Doctors Are Creating Too Many Patients 566
Hugh Pickens writes "H. Gilbert Welch writes in the LA Times that the threshold for diagnosis has fallen too low, with physicians making diagnoses in individuals who wouldn't have been considered sick in the past, raising healthcare costs for everyone. Part of the explanation is technological: diagnostic tests able to detect biochemical and anatomic abnormalities that were undetectable in the past. 'But part of the explanation is behavioral: We look harder for things to be wrong. We test more often, we are more likely to test people who have no symptoms, and we have changed the rules about what degree of abnormality constitutes disease (a fasting blood sugar of 130 was not considered to be diabetes before 1997; now it is).' Welch says the problem is that low thresholds have a way of leading to treatments that are worse than the disease. 'We are trained to focus on the few we might be able to help, even if it's only 1 out of 100 (the benefit of lowering cholesterol in those with normal cholesterol but elevated C-reactive protein) or 1 out of 1,000 (the benefit of breast and prostate cancer screening),' writes Welch. 'But it's time for everyone to start caring about what happens to the other 999.'"
WOOOOOOOOSH (Score:2, Informative)
That's the sound the point of this story made when it flew past your head. Maybe you missed the part about "diagnosing people with no symptoms".
Anyway, we're all sorry for you and we'll all cry ourselves tonight hugging our loved ones thanks to your heartfelt tale, but it has nothing to do with what is being discussed here. Maybe you should submit this to your doctors : Reading Comprehension fail might be another symptom.
Diabetes? Bad example (Score:4, Informative)
Lawyers (Score:5, Informative)
In a court of law the question to be asked "Was there a test to determine the problem with my client's husband that would have saved his life if you had done it?" That single question is the reason for all of this, because if the answer is "yes", which is always is even if there were no legitimate reason to run said test, then the doctor is guilty of malpractice. He does that three times, he is no longer a doctor.
Stop blaming the people trying to help you, who have to protect themselves from the lawyers. Blame the root cause.
Re:Kind of agree... (Score:5, Informative)
My girlfriend, a doctor, agrees. I just texted her the article and her response:
"We make more patients bc we practice defensive medicine. No one wants to be sued".
That might be in the US.... (Score:5, Informative)
Because where I live, I suffered from a crippling disease for 5 years that almost ended up fatally, and going week after week after week to the medic, treated like a liar or an attention whore, coming back home every day without results.
Until, finally, after years of calamity, they found what it was. About f*cking time if you ask me, it ended up being a serious intestinal disease combined with a esophagus and a circulatory thing and lots of inconvenient little things.
Please take note of the time. 5 years of my life lost without being able to go out of home and unable to work, socialize or well, just about anything that wasn't being yellowish in color.
Because of medics, who could have detected this much earlier, I lost the best years of my life, the ones between young adulthood and proper adulthood. I am like a hermit who just came out of a cave. All because medics didn't want to do a bit of work and do science stuff.
Here, where free healthcare exists, medics are only concerned about getting their taxpayer-founded salary every month, and don't give a crap if the patient dies or not.
After seeing medic after medic and having to hear "it must be psychosomatic" for years, I have very little respect for the medical guys.
A medic like the ones described in the article would have saved me 5 years of my life. That's not something trivial.
Re:This is just stupid (Score:5, Informative)
I agree.
My late brother's doctor told him his swollen lymph nodes were nothing -- he had no symptoms, and a routine white count showed no infection.
That's how lymphoma presents. The next year he was in the ER due to wheezing, and was diagnosed with stage 3 Hodgkin's lymphoma, which eventually killed him (photos of his last years) [gregerson.org]. He had a bone marrow and stem cell transplant...not looking for lymphoma in someone asymptomatic turned out to be pretty expensive as well as fatal for the patient.
This story is not rare, either. After speaking to a handful of other Hodgkin's patients, they all had similar experiences. And those were the survivors.
Re:Kind of agree... (Score:5, Informative)
The Medical Malpractice Myth. [uchicago.edu]:
Re:WOOOOOOOOSH (Score:0, Informative)
Anyway, we're all sorry for you and we'll all cry ourselves tonight hugging our loved ones thanks to your heartfelt tale
You're a real fucking scumbag, you know that, geek filth? Go fuck yourself in the ass with a cattle prod, shit rag.
Re:Symptomatic (Score:4, Informative)
Of course not, first line treatment for Diabetes is lifestyle changes: Proper diet, weight-loss and regular exercise. Only after failure of these measures do you recommend drug treatment (usually oral drugs, and only later Insulin and other drugs given by injection). The benefit of classifying the patient as having Diabetes, is that there is a better chance of her conforming to the lifestyle recommendations.
If you tell some one that he may have a disease, he will not necessarily listen to your recommendations. However, if you tell him that he has Diabetes and that if he doesn't lose weight he will have to start taking drugs or risk a heart attack, there is a greater chance that he will do something about his weight and diet. Just look at all the people who stopped smoking after having their first heart attack. Nothing like a nice slap in the face (metaphorically speaking) to make someone wake up and smell the coffee.
Re:Kind of agree... (Score:4, Informative)
You are ranting and raving as if a multi-million dollar judgement is not infact proof that a doctor has made a dire mistake. You are really whining about doctors being held responsible for their mistakes. This is not a remarkable thing for any sort of professional or any proper adult really. Doctors need to be held accountable for their screwups and in some cases just plain greed and disregard. The same goes for incompetent nurses.
If there are too many malpractice suits, then it's time to consider cleaning up the profession in question.
Ignoring the problem will just ensure that quality of care degrades the the medical versions of Crassus never gets his due.