Forget the reassurance, people want Cipro

Street Smarts. By Scott Gottlieb, MD, AMNews contributor. Nov. 12, 2001.

STREET SMARTS

A column looking at the corporate side of health care

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A woman who writes for one of the weekly news magazines based in New York complained of a really bad cough. She had chest pain and felt short of breath and eventually developed a low-grade fever.

Concerned she may have anthrax, she went to the emergency department. The doctor on call examined her and told her not to worry, it was just a virus. No ciprofloxacin, no chest x-ray, no anthrax test.

The physician's reassuring words weren't enough. The woman wasn't satisfied until she saw an infectious disease specialist a few days later.

She remembered that article she wrote about the Middle East. She went over the mail she had received the last month. And she wanted the blood test and the prophylactic fluoroquinolone until the results were back.

Evidenced-based medicine is not cutting it here. On the cusp of a health scare, people are leaning hard on doctors to provide treatments and tests.

The fact that this attack has been targeted at professionals with the biggest megaphones has increased the heat on us.

Officials at the Centers for Disease Control and Prevention, in particular, have been roundly criticized in the media for spreading reassuring words before all the medical facts were in.

That postal workers took the official advice and died has not been lost on the media.

Officials were confused and harassed and did the best they knew under the most difficult circumstances. These are good people working hard in a strange new world.

In the final analysis, we might find that we were all duped by the terrorists. We were put on the trail of the low-grade, clumpy anthrax that was sent to New York only to be off-guard when the high-grade, finely milled stuff turned up in Washington, D.C. [...]