Just Say No to "Just Scoot up": The End of the Pap Smear

http://www.nytimes.com/2009/04/07/health/07virus.html?em

Here is in an insight into everything that's wrong with American Medicine. The New York Times report that a newly discovered dna test is so much more accurate than the traditional Pap smear as to make that humiliating and sometimes painful test (not to overshare, but that's my truth) obsolete. What might be an obstacle to this miracle? American Medicine's Paternalism.

According to Debbie Saslow, executive director of the American Cancer, her greatest problem in getting the Pap smear replaced by DNA testing is that
" [W]e haven’t been able to get doctors to go along,” Why not? Are doctors concerned about the cost or accuracy of the new test? Not at all. They are concerned about the ability of American Women to manage their own health. Dr. Saslow reports that “The average gynecologist, especially the older ones, says, ‘Women come in for their Pap smear, and that’s how we get them in here to get other care.’ We’re totally overscreening, but when you’ve been telling everyone for 40 years to get an annual Pap smear, it’s hard to change.”

I'd like to suggest that if there were a DNA test for prostate cancer that would replace the current hands-on method of diagnosis, it would be adopted faster than you could snap on a latex glove.

I have a student currently writing a paper on the gender inequalities of Health Insurance (why is Viagra covered but not birth control?), but I wonder if our bigger problem isn't that it's hard to focus on the goals of quality and cost effectiveness when you're blinded by paternalism. And lest anyone think this is a criticism of male doctors, it is not. The values of the medical profession in the United States are transmitted equally to men and women. While this quote by Dr. Saslow is directed signficiantly at older doctors (more of whom are probably male)I would be surprised if they are the only ones to endorse this view.