Harkless, Gene Elizabeth. "Do I really need to have that test? Understanding risk and making medical decisions in the age of TMI." 2010. University Dialogues, The University of New Hampshire. Durham, NH. Pg. 17-19.
This essay deals with the motivation of clinicians responsible for patient care, and the counterintuitive way in which women are dealt with in the United States healthcare industry. First Harkless asks, why do clinicians make the decisions that they do? Are they motivated by evidence, market pressure, ritual or ignorance? In her essay, she makes it clear that she believes they are not motivated by the first option.
Harkless uses the care of young females to further illustrate her point. Doctors have pressured women to perform breast self-examination for decades for early detection of breast cancer, a practice that has very little supporting evidence. Women see doctors four times as often as men for preventative reasons, half for Pap smears. Beginning at age 21, it is recommended that young women get tested for signs of early cervical cancer every three years. Between two and three million abnormal Paps are found each year, however only half of one percent of those result in a precancer diagnosis. Most healthcare providers perform the tests much more frequently. In addition, many doctors require that young women have a Pap smear before they will prescribe contraceptives, although pregnancy prevention and cervical cancer have almost nothing to do with each other. I found Harkless' essay refreshing, because healthcare providers are protected by the assumption that they know better than their patients, while relevant information is routinely kept from patients. Doctors do have the information from studies that have been conducted to improve patient care by administering effective tests abd doing away with unnecessary and wasteful screening, however many are ignoring this knowledge and enforcing the status quo of young women being treated as if they are not responsible enough to use accepted evidence to make their own medical choices.
To be continued...
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