Doctor exposes the dangers of overtreatment
Inside the bag was a moist blue towel. Wrapped inside that towel was her right breast. She was hoping it could be reattached.
Doctors in the United States don't see cancer patients like this every day. A mixture of fear, poverty and lack of paid sick leave had led her to delay cancer treatment for years. Eventually, the tumor grew so large that it cut off the blood supply, causing her right breast to die and fall off, says Otis Brawley , chief medical officer at the American Cancer Society , who saw the woman in the ER that morning in 2003.
MORE: Excerpt from 'How We Do Harm:' Chapter 10In his new book, How We Do Harm: A Doctor Breaks Ranks About Being Sick in America , Brawley presents the woman's suffering as a metaphor for a rotting health system that is run, he says, "by the greedy serving the gluttonous."
A nation of extremes
Brawley uses the book, on sale today (St. Martin's Press, $25.99) and co-written with journalist Paul Goldberg, to show that ours is a nation of extremes, with the poor or uninsured frequently denied even the most basic care while the well-insured often are "overtreated," receiving unproven drugs and procedures that can cause real harm.
"Our medical system fails to provide care when care is needed, and fails to stop expensive, often unnecessary and frequently harmful interventions, even in situations when science proves those interventions are the wrong thing to do," Brawley writes. Too many patients, Brawley writes, get a "wallet biopsy" that decides whether they'll get care. Patients without money or insurance often get no care until they're "sick enough or old enough for government benefits to kick in." Then, patients are welcomed back into the system, "because even at Medicare and Medicaid coverage rates, you can make money on uncontrolled diabetes, kidney failure, heart disease and late-stage cancer.
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"We find it a very effective way to get the word out," Sebelius said, sitting with about 20 women in the living room of longtime St. John's Road resident Lynda Burton, who teaches health policy at the Johns Hopkins University School of Public Health.
But doctors may not question the system, either, says Thomas Smith, director of palliative care at Johns Hopkins Medical Institutions in Baltimore. "Most doctors are sleepwalkers, not evildoers," Smith says. "A lot of people are trying to do their best
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