The recent controversy on EPO is leaving doctors in a no-win situation:

John Glaspy, an oncologist and professor of medicine at UCLA, says that for patients with falling hemoglobin – a critical protein carried by red blood cells — doctors must face a quandary. “When we see a patient whose hemoglobin is falling, there is a theoretical risk if we do something – blood clots and possible effect on survival – and a risk if we don’t do something: transfusions and symptoms like fatigue, shortness of breath and chest pain,”

“Doctors feel concerned and unguided, because the black-box warning makes them feel vulnerable and at risk to be criticized after the fact,” he says. He adds that he doesn’t feel the drugs are commonly over-prescribed.

Ed Silverman thinks it’s about the money. Maybe, but you just have to accept that sometimes medicine is practiced in shades of gray, not black and white.