OK, it’s really called the American Medical Association, but it most often represents the world view of ologists not primary care. The House of Delegates of the AMA is 80%-85% ologists. When there is any conflict between the views of primary care vs. those of the ologists, guess who usually prevails.
When I talk to people outside of the healthcare professions (and some within) about a new vision for our healthcare system, they commonly rebut my points or ask questions lumping all doctors into one pot. “You doctors don’t want to lose your big fees” or “You doctors whine too much about malpractice.” I am not “You Doctors,” nor are many family physicians.
The AMA House of Delegates recently passed a resolution that “expressed concern” about the US Preventive Services Task Force’s recommendations against PSA screening. A urologist AMA member stated that, “Thousands of men will die” because of the recommendation.
The PSA test is the poster child for a technology that was unleashed on the public without appropriate evaluation. Randomized controlled trials are now being completed that essentially show that the test – and the prostate rectal exam by the way – makes no impact on the life expectancy of men. The absolutely most optimistic projection, ignoring all the negative findings, estimates that PSA testing will extend mens’ lives by no more than 2 ½ days. (Yes, DAYS).
Tens of billions of healthcare dollars have been wasted on the PSA test and its downstream harms of unnecessary tests, procedures, and damaging side effects. The American Ologist Association does not care about the economic harm to the country of this waste of resources. Those doctors and I have little in common.
It is so hard to change a habit and PSA testing is a habit. I no longer test PSA; but how many men over 75 get this test every single year. My best friends’ 85 your old father has a PSA done in the ER; give me a break and then the urologist did biopies on this 85 year old man and OMG he is now receiving lupron injections every month. Let’s be honest It is all about the money!!!
A lot of it is the money, and maybe I’m naive about this, but I also believe that many of the aggressive ologists truly believe that their overtesting and overproceduring are in the best interest of their patients. They minimize the risk of their interventions and overplay the danger of leaving people alone.