Medicine
I told the whole prostate cancer story to a class at Georgetown University this morning, from the scientific evidence through last November's politically-motivated U.S. Preventive Services Task Force meeting cancellation that prompted my resignation from the federal government. When I was done, the instructor asked me why no present or past USPSTF members have yet come forward to confirm my story. It's understandable that my former AHRQ colleagues would remain quiet - unlike me, most of them don't have the option of leaving their jobs in the middle of an economic recession - but individual Task Force members aren't employed or paid by the government. Why haven't any of them spoken out about these insults to their independence and evidence-based medicine?
I don't know the answer, of course, but I have two theories. The first is that the government and former TF Chairman Ned Calonge (who has steadfastly maintained the "scheduling conflicts" story despite the easily verifiable fact that virtually everyone who was invited to the November 2010 meeting was, in fact, able to attend, and had already made travel arrangements) managed to convince the rest of the Task Force that I have a political axe to grind and simply invented the tale of the White House's involvement. In other words, they think I lied. The second explanation is that the Task Force believes my story, but have rationalized that preservation of the group's existence is a greater good compared to drawing attention to a controversial guideline that will inevitably be portrayed by political opponents as health care rationing - especially if more "D" grade ("don't do it") recommendations are in the works.
In the immediate aftermath of my blog post, my then-boss called me into his office and, after expressing his deep disappointment, called me an "idealist," as if it was a dirty word. (I hasten to add that after emotions cooled a bit, he was supportive of my decision and even helped to repair some strained relationships with my colleagues.) But that label - "idealist" - sticks with me now. Am I an idealist for believing that when the health of millions of men are at stake, science should come first, and politics second? Am I an idealist for wanting to be completely truthful to a group of respected scientists whom I spent 4 years of my life serving, and whom I considered colleagues and even friends? Am I an idealist for thinking that some means are never justified by the ends? Very well, then, I accept that label. And if being an idealist ultimately made me a pariah in government service, what is the opposite of idealist?
I hoped at the time, and still do, that by making the reasons for my resignation public, I would ultimately help to preserve the scientific independence of the USPSTF and their decisions to only recommend clinical preventive services of proven net benefit, politics be damned. The new leadership of the Task Force, empowered by the 2010 health reform law, now has an unprecedented opportunity to support and improve the health of all Americans - even if that means telling them that there are some tests they just don't need. I pray that they seize it, and wish them all the best.
- Mammograms And Death Panels: Why The Preventive Services Task Force Keeps Pulling Its Punches
Health reform was supposed to have been good news for the U.S. Preventive Services Task Force. Until 2009, this independent panel of federally-appointed experts in primary care and preventive health was not particularly well known, and its evaluations...
- Ppip: Prevention Politics Injures Patients
PPIP is an acronym that officially stands for "Put Prevention Into Practice," which serves as both the name of the Agency for Healthcare Research and Quality's programs to disseminate the preventive care recommendations of the U.S. Preventive Services...
- Psa Testing: Will Science Finally Trump Politics?
Maybe the third time will finally be the charm.In early November 2009, the U.S. Preventive Services Task Force voted unanimously to update its 15-month old recommendations on screening for prostate cancer in men younger than 75, changing its previous...
- "politics Trumped Science": The Stories Behind The Sound Bite
Last November, when I publicly announced my resignation from the support staff of the U.S. Preventive Services Task Force after 4 years as a medical officer at the Agency for Healthcare Research and Quality, media reports suggested that I had done so...
- The Meeting That Wasn't, And A Surprise Announcement
Although I normally arrive at work around 9 AM on Mondays, today would have been an important exception. This was to be the first day of the third U.S. Preventive Services Task Force meeting of 2010, and about now, outgoing Task Force Chairman Ned Calonge...
Medicine
Idealist
I told the whole prostate cancer story to a class at Georgetown University this morning, from the scientific evidence through last November's politically-motivated U.S. Preventive Services Task Force meeting cancellation that prompted my resignation from the federal government. When I was done, the instructor asked me why no present or past USPSTF members have yet come forward to confirm my story. It's understandable that my former AHRQ colleagues would remain quiet - unlike me, most of them don't have the option of leaving their jobs in the middle of an economic recession - but individual Task Force members aren't employed or paid by the government. Why haven't any of them spoken out about these insults to their independence and evidence-based medicine?
I don't know the answer, of course, but I have two theories. The first is that the government and former TF Chairman Ned Calonge (who has steadfastly maintained the "scheduling conflicts" story despite the easily verifiable fact that virtually everyone who was invited to the November 2010 meeting was, in fact, able to attend, and had already made travel arrangements) managed to convince the rest of the Task Force that I have a political axe to grind and simply invented the tale of the White House's involvement. In other words, they think I lied. The second explanation is that the Task Force believes my story, but have rationalized that preservation of the group's existence is a greater good compared to drawing attention to a controversial guideline that will inevitably be portrayed by political opponents as health care rationing - especially if more "D" grade ("don't do it") recommendations are in the works.
In the immediate aftermath of my blog post, my then-boss called me into his office and, after expressing his deep disappointment, called me an "idealist," as if it was a dirty word. (I hasten to add that after emotions cooled a bit, he was supportive of my decision and even helped to repair some strained relationships with my colleagues.) But that label - "idealist" - sticks with me now. Am I an idealist for believing that when the health of millions of men are at stake, science should come first, and politics second? Am I an idealist for wanting to be completely truthful to a group of respected scientists whom I spent 4 years of my life serving, and whom I considered colleagues and even friends? Am I an idealist for thinking that some means are never justified by the ends? Very well, then, I accept that label. And if being an idealist ultimately made me a pariah in government service, what is the opposite of idealist?
I hoped at the time, and still do, that by making the reasons for my resignation public, I would ultimately help to preserve the scientific independence of the USPSTF and their decisions to only recommend clinical preventive services of proven net benefit, politics be damned. The new leadership of the Task Force, empowered by the 2010 health reform law, now has an unprecedented opportunity to support and improve the health of all Americans - even if that means telling them that there are some tests they just don't need. I pray that they seize it, and wish them all the best.
- Mammograms And Death Panels: Why The Preventive Services Task Force Keeps Pulling Its Punches
Health reform was supposed to have been good news for the U.S. Preventive Services Task Force. Until 2009, this independent panel of federally-appointed experts in primary care and preventive health was not particularly well known, and its evaluations...
- Ppip: Prevention Politics Injures Patients
PPIP is an acronym that officially stands for "Put Prevention Into Practice," which serves as both the name of the Agency for Healthcare Research and Quality's programs to disseminate the preventive care recommendations of the U.S. Preventive Services...
- Psa Testing: Will Science Finally Trump Politics?
Maybe the third time will finally be the charm.In early November 2009, the U.S. Preventive Services Task Force voted unanimously to update its 15-month old recommendations on screening for prostate cancer in men younger than 75, changing its previous...
- "politics Trumped Science": The Stories Behind The Sound Bite
Last November, when I publicly announced my resignation from the support staff of the U.S. Preventive Services Task Force after 4 years as a medical officer at the Agency for Healthcare Research and Quality, media reports suggested that I had done so...
- The Meeting That Wasn't, And A Surprise Announcement
Although I normally arrive at work around 9 AM on Mondays, today would have been an important exception. This was to be the first day of the third U.S. Preventive Services Task Force meeting of 2010, and about now, outgoing Task Force Chairman Ned Calonge...