RESPECTFUL INSOLENCE

"A statement of fact cannot be insolent." The miscellaneous ramblings of a surgeon/scientist on medicine, quackery, science, and pseudoscience (and anything else that interests him).

Medicine Surgery

American medical care at its finest

Post author By Orac
Post date June 13, 2009
40 Comments on American medical care at its finest

What should a doctor recommend for a 90 year old man with pancreatic cancer and liver metastases? Palliative care? Hospice? Those would seem to be the most reasonable options. If I were that 90 year old man, that’s what I’d recommend. Unfortunately, I know from experience that that is all too often not what happens. I know and have seen the ordering of many invasive tests that won’t change the outcome.

So does Buckeye Surgeon.

American medicine, as it is practiced now, all too often takes on a momentum that is very difficult to stop, a momentum demanding more, more, more, more, even in the face of a hopeless situation. Sometimes it’s driven by the family’s desire that doctors do “everything possible,” but, as this case demonstrates, it can happen even without such an insistence. It seems to happen even though individual physicians involved know there’s no hope and that what they’re doing is futile. It is a major contributor to the way that end-of-life care makes up such a large portion of what we spend on healthcare.

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By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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