Three lessons from a single author paper in the NEJM

Oct 29, 2013




This paper, “Urologists’ Use of Intensity-Modulated Radiation Therapy for Prostate Cancer” by Jean M Mitchell, caught my eye. Not my normal bedtime reading but…

First, a single author paper in the NEJM. How refreshing. Two of my first three publications (one in the BMJ) were single author papers. Traditions of science change, but in my case the supervisor guided, rather than attached their names. Second, the paper states that the overall 10 year survival for men with prostate cancer is 98%. At the present time, a variety of forces are trying to change definitions of ‘skin cancer’ all in my opinion to increase the market for drugs and treatment, but for most non-melanom skin cancers, survival is close to this 98%. The term cancer is being corrupted, by money.  Finally the paper shows—yet again—that doctor’s clinical behaviour is deeply influence by reimbursement. One of the key characteristics of a professional is that this should not happen.  None of us really believe the banks have firewalls between ‘safe’ banking, and roulette banking; but it is sad to see how far professional ideals have been corrupted by the market. Shareholder value was always a crazy way to run a business, even when the shareholder is close N of 1.

Post by Jonathan Rees

Clinical academic and skin watcher at the University of Edinburgh

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