Gems on the Web

I found a few recent gems on the Web I wanted to bring to your attention. A veterinary oncologist, Karen Oberthaler, MD, says we should treat people like dogs.

By this, she means we should know when to stop pouring money after futile treatments and tests, especially for the more senior adult patient, and realize when to focus on the comfort of the patient. She believes that the core of this is allowing the patient and the family — to some degree — dictate the direction of care. The thought being that if they realized how remote the chances are, they wouldn't go for it.

While I certainly agree with her in principle, the reality is a lot more nuanced, and is balanced against complex emotions on the part of the patient and loved ones, patient autonomy to make health care decisions and perhaps the remote, but real chance of an amazing response. However, I applaud Dr. Oberthaler for adding her voice to the conversation and reframing our care of elders based on her unique perspective as an animal oncologist.

In a positive move towards encouraging prevention, the recently passed health care reform act will mandate eventually (key word: eventually) that insurers must cover preventive health tests, like cancer screening tests, without a copay.

I spend a fair amount of my time thinking about how we can improve rates for colorectal cancer screening in Wisconsin, and although there are many barriers (time off work, access to tests, cultural stigma of the test, etc.) this will help eliminate at least one of those barriers, which is a welcome change. As I tell patients, although colonoscopy is certainly a big hassle, it's a lot easier than a colectomy and chemotherapy once you have colorectal cancer.