“Immoral pressure” on doctors to restrict access to life-saving tests

It’s a new low in the reality of Portuguese healthcare. State-payrolled GPs and family practitioners are under “immoral pressure” to restrict patient access to life-saving tests.

In this case, the president of the national society of gastroenterology was talking about colonoscopies – the tests that can mean the difference between life and death, due to their ability to give detect and eradicate early stage intestinal cancers.

José Cotter was speaking on the European Day for the Fight Against Colon Cancer – though what he had to say will bring few surprises.

Restrictions on what used to be viewed as routine tests have been in force since the early days of austerity.

Patients who were recalled every three years for ‘check ups’ and told “one thing you can be sure, you will never die from bowel cancer”, found themselves returning to the back of the queue as doctors were pressured to prescribe less effective, much cheaper tests.

Now, the “serious consequences” have become all too apparent, and Cotter claims they could have repercussions on health professionals “for reasons of medico-legal responsibility”.

The worst of institutional pressure is that pre-cancerous conditions have been allowed to go unnoticed, he explained.

If detected in time, they could also have been removed during colonoscopy procedures.

As it is, health policies have allowed them to develop to the point where they seriously prejudice patient health and require “even more expensive” surgery and other treatments – “chemo- and radiotherapy being the most frequent”.

Expresso stresses that colon and rectal cancers are responsible for the highest number of cancer-related deaths in Portugal.

“In 2014 alone, there were 7000 cases of the disease, with a mortality rate within five years of 50% of them”.

Of course, lifestyle choices can take much of the blame, Cotter agreed, but the lack of people called in for routine testing “at the right time” contributes to these figures and results in the loss of many lives and “the conditioning” of others.

“Various tests are possible”, Cotter agreed. “But with the exception of colonoscopies, they all show themselves to be insufficient” to detect early stage cancers.

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