Thursday, April 3, 2008

Masking Propaganda as Research 

The recent "study" of physician attitudes

By Greg Scandlen

Filed As:  Health Care

Here’s a survey question for you. Please check the box that is closest to your beliefs and return the form to me –

___ Reporters are idiots

___ Reporters are morons

The results will be published in the prestigious Annals of Internal Medicine.

This survey would have as much validity as the latest “study” that is making the rounds in the nation’s press. The Reuters headline is, “Doctors Support Universal Health Care: Survey.” The South Florida Sun Sentinel puts it, “Study: Most Doctors Support National Health Insurance.” I won’t regurgitate the content of the articles here, other than to say they uncritically parrot the line put out by the “authors” of the “study.”

Let’s look instead at the “study” itself. This is not as easy as it sounds. Yes, it was published in the Annals of Internal Medicine, but the content is available only to paid subscribers. Fortunately a friendly internist was able to send it to me. I opened up the file on my computer and was surprised to learn that it wasn’t a “study” at all. It was a one-page letter to the editor. Now a letter has the distinct advantage of avoiding the peer review process that applies to published articles. It is also able to avoid including any embarrassing information about methodology.

The letter was written by Aaron Carroll, MD and Ronald Ackerman, MD, both of the Indiana University School of Medicine. I don’t know about Dr. Ackerman, but Dr. Carroll is a member of the board of directors of Physicians for a National Health Program (PNHP), so is hardly an unbiased researcher. Interestingly, the Annals requires the disclosure of financial conflicts of interest, but not political conflicts or biases.

The survey itself, though only summarized in the letter, apparently asks only two questions --  1. In principle, do you support or oppose government legislation to establish national health insurance? And 2. Do you support achieving universal coverage through more incremental reforms? They sent this out to 5,000 physicians and got back 2,193 responses. So the sample was entirely self-selected. And who knows what their cover letter might have said? Coming from a leader of PNHP, it might have been calculated to infuriate physicians who believe in freedom, resulting in these doctors discarding the survey.

So, there was absolutely nothing scientific about this. It was pure propaganda. But the idiotic reporters take it at face value, much as they did a few years ago when the Commonwealth Fund published a startling survey finding that the vast majority of employers supported an employer mandate. Few reporters questioned the unlikely finding, so I dug deep into the survey and discovered that Commonwealth gave these employers only two choices – an employer mandate or a single-payer. Pick your poison. And you wonder why we enact such horrible policies in this country.

• posted by Greg Scandlen
• 11:15 am
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