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January 4, 2007

The epidemic of diagnosis

Following on the strong NY Times medical-related stories of Lawrence K. Altman (here, here and here) over the holiday season, Drs. H. Gilbert Welch, Lisa Schwartz and Steven Woloshin contribute this op-ed to the Times in which they make the salient point that the American health care system is a hypochondriac's dream:

For most Americans, the biggest health threat is not avian flu, West Nile or mad cow disease. It’s our health-care system.

. . . The larger threat posed by American medicine is that more and more of us are being drawn into the system not because of an epidemic of disease, but because of an epidemic of diagnoses.

Americans live longer than ever, yet more of us are told we are sick.

How can this be? One reason is that we devote more resources to medical care than any other country. Some of this investment is productive, curing disease and alleviating suffering. But it also leads to more diagnoses, a trend that has become an epidemic.[ . . .]

. . . the real problem with the epidemic of diagnoses is that it leads to an epidemic of treatments. Not all treatments have important benefits, but almost all can have harms. Sometimes the harms are known, but often the harms of new therapies take years to emerge — after many have been exposed. For the severely ill, these harms generally pale relative to the potential benefits. But for those experiencing mild symptoms, the harms become much more relevant. And for the many labeled as having predisease or as being “at risk” but destined to remain healthy, treatment can only cause harm.

Read the entire article. Then take a chill pill! ;^)

Posted by Tom at January 4, 2007 4:07 AM

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