that should influence their treatment of the individual in front of them." What's more...
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...
...Garraway, is the “bottleneck” that occurs when trying to put our expanding knowledge of how genetic mutations cause cancer into practice in the clinic. “Hundreds of these mutations are now known, but the challenge is how we extract relevant information from patients who walk into the clinic without having to sequence all of their genes,” said Garraway. The study presents a streamlined way of detecting mutations in key oncogenes, or genes that promote cancer growth. By adapting a common scientific method called high-throughput genotyping to target specific sequences...