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Re: Bone density mafiaFrom: Zach Newton (zbnewton@atl.mindspring.com)Fri Nov 29 07:53:18 1996
Mats Bergstrom wrote:
(snip)
> It seems to me there is a 'bone density mafia' out there who, A straight forward phrase powerfully distills the rhetoric of hucksters. The appeal through advertising and "network propaganda" to the general public is the driving force to stimulate patient demand for bone densiometry studies and metabolite-measurement of bone catabolism. Assessment of bone metabolism properly belongs in the realm of internists/endocrinologists/oncologists who have a basis for concern regarding systemic or organ-specific disease that affects bone metabolism. Gynecologists address lifestyle and theraputic interventions concerned with degenerative processes amenable to modification. Authors and self-declared gurus who focus on a single issue for the rationale of HRT/ERT corrupt the over-arching principle of optimized preventive health. I have occasional patients exposed to this "scientific" popularism who inquire about or specifically request referral for bone densiometry. The argument that bone densiometry is necessary to select out the "high risk" patient for osteoporosis is disenguous. The process is universally associated with ageing, impacted by genetics, diet, activity and estrogen status. That a patient deserves to have the results of a bone densiometry study to decide personally if she wishes to accept the recommendation for HRT/ERT is specious. I have been awestruck by the rarity of new patients under the regular care of an internist or family practioner who have never been counselled about calcium supplementation and regular weight-bearing exercise (such as walking). Not uncommonly, some of these women have had prior bone densiometry screens (sometimes serial studies). "Bone density mafia" - Dr. Bergstrom is deserving of the first ob-gyn-l Phrase-Of-The-Week Award. (Dr Braun's wagging dog tail nominated for quote of 1996).
-- Zach Newton Z. B. Newton, III, M.D. Atlanta Gyn
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