Medical Profession Accountability (Soap Box)

[Mike Bohan <mike.bohan@yale.edu>]

Hoy! Hoy! RadSafers,

Dr. Weiner said:

"I do think there should be a requirement to inform the patient fully, no
matter how "scared" they might be, and the physician should do this so that
the patient can do a proper comparative risk assessment.  I do also know
from painful personal experience that the information to do a proper
assessment has to be pried out of many physicians and one has to know
exactly the right question to ask.  I don't think all this requires
million-dollar settlements, but something should be done to make the medical
profession more accountable in this respect."


I've hashed this out previously here with Sandy in the past (you can look it
up in the archives), but I feel that some clarification is needed again...

While I agree that in a perfect world patients should and deserve to be fully
informed, unfortunately in the real world this is not always practical.  I
would like to believe that most individuals would be smart enough to realize
that when they are sent to the radiology or nuclear medicine department that
they will be getting some radiation exposure as a result.  However, they
shouldn't expect that they're going to receive an education in radiation
science for a diagnostic study.  If they're going to receive a therapeutic
study, informed consent is required and more information is usually provided. 

Most technologists, especially in these days of managed care, have a busy
schedule that they have to scramble to keep.  If they have to ensure that
every diagnostic patient is "fully informed" (let's see now, should we mention
the isotope, administered activity, biological excretion rate, physical half
life, effective half life, maximally exposed organ, CEDE, potential genetic
effects, potential risks of cancer induction, LNT, hormesis, and on and on,
... hopefully, by now your getting my point), they're going to do one patient
per day!  So much for "managed care"!!!  %^)

One of the real roots of this problem is the science educational system in
this country.  I've got two sons, one in grammar school and another in junior
high.  When I look at their text books while helping with homework, radiation
is hardly mentioned and whenever it is, mentioned usually in some negative
connection.  

Hopefully, many on this list have received a B.S. in the sciences.  If it
wasn't specifically in rad. physics, how much radiation science was included
in the standard curriculum???  I was a Bio major and I can say "NOT MUCH"! 
About all I got was, what an alpha, beta, and gamma ray were.  I train medical
residents and physicians frequently,  when I ask them what radiation science
training they received in medical school, they say "NOT MUCH"!  Yet, once they
receive their medical license, they're authorized to prescribe x-rays in most
states with no further training requirements.  I've only been trying to get
med. schools to include rad. science in the curriculum for 15 years.

At least my technologists have all been taught LNT and believe in it
religiously for their own personal exposure.  Unfortunately, their
understanding of it's proper use and limitations is seriously lacking, as is
being discussed on another thread on RadSafe.

Well, I could expound all day on the world's deficiencies, but I believe it is
a little much that we expect rad. and nuc. med techs to makeup for all the
failings of our educational system and all the misinformation about radiation
that is shoveled out to the general public daily by our government officials,
the media, activist groups, etc.  They just don't have the time or training in
public education necessary to do it.  (It's also not in their job description!!!)

Please step back, I'm leaving the soap box now!  %^)

Cheers,

<><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><
Michael J. Bohan, RSO   |  e-mail: mike.bohan@yale.edu
Yale-New Haven Hospital |    Tele: (203) 688-2950
Radiological Physics    |     FAX: (203) 737-4252
20 York St. - WWW 204   |    As usual, everything I say may be plausibly
New Haven, CT    06504  |    denied at my employer's convenience ...
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