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Task force recommends against PSA test for prostate cancer

New guidance urging physicians to stop using the prostate-specific antigen test to screen men of any age for prostate cancer has raised objections among some doctors and at least one medical organization. The recommendation, issued May 21 by the U.S. Preventive Services Task Force, says the small potential benefit of PSA screening in asymptomatic patients does not outweigh the expected harms of biopsies and treatment for cancerous tumors that often are slow-growing and not life-threatening. Such problems include fever, bleeding and infection from biopsies and urinary incontinence and erectile dysfunction due to radiotherapy and surgery, the task force said. The guidance does not apply to men who have been diagnosed with prostate cancer or those being treated for the disease. Some critics worry that the recommendation could cause health insurers to stop covering the test for men who still want it, causing prostate cancer deaths to increase. The task force released a draft re ...

Some patients fear speaking up will upset their doctors

Even well-educated, well-to-do patients have trouble asking their physicians questions about treatment options or expressing their medical preferences and values, said a study drawing on focus groups with older adults in the San Francisco Bay Area. Clear themes emerged from six focus group sessions with 48 patients in Palo Alto, Calif., the study said. Patients said they wanted to have a more active role in making medical decisions with their physicians, but feared upsetting them. The patients, all of whom were 40 or older, said they did not feel as though their physicians listened to or respected what they had to say. Many patients worried that questioning their physician’s recommendations could hurt the doctor-patient relationship. “If I were to do that, I would think … is the guy going to be … [angry] at me for not doing what he wanted?” asked a 64-year-old man quoted in the study. “Is it going to come out in some other way that’s going to lower the quality of ...

Medical schools close to reaching long-term enrollment goals

The nation’s allo-pathic medical schools are on track to increase enrollment by close to a 30% goal set by the Assn. of American Medical Colleges six years ago. But future physician shortages won’t be alleviated unless more graduate medical education positions are created to keep pace with the growing number of medical degree graduates, education officials say. “This won’t amount to a single new doctor in practice without an expansion of residency positions,” said AAMC President and CEO Darrell G. Kirch, MD. Based on expanded class sizes from the addition of new medical schools and expansions at existing medical schools, first-year allo-pathic enrollment is projected to reach 21,376 by 2016-17, a 30% increase above first-year enrollment of 16,488 in 2002-03. That means the schools will have reached the AAMC goal just one year behind schedule. “U.S. medical schools are doing all that they can to address a serious future physician shortage in this country,” Dr. ...