A ‘wicked problem’ of built-in bias; breast cancer screening and diagnosis trends; on physicians and taxes in the gig economy – Morning Medical Update

Author(s):

Richard Payerchin

Key Takeaways

Pulse oximeters exhibit reduced accuracy for darker-skinned patients, complicating efforts to replace biased technology with universally accurate alternatives.
The 2009 breast cancer screening guideline changes have led to ongoing debate and affected screening rates and treatment stages in the U.S.
Physicians' participation in the gig economy, such as through JustAnswer, has prompted federal investigation into tax compliance and income reporting.

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doctor physician black patient pulse oximeter: © Seventyfour - stock.adobe.com

Bias in the machine

Pulse oximeters are ubiquitous in hospitals to measure patient blood oxygen levels. American medicine has known for decades that the optical meters are less accurate for patients with darker skin tones, leading to potentially undetected and untreated hypoxemia. Why is it so difficult to swap out current machines with built-in bias for new technology that is accurate for all patients? Read about this “wicked problem” in a study and commentary published in JAMA.

Screening for breast cancer – or not

In 2009, the U.S. Preventive Services Task Force changed breast cancer screening guidelines for women at average risk of developing breast cancer. The changes were not without controversy, and since then numerous publications have tracked reductions in breast cancer screenings in the United States. Here’s a study that examined trends in breast cancer stage and surgical treatment before and after the 2009 guideline changes.

Doctors in the gig economy

Physicians are highly trained scientists who care for people, so it’s no surprise their expertise is in high demand, whether in person or online. Apparently there were some who assisted patients through the JustAnswer digital platform from 2017 to 2020. Late last month, a federal court authorized the Internal Revenue Service to use a “John Doe summons” to see if the Covina, California-based company paid any experts who did not report that income for tax purposes. While it’s not strictly medical, learn what the U.S. Department of Justice has to say about the gig economy and tax ramifications here.