I'm sure that the issues are more complicated than this. Can we hear from the midwives, please.
Incredible that all of the comments I have read so far are placed anonymously.
The fact of the matter is that physicians who are trained outside of the country cannot be expected to match the performance of those trained in the UK. The reasons for this are both cultural and academic.A family physician's training does not consist only of the preceding three years; it started before the time that they first attended elementary school.On top of that, medical schools vary a great deal in their quality of training, especially in countries where there are a lot of private medical schools.
However, times have changed. When I was a student nobody ever dared to question examiners. Nowadays, with the modern concept of transparency, there are constant challenges to what examiners think. I suppose this is a good thing, and it reminds us that objectivity is the essence of examinations: it is the new order of things. This means either a lot of dependence on well-constructed multiple choice questions, or a team approach to examining in practical and oral examinations, incorporating the use of checklists. This is going to have to replace extreme trust in examiners' integrity. The bonus is that it will stand up to scrutiny by appeal bodies and by the courts.
They don't say what you're supposed to do about these abnormalitites.
I can’t imagine why anyone would object to this sort of program. I would have thought it was the very essence of primary care, and am surprised that family doctors aren’t already doing it. Whether or not the results of this study lend further support to this type of practice is, however, unclear without further information. Some of the questions that immediately spring to mind are: Was there any proven increase in survival in those identified (including quality of life considerations) as a result of the screening over and above what would be expected in a similar cancer identified later? Was disease-specific mortality lowered? What happened to those whom the physicians decided not to investigate further? If indeed the proposed interventions and benefits to be derived from them are subject to the laws of diminishing returns then comments about this should be forthcoming, and the guidelines modified accordingly.
The difference between informing and encouraging is often vexed, and definitely located in a grey area, at least until the whole thing has been debated and submitted to legal testing. Practitioners had the same problem some years ago with contraception: Did its provision constitute encouragement to be promiscuous? However, doctors, like teacers, are in the business of providing information, not witholdng it.
People should take a lesson from the Americans, and stay no more than two terms.