A little of the first—a whole lot of the second
Finally, a thoughtful member of the medical community speaks out—in a recent Op-Ed in the New York Times and in a recent video; both of which are featured in this blog. I am talking about Dr. H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice, and the author of Over-diagnosed: Making People Sick in the Pursuit of Health. From his 2-27-12 Op-Ed in the Times:
Screening the apparently healthy potentially saves a few lives (although the National Cancer Institute couldn’t find any evidence for this in its recent large studies of prostate and ovarian cancer screening). But it definitely drags many others into the system needlessly — into needless appointments, needless tests, needless drugs and needless operations (not to mention all the accompanying needless insurance forms).
This process doesn’t promote health; it promotes disease. People suffer from more anxiety about their health, from drug side effects, from complications of surgery. A few die. And remember: these people felt fine when they entered the health care system. (See link to complete article below)
Since I began this blog in February of 2011, I have blogged about the huge screening $$ business several times. For example, we have a $50 billion colonoscopy screening business for a disease that carries a 7% likelihood of death. The primary problem is that our medical industry fails to explain how we can lower that risk.
They place all the emphasis on early detection—which is followed by all the testing and procedures that Dr. Welch mentions in his article. He also talks candidly about the problem in this very informative 8-minute video, made possible by Dr. John McDougall.
In the video, he states that it takes 2500 women being screened for ten years in order to save one from dying from breast cancer. At the same time, roughly half (1200 or so) will have a “false positive” and half of them (about 600) will go ahead and have a biopsy. Ultimately, from 5 to 15 will be treated (surgery, radiation, chemo) for a disease that would never have caused a problem in their lives. He sums it up thusly at the end of this video:
“Within the community of medicine, there seems to be much more healthy skepticism about this problem nowadays. But I’ve got to be clear that there are strong commercial forces always out there looking for new ways to label people as diseased—because that starts a treatment cascade and it’s a great way to make a lot of money. The reality is that it’s much easier to find a new patient to use your therapy than it is to develop a better therapy.”
I encourage you to read Dr. Welch’s entire Op-Ed (See link below). In fact, everyone should read that piece and then begin asking their doctors how they can promote health and lower their risk of disease. I found this Op-Ed to be a breath of fresh air; something we don’t often hear from our money-driven medical community. Here is one quote from the piece—Dr. Welch candidly describing about how we got where we are:
How did we get here? Or perhaps, more to the point: Who is to blame? One answer is the health care industry: By turning people into patients, screening makes a lot of money for pharmaceutical companies, hospitals and doctors. The chief medical officer of the American Cancer Society once pointed out that his hospital could make around $5,000 from each free prostate cancer screening, thanks to the ensuing biopsies, treatments and follow-up care.
Here are a few of my earlier blog posts on this topic.
Finally, here is a link to Dr. Welch’s Op-Ed from 2-27-12: Over-diagnosis as a Flaw in Health Care – NYTimes.com. Or maybe you’d like to take a look at his book on Amazon. If so, click here. Over-diagnosed: Making People Sick in the Pursuit of Health Here is the book’s description from its Amazon page:
A complex web of factors has created the phenomenon of over-diagnosis: the popular media promotes fear of disease and perpetuates the myth that early, aggressive treatment is always best; in an attempt to avoid lawsuits, doctors have begun to leave no test undone, no abnormality overlooked; and profits are being made from screenings, medical procedures, and pharmaceuticals.
Revealing the social, medical, and economic ramifications of a health-care system that overdiagnoses and overtreats patients, Dr. H. Gilbert Welch makes a reasoned call for change that would save us pain, worry, and money.
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—J. Morris Hicks…blogging daily at HealthyEatingHealthyWorld.com
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