Screening for lung cancer

There is a good piece in Slate about a recent high-profile article that appeared in the New England Journal of Medicine. The research involves screening for lung cancer, which remains one of the most common and least treatable forms of cancer. The article examines the use of CAT scanning the lungs of "high risk" individuals to find spots that may represent cancer. I think the Slate article does quite a good job explaining some of the pitfalls of screening for any disease and is accessible to many people without medical training. It is sobering to note that very few screening tests have been proven to SAVE LIVES. Even mammography for young women (40-50 years-old) remains controversial. This is a point that causes difficulty for many non-medical people. "If you diagnose it early, it must be easier to treat!" But the truth is much, much messier, and the law of unintended consequences comes into play, especially when the diangosis and treatment of a disease like lung cancer involves pretty invasive and toxic procedures: we just don't know if the complications are worse than the disease.

Welcome to Critical Health

Thanks for stopping by! In the first post, I'd like to answer a few key questions:

Who am I?
I am a medical doctor specializing in pulmonary and critical care medicine. That is, I specialize in lung diseases and the care of patients who are seriously ill, usually in the intensive care unit. I practice medicine at a large, academic referral center in a big city. I spend most of my time doing research, working on the biology of lung inflammation, especially severe respiratory failure.

What is this blog about?
Health care and medicine are among everyone's top concerns. I hope to provide some insight into many issues regarding modern healthcare, especially issues relevant to my specialties. I think critical care medicine, in particular, is a very interesting focus for our debates about health care, because ICU care consumes a lot of resources. Many patients in the ICU lack the ability to make decisions for themselves, highlighting important questions about patient autonomy. Finally, patients in the ICU are often desperately ill, and many will die, raising crucial questions about care at the end of life.

How often will this blog be updated?
I plan to update at least every day, and more if interesting topics arise.

How can readers contribute?
Please feel free to comment on anything you see or draw attention to links you think are relevant. I will review comments and and try to get them posted within a day, hopefully less. The typical caveats about insulting or inflammatory posts will apply, and links or comments that have commercial interests will not be posted.