Back to work

    For some months now, I felt that I had nothing to say here.  The political turmoil has left me speechless.   So much hatred on display.  We just returned from a trip to London between two graduations on the east coast. The  Brits are debating whether to leave the EU, with plenty of vitriol leading up to the referendum in June.   Everyone asked us about Trump.  I think it made them feel better about their own problems.

        In February,  I received a letter that it was time for my "annual mammogram". The letter distorted the  American Cancer Society guidelines in order  to drum up business.  I felt ashamed for the hospital where I used to practice.  When I protested to the radiologist in charge, she admitted that the letter was inaccurate ( even the ACS now recommends mammograms every other year for my age group) but said that it didn't matter, because radiologists still recommend yearly tests.  She doesn't want any part of  empowering us to make our own choice if that choice could jeopardize her income.  

      At my daughter's  graduation from medical school, one of the speakers pointed out that we would never have been able to eliminate polio if that vaccine had been priced equal to the cost of caring for someone with polio, the way the pharmaceutical companies claim that hepatitis C drugs are priced.  Of course, internal memoranda suggest that there was no such calculation, just a decision to charge as much as the market could  bear.  Meanwhile, other pharmaceutical companies raise the prices on drugs decades past their patents to outrageous levels, so that even people with insurance can't afford them.   For the first time, the percentage of patients without insurance has dropped to single digits but doctors still have to "explain" to patients why they can't access the treatment they need. 

       When my son received his masters in education a few weeks later, one of the student speakers spoke of how he hoped to bring the benefits of modern medicine to his  home village in China.   Not "precision medicine", the  expensive individualized genetic treatment that has seduced the medical profession with its potential profits (at the expense of public health) just basic health care.  At both graduations, speakers focused on the inequities of the current system, which are strikingly similar, in education and health care.  It was good for me to hear their academic perspective, because it made me realize that whoever is elected, my job remains the same.