The U.S. Preventive Services Task Force recommends against prostate-specific antigen tests because they generally harm more patients than they help by leading to overdiagnosis and overtreatment of cancers that were not likely to be deadly.
However, even knowing this, two physicians, H. Gilbert Welch, MD, professor of medicine at the Dartmouth Institute in Lebanon, N.H., and Peter Albertsen, MD, professor of surgery and chief of urology at the University of Connecticut Health Center in Farmington, staunchly believe Medicare should not penalize physicians for ordering such tests, according to their Op-Ed in The New York Times.
They gave three reasons. The first is that physicians do not need another performance measure. The second is that they feel it's wrong to reward physicians for not offering the option to screen for cancers. The third is it promotes the idea that the main concern about over-screening is costs, which they say is not the case. The issues, Drs. Welch and Albertsen wrote, would still be the same.
They said physicians should not be punished for screening, but the tests should not be free for the patient. The cost should help patients more carefully choose if screening is right for them. Instead, Drs. Welch and Albertsen wrote, physicians should be rewarded and penalized based on the time spent discussing trade-offs with patients.
Read the full Op-Ed here.
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