I was shocked to read about what some doctors at my institution have been doing. Read the whole article, which is thoroughly researched, painstaking, and, not to mince words, damning. A group of radiologists, with a distinguished senior scholar at the head, have been interpreting X-rays and CT scans against medical and scientific consensus, sacrificing not just intellectual consistency but the fortunes of coal miners and other workers, whose diagnoses of black lung were thrown into shadow, and whose legal suits found in favor of their employers.
We can point fingers at these doctors. If I didn’t work at Hopkins, perhaps I would go on at greater length here about what their systematic deviation from scientific practice means for patients’ lives.
The more you think about it, though, the more you realize that we are all implicated, in greater or lesser measure, in similar activities. Our motives are perhaps not as venal; the connection to coal company’s payment not as relevant. But inconsistency of diagnostic practice, dealing out judgments, interpretations, and prescriptions not based on the best scientific evidence, and depending on pseudoscientific “lore” under the influence of economic factors are all widespread in today’s medicine.
In fact, if you consider how widespread in today’s medicine is the use of non-evidence-based treatment, you understand that this pneumoconiosis story is only the tip of a very black iceberg indeed.
Zackary Berger, MD, ACP Member, is a primary care doctor and general internist in the Division of General Internal Medicine at Johns Hopkins. His research interests include doctor-patient communication, bioethics, and systematic reviews. He is also a poet, journalist and translator in Yiddish and English. This post originally appeared at his blog.