Monday, March 2, 2009

Unnecessary Medical Pseudoscience Procedures

This blog is not about women's health. Just want to warn you. This just happens to be in the news today and it sort of proves my point about the dangers of pseudoscience.

In Newsweek you will see an article that is one of the biggest reasons I started this blog and the accompanying book. Basically doctors are giving  tests to women that can't have the disease they are testing for.

Million women without a cervix are getting Pap tests. A Pap test (also called a Pap Smear) is used to detect cancer of the cervix. If you don't have a cervix, you can't get cancer of the cervix. Hard to test for a disease of something you don't have.

This is sort of like testing the eyesight of someone that has lost their head. This would be even funnier if it was something that was funny to everyone. Sorry it is not all joy and skittles, but this is about pseudoscience and we sometimes need one tragedy to point out another.

Why are doctors doing these pointless tests? Is it science? Well, it is based on science. They are following recommendations from doctors and perhaps scientists. The advice is that every woman who is sexually active should have the test. It is usually done as part of a general exam every one to five years.  The test is recommended by smart people, so they do it. The recommendations are based on a lot of good science. Sadly their is a little reasoning that they are forgetting with some of their patients.

The reason for the pseudoscience is nothing more than habit. It is mental inertia. A thought in motion remains in motion. Condition and response. 

You start doing Pap tests for every checkup and you keep doing it. No questions asked. You do it once and you will do it again. Why do you think that you drink so much Starbucks coffee. Sure the first one was good, but by the 30th cup it is definitely a creature of habit that asks for that latte.

Are doctors making an extra buck because they know they can? Maybe a few. Certainly the people that make the test, don't go out of their way to prevent excessive testing. I can't imagine there's  a big conspiracy of doctors and test labs out there. My favorite quote that applies here: Never assume malice, when simple stupidity will explain it all.

Is this about insurance companies somehow benefitting from this? Probably not. Again, just habit. Perhaps it's cheaper to test than it is to customize the procedures to exclude women who have had hysterectomies.  But here again it may be habit.

Even the women should know better. But they too are under the spell  of habit. They might question the procedure, but odds are that they won't because of another hobgoblin of pseudoscience: Authority. Authority causes all sorts of miscommunication and assumptions. The doctor prescribes a test, why question? They are a doctor, right?

Authority reenforces the habits. Even the doctors and insurance companies are under the influence of the authority figures that created the guidelines. 

As you can see, though this is an issue with women's health, it is really about habit and authority.

One last thing is stupidity. Are these people stupid? Is your doctor incompetent? My argument is no. Habits are hard to break and authority is a powerful reenforcement. 

Ask a doctor why and I'll bet they'll be as confused as you. Ten to one they will slap themselves on the forehead and say, "Duh! I never thought of it that way." Perfectly smart people, just lacking proper frame of mind and a knowledge of the evils of pseudoscience.

Want to fight pseudoscience at the doctor? Do your own research and ask questions.

Forward this blog to your doctor and anyone else that may be surprised.