-----Mensagem original----- De: owner-lbo-talk at lists.panix.com [mailto:owner-lbo-talk at lists.panix.com]Em nome de Marta Russell Enviada em: sexta-feira, 11 de maio de 2001 18:44 Para: lbo-talk at lists.panix.com Assunto: Re: doctor disease
Joanna clearly meant that when you have more experience with the profession out of a personal medical issue you may learn the pitfalls of believing that doctors are mostly competent and enlarge your view on the topic.
When it takes going to three or four doctors to find one who can diagnose a blood clot in the leg when the leg is turning blue as happened to a good friend of mine (and caused him hospitalization cause of their ineptitude and failure to catch it when it started), ain't it obvious? This friend of mine won an Oscar years back and he and his partner were horrified at what they were put through. They went from believers in the medical profession to a better to know more than the docs do position just to survive the medical practioners.
Marta
-I would like to make some statements to defend my profession here: 1-It´s true that medical mistakes cause a lot of harm to people, however, much of this harm is due to the limitations of medicine as science. Each disease has many diferential diagnosis, so it´s not always possible to establish a correct diagnosis. Furthermore, many medical treatments have a certain rate of complications, however, they are used despite this because benefits overcome the risks. If we use Tamoxifen as adjuvant therapy for breast cancer, for instance, you must expect an increasing of venous thrombosis, uterine cancer and lung embolism, some of them fatal, however, the benefits here far overweights the risks, as Tamoxifen is associated with a decrease in breast cancer related mortality. 2-Medicine is heavily dependent on a support structure that is not always present. This is probably not very important in your country, but I´m quite sure that many of my patients die from lack of critical laboratory or radio- logical exams that are not disposable in a Third world country. Probably it happens in your country with the uninsured or those who have relatively poor insurance. 3-Medicine is becoming very complex, and I think medical schools are somewhat confused about what to teach, what abilities must be learnt by students. When I ended my graduation, I became horrified with my ignorance (and I was graduated in one of the best schools of my country, probably at the level of an average school in USA). The same trouble is saw with post graduation courses. In many institutions, medical residents are used as cheap workforce and in some cases they work more than 60-70h/week (in both your and country and mine) 4-As medical care is becoming a commodity, there is a complete pervertion of medical practice, since it´s oriented by immediate profits. Off course, many (maybe the majority) doctors are aware of the contradiction between the patient well being and immediate and monetary gains, but its difficult not to follow the "market logic" in a market economy. 5-The pharmaceutical industry has a big influence over medical practice and we are subjected to a massive brainwashing. Not all doctors have time enough to study in order to keep themselves up to date with scientific advances (many doctors in Brazil work more than 50-60h/week, I don´t know how it works in the USA), so they usually are very vulnerable to this brainwashing. 6-In my country (and other third world ones) we are experiencing a proletarization of the medical profession, ie, increasing working hours, decreasing wages, worsening of labor standards, obviously this led to a decline in healthcare quality. This happens together with privatization, which increases the demands for growing productivity. I don´t know what is happening in the USA, but in some European countries we are seeing similar complaints.
Alexandre