Housekeeping

This blogging every day thing having been wildly unsuccessful, I will still try to prop it up with some not interesting posts, before giving up almost entirely.

What's in my head? That song that goes, "oooo, your body girl, makes the fellows go, oooo" rinse, repeat. It's driving me insane. I don't even know where it's from.

I need to find a good brussel sprout recipe for Thanksgiving.

T & A Lady has some great questions about the mammogram debate that I'd like to validate. First of all, kudos, all the right questions. I don't have all the answers but the problem with mammograms is something like this: 4 out of 1000 women under the age of 50 who are NOT screened will get breast cancer. 3 out of 1000 women under the age of 50 who ARE tested will be found to have breast cancer. That is statistically insignificant, and may cause to unnecessary further testing and procedures, which have non-negligible costs to the healthcare system. The cervical cancer screening debate (whether to get a PAP smear before age 21) is actually more troublesome, because in addition to the statistical insignificance of early detection, women who undergo an unnecessary procedure to remove benign tumors which may be found in screening (and which would otherwise go away on their own) may result in fertility problems. So now the unnecessary screening has created a health risk. I got all this from a New York Times article I read last week but which I am too lazy at this moment to hunt down.

But the whole debate points up something I find even more irritating and troubling and which I run into more frequently now that I work more closely with health care, and that is a lack of interest in, or understanding of, evidence-based medicine. Doctors have lobbied so hard to be taken seriously over the past 1.5 centuries, that we mistake them for scientists. And while many of them are, the practice of medicine is remarkably driven by intuition, litigation-avoidance and guesswork. Maybe most doctors in the fee-for-service model don't have time or access to peer reviewed data (not paid for by Big Pharma) and statistics that could help shape care. The particulars of this are interesting (to me) but the bigger point I wanted to make is the failure to view health care through this lens is one of many problems with the healthcare reform debate. Just irritating scaremongering.

We are here for Thanksgiving, hopefully doing lots of hiking, eating, running, movie viewing and trying to not get on eachother's nerves. Have a great holiday weekend.