Longer looks: Why we still have faith in physicians

Apr 27 2012

Every week, Kaiser Health News reporter Jessica Marcy selects interesting reading from around the Web.

National Journal: Why We Trust Doctors
This patient is no fool, and she does't award trust liberally. … Yet, somehow, (Mary) Morse-Dwelley never lost faith in Pellegrini. She'd hear the click of her doctor's shoes in the hallway, see her blond hair and funky glasses, and feel confident that she was in good hands. This, too, represents a broad trend: As we have become better-informed patients, we have grown more cynical about a health care system that is ever more corporate and reliant on technology. Nevertheless, our faith in physicians has proved incredibly durable. Gallup, which has polled on public trust in professionals every year since 1976, reports high and rising marks for doctors. In the latest survey, from 2011, 70 percent of respondents rated medical doctors as high or very high when asked about their "honesty and ethical standards," a record. When the Kaiser Family Foundation asked Americans whom they trusted in 2009-;the height of the debate over the health care law-;78 percent said they believed that their doctors put patients' interests ahead of their own (Margot Sanger-Katz, 4/26).

American Medical News: Bariatric Surgery Maintains, Doesn't Gain
In a way, bariatric surgery is like the member of the chorus who spent years waiting for a big break, got it, became a star, and then found out that success was harder than it looked. After decades of slow growth since the first procedure was performed in 1954, rates escalated rapidly in the first few years of the 2000s but hit a wall recently. That wall may not be so easy to get past, even if the economy fully recovers. A total of 36,700 bariatric surgeries were carried out in 2000, and then jumped 29% to 47,200 in 2001, according to the American Society for Metabolic & Bariatric Surgery. An additional 63,100 were carried out in 2002, an increase of 34% from the previous year. In 2003, 103,200 procedures were performed for an annual growth rate of 64%, the biggest increase in the previous decade. Hospitals and large health systems opened bariatric surgery centers as revenue builders and to serve their communities. General surgeons started specializing in the procedure (Victoria Stagg Elliott, 4/23).

The New York Review of Books: Why the Mandate Is Constitutional: The Real Argument
The Supreme Court's hearings in the health care case, US Department of Health and Human Services v. Florida, over a nearly unprecedented three days of oral argument in late March, generated all the attention, passion, theater, and constant media and editorial coverage of a national election or a Super Bowl. Nothing in our history has more dramatically illustrated the unique role of courtroom drama in American government and politics as well as entertainment. … The prospect of an overruling is frightening. American health care is an unjust and expensive shambles; only a comprehensive national program can even begin to repair it. One in six Americans lacks any health insurance, and the uninsured of working age have a 40 percent higher risk of death than those who are privately insured (Ronald Dworkin, 5/10).

TIME: Debt Collectors In The E.R. And Delivery Room: Is Profit-Driven Medicine At A Breakpoint?
Imagine that you've brought your child to the emergency room and you're revealing your most private health information to the hospital staff member at the desk, desperate because you fear your child's very life is at risk. But the desk clerk seems more concerned about getting paid than giving care, and even makes veiled threats against your credit score if you're not able to cough up the money to cover the bill. Who is this heartless bureaucrat? Is it a hardened triage nurse? A bored clerk? Would you believe it could be a third-party bill collector posing as a hospital staffer? Welcome to 21st-century American medicine (Maia Szalavitz, 4/25).

The Atlantic: Women Rejoice: Time To Bid Farewell To Your Annual Pap Smear
For fifty years an annual Pap smear has been the gold standard of screening for cervical cancer in women. Now a federal advisory group and the nation's leading cancer organization have changed their tune. They no longer recommend that women have a Pap test each year. The recommendations do not apply to women who are at very high risk for cancer, such as those who have been diagnosed with a high-grade precancerous cervical lesion or who have weakened immune systems. The US Preventive Services Task Force, (USPSTF) a panel of independent experts convened by the government, and the American Cancer Society (ACS) have each released new guidelines for cervical cancer screening that recommend against routine yearly testing. Instead, the guidelines recommend testing every 3 years for women aged 21 to 65 (Susan H. Scher, 4/24).

American Medical News: Health System Changes Inspire More Med Students To Pursue Dual Degrees
As they contemplate careers in a rapidly changing health care landscape, a growing number of medical students are deciding that a medical degree is not enough. Most U.S. medical schools offer students the chance simultaneously to get advanced degrees in a variety of other areas, such as public health, law, business administration, mass communications and the sciences. Some schools have offered the programs for more than two decades. However, more recently, dual degrees are growing in popularity as prospective physicians feel they must develop expertise beyond medicine to compete in a dynamic health care market. Combined enrollment nationwide in MD/PhD, MD/JD and MD/MBA programs alone has increased 36%, from 3,921 in 2002 to 5,349 in 2011, according to the Assn. of American Medical Colleges. Most of them, 5,023, are in MD/PhD programs. The AAMC suspects its MD/JD and MD/MBA tallies are undercounted (Carolyne Krupa, 4/23).