Consumer Focused Health

We appear to be entering an era of uncertainty, where once again we realize that the practice of medicine is an art, not a science.

While doctors may carry scientific tomes in their heads and engineering marvels on and around their persons (although surprisingly few computers to date), the clinical practice of medicine is being rediscovered as an art, not a cookbook science. As new studies challenge the existing metrics evaluating risk through a black/ white approach dedicated to lowering intermediate clinical markers (see cholesterol for the otherwise low risk patient, glucose for Type 2 diabetics, BMI for the overweight, quantity of bloodborn “humors” to be released by lancet, etc)

Big lesson: Lower does not mean better

So, as we find out that cookbook medicine may actually be harmful in addition to being expensive, we have the same issue that is currently cracking the mortgage industry: evaluating and managing risk is hard and replacing underwriting with automation and customer service reps leads to problems when real judgment is required.

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A NYTimes article highlights that the FDA reaffirmed its stance on a lifetime ban on gay men as blood donors, a policy it has kept since the 1980′s. While the AIDS epidemic and poor quality of testing made that policy make sense from a public health perspective, the heavy-handed nature of the decision makes much less sense today.

In March 2006, the Red Cross, the international blood association AABB and America’s Blood Centers proposed replacing the lifetime ban with a one-year deferral after male-to-male sexual contact. New and improved tests, which can detect H.I.V.-positive donors within 10 to 21 days of infection, make the lifetime ban unnecessary, the blood groups told the F.D.A.

In a document posted Wednesday, the drug agency said it would change its policy if it received data proving that doing so would not pose a “significant and preventable” risk to blood recipients.

The agency said the H.I.V. tests now in use were highly accurate, but still could not detect the virus 100 percent of the time.

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