Kathryn Hinsch, founder of the Women's Bioethics Project, was quoted on CNN Health, regarding ethical issues in cosmetic surgery and patient-doctor relationships:
"Part of the fundamental trust between a patient and doctor is the idea that the doctor has the patient's best interest at heart, and that there is no financial incentive for the doctor to perform any procedure," Hinsch says. "When doctors start adding cosmetic procedures, which they're adding because they're big moneymakers, there's a corruption of that basic trust."
The article goes on to explore how physicians sidestep this ethical quagmire by never directly hawking their fat-blasting, wrinkle-smoothing, and hair-removal services, but that even a stack of brochures in the waiting room, Hinsch insists, sends the message to patients that looking younger is a matter of good health. To read the complete article, click here.
Kudos to Kathryn for the recognition and speaking up on the ethical issues!
Showing posts with label cosmetic surgery. Show all posts
Showing posts with label cosmetic surgery. Show all posts
Wednesday, December 02, 2009
Tuesday, March 18, 2008
Paging Dr. Welby
I used to wish I'd been good enough at math and science to go to medical school. Not any more. See, I'd have wanted to take care of whole families, the range of their problems, over a long time (until one of us died or moved away, I guess). Now I'm all grown up, and I know some primary-care docs who are willing to share something of what their professional lives are like ... and I am glad I didn't go that route. (Though I still resent Mr. Savinelli for saying that girls just aren't good at math, which has played a way bigger role in my life than it probably should.)Anyway: what brings me here today is yet another report of how the best and brightest medical students are choosing specialties that are as far away from primary care -- and, not incidentally, from sick people -- as they can. This article in the NYT highlights the competition to get into dermatology and plastic surgery, which are apparently the current "it" specialties. Good hours, patients who can pay, and few patients dying on you. Pretty sweet.
Social justice issues? Well, we the taxpayers pay for the bulk of medical education in this country. Unfortunately, we're not turning out anywhere near the number of GPs we need ... especially as the population grays. Also, while most of us probably wouldn't begrudge the desire for a normal family life, isn't it in the nature of the professions to put your clients first? If a career in medicine is primarily about money and status, not caring for sick people, what does that mean for the profession? And what does it mean for the rest of us?
Friday, January 25, 2008
Breast reconstruction and infection: you be the judge
The NYT has run a couple of articles this week on breast implants. I might eventually come back to blog about the first one, but today, it's the second that's got my goat.
The second one reports on a research study published in Archives of Surgery (abstract). The NYT article reports, accurately, that the study found that women whose post-mastectomy reconstruction used silicone implants instead of women's own tissue were twice as likely to acquire infections. But there are a couple of interesting things you might notice, if you go look at the abstract.
One is that the absolute risk of infection in these procedures is 12.4% for women with implants, and 6.2% in women whose reconstructions don't involve implants. Double, yes, fair enough. But the abstract also notes and that women who had mastectomies without reconstruction had a 4.4% risk. So...a fairly substantial increase in relative risk occurs between women who forego reconstruction and those who have it, with still higher risks for those who also choose implants. But if you look at the news reports, no-reconstruction, interestingly, is not even reported on as a possible choice. How come? (No hate mail, please: I don't in any way mean to imply that women should or shouldn't have reconstructive surgery, only that the way this particular study has been reported in the popular press is somewhat misleading.)
If you look at the abstract yourself, you might notice a few other things that might give you pause. The study included only 50 women in total--not a very substantial sample size. And the finding that was picked up by the media was incidental to the primary finding of the project, which focused on the economic costs associated with such infections. Also, the study sample was women on their initial hospital admission for the mastectomy/reconstruction procedure, and women who were readmitted...which could conceivably leave out women who *didn't* experience infections as a result of these surgical procedures.
Given how much of our health information comes to us through media filters, we need to be savvy consumers of that information. We need to understand how research works, so that we don't uncritically accept the media spin of research reports. Something happens to research results when they are morphed into news bites...and if we're basing health care decisions for ourselves and our families based on that information, we've got to know how to read critically. It's my hope that we can educate ourselves about how to be more critical consumers of media products. At the same time, I'd like to see women apply judicious pressure on the media to step up to the educational role, and not just pursue the latest bright shiny object.
The second one reports on a research study published in Archives of Surgery (abstract). The NYT article reports, accurately, that the study found that women whose post-mastectomy reconstruction used silicone implants instead of women's own tissue were twice as likely to acquire infections. But there are a couple of interesting things you might notice, if you go look at the abstract.
One is that the absolute risk of infection in these procedures is 12.4% for women with implants, and 6.2% in women whose reconstructions don't involve implants. Double, yes, fair enough. But the abstract also notes and that women who had mastectomies without reconstruction had a 4.4% risk. So...a fairly substantial increase in relative risk occurs between women who forego reconstruction and those who have it, with still higher risks for those who also choose implants. But if you look at the news reports, no-reconstruction, interestingly, is not even reported on as a possible choice. How come? (No hate mail, please: I don't in any way mean to imply that women should or shouldn't have reconstructive surgery, only that the way this particular study has been reported in the popular press is somewhat misleading.)
If you look at the abstract yourself, you might notice a few other things that might give you pause. The study included only 50 women in total--not a very substantial sample size. And the finding that was picked up by the media was incidental to the primary finding of the project, which focused on the economic costs associated with such infections. Also, the study sample was women on their initial hospital admission for the mastectomy/reconstruction procedure, and women who were readmitted...which could conceivably leave out women who *didn't* experience infections as a result of these surgical procedures.
Given how much of our health information comes to us through media filters, we need to be savvy consumers of that information. We need to understand how research works, so that we don't uncritically accept the media spin of research reports. Something happens to research results when they are morphed into news bites...and if we're basing health care decisions for ourselves and our families based on that information, we've got to know how to read critically. It's my hope that we can educate ourselves about how to be more critical consumers of media products. At the same time, I'd like to see women apply judicious pressure on the media to step up to the educational role, and not just pursue the latest bright shiny object.
Tuesday, January 08, 2008
One Stop Medical Shopping: Convenience and much more
Would you want to get your pap smear and wrinkles filled in by the same doctor? An article in Health explores how more and more doctors are cashing in on cosmetic procedure boom and quotes our founder and blogger on the potential pitfalls:
"This boon for physicians, then, may be a bust for patients, says Kathryn Hinsch, founder of the Women’s Bioethics Project, a public-policy think tank in Seattle. 'A big problem is that any doctor with very minimal training can perform these procedures, so the potential safety issues are high...Part of the fundamental trust between a patient and doctor is the idea that the doctor has the patient’s best interest at heart, and that there is no financial incentive for the doctor to perform any procedure,' Hinsch says. 'When doctors start adding cosmetic procedures, which they’re adding because they’re big moneymakers, there’s a corruption of that basic trust.'
For more on what the article and what Kathryn had to say about this, click here.
"This boon for physicians, then, may be a bust for patients, says Kathryn Hinsch, founder of the Women’s Bioethics Project, a public-policy think tank in Seattle. 'A big problem is that any doctor with very minimal training can perform these procedures, so the potential safety issues are high...Part of the fundamental trust between a patient and doctor is the idea that the doctor has the patient’s best interest at heart, and that there is no financial incentive for the doctor to perform any procedure,' Hinsch says. 'When doctors start adding cosmetic procedures, which they’re adding because they’re big moneymakers, there’s a corruption of that basic trust.'
For more on what the article and what Kathryn had to say about this, click here.
Wednesday, January 10, 2007
And I thought the MegaMillions Lottery was bad enough ...
An interesting article appeared on the BBC website yesterday (http://news.bbc.co.uk/2/hi/health/6243705.stm). An association of British plastic surgeons is criticizing a company in the Czech Republic for running a lottery in which the grand prize is a cosmetic surgery package worth £6,000 (over $10,000 US), describing it as a marketing gimmick. I could rant for pages about medical marketing, medical tourism, or unrealistic media-driven notions of beauty but my brain is still oxygen-starved after my daily run ... according to the latest issue of Men's Health, I'm a little too fat thanks to my holiday overindulgence.
Borrowing a page from the environmental activist playbook, who often purchase hunting licenses for species like mountain lions but simply not use them, I have already bought a couple of lottery tickets. If I win, I plan to donate the prize package to someone truly needy, such as a burn victim, breast cancer survivor, or a child born with a cleft palate. If you'd like to do the same, you can buy your lottery tickets here: http://www.europa-international.net/
Borrowing a page from the environmental activist playbook, who often purchase hunting licenses for species like mountain lions but simply not use them, I have already bought a couple of lottery tickets. If I win, I plan to donate the prize package to someone truly needy, such as a burn victim, breast cancer survivor, or a child born with a cleft palate. If you'd like to do the same, you can buy your lottery tickets here: http://www.europa-international.net/
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