Cognition & Reality

Tuesday, 12 October 2010

Medical Imperialism

Filed under: Diagnosis,Medical Morality — drtone @ 2:56 pm

I have discussed before the unsuitability of doctors as arbiters of the larger questions that face our society and the individuals within it. A case in point is the behavior Kaiser Permanente has exhibited toward me regarding a high-ish PSA score I received in June. When they first notified me of the test results, they immediately tried to hustle me into their process for addressing prostate cancer. The rush to judgment disturbed me when I was already agitated and afraid. Moreover, their refusal to test me again before offering me a biopsy went against my own instincts as a test developer. It is SOP with a screening test to give it again when it shows a positive result, which Kaiser refused to consider in my case.

They scheduled me for a “consult” with a urologist prior to giving me the biopsy. In response to my own anxiety, generated in part by my having had a previous prostate biopsy and therefore knowing how unpleasant an experience it is, I rescheduled the appointment. As I began to discover more and more about the inefficacy of the current prostate cancer treatment regime, such that prominent physicians were going on record against it. I became even more wary of keeping my appointment. So I postponed it twice more.

After I rescheduled my most recent appointment, I received a call from a nurse in the office of my “primary care provider.” She scheduled another appointment for me, and told me that they had sent me a letter regarding the issue. A few days later I received that letter, which had been sent via certified mail. It warned in the darkest terms about the “potentially fatal” condition the my PSA score signaled, and it contained this sentence: “The only way for you to know how to deal with this is to consult your physician.” If only the nurse, the doctors behind her, and Kaiser behind them were reflective enough to grasp the arrogance, presumption, paternalism, and speciousness of that claim. Alas, they are not. The consciousness underneath it, or lack thereof, is truly dangerous in a society that has decided to treat doctors as if they have all the answers.

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