I’m traveling today, and sitting in Dallas/Fort Worth Airport.  As always, my frustration level soars as I go through the intricacies of airport security.  I’m glad we’re secure, but I’m not always sure that the things we do make us more secure.  And I can’t help but find comical irony in many of them.

Everyone leave your shoes behind!

Everyone leave your shoes behind!

For instance, the monitor in the security line has a list of things we can’t bring aboard.  Pictures of guns (always a Glock!), knives, ball-bats, fire-works.  Why not a picture of a terrorist?  Oh, that’s right, it would be judgmental and mean.  After all, what does a terrorist look like?  We aren’t allowed to suggest.  Perhaps a picture of a very angry infant or threatening old lady…

And there’s the pervasive checking of identification cards.  As if, after checking in at the front desk, someone will accidentally slip up and present the security guard with their Al Qaida Platinum Membership Card.  ‘Oops, sorry, here is my genuine American driver’s license!’

But I digress.  As I went through the line and took off my shoes, yet again demonstrating that my footwear has no potential for dangerous, rapid expansion under high heat and pressure, I began to wonder.

We in medicine are expected to demonstrate at least some benefit of the things we do to our patients.  The government wants to have comparative effectiveness data to see what works and what doesn’t, and what needs to continue being reimbursed.  I’m not sure that’s always a good idea, but it is what it is.

So let me ask, ‘how many shoe bombers have we now caught, except for the first one?’  Is there data?  Is there any suggestion that the enormous slow-down of the security lines that results from shoe removal and re-application causes any improvement in security?

Isn’t it ironic that the government wants us to cut costs on unnecessary procedures, even as we have no real idea if all of the gesticulations we endure in airports have any bearing on our safety?

If someone has information here, please let me know!  I’m just tired of taking off my shoes, fumbling with my ID, unpacking all of my stuff and feeling my pulse in my temples.

Edwin

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