Newspaper article The Queensland Times (Ipswich, Australia)

Are We Over-Diagnosed? We May Need to Cultivate a Fundamental Shift in Our Thinking about the Limits of Medicine

Newspaper article The Queensland Times (Ipswich, Australia)

Are We Over-Diagnosed? We May Need to Cultivate a Fundamental Shift in Our Thinking about the Limits of Medicine

Article excerpt

Byline: Ray Moynihan and Dr Iona Heath

THE more we learn about the problem of too much medicine and what's driving it, the harder it seems to imagine effective solutions. Winding back unnecessary tests and treatments will require a raft of reforms across medical research, education and

regulation.

But to enable those reforms to take root, we may need to cultivate a fundamental shift in our thinking about the limits of medicine. It's time to free ourselves from the dangerous fantasy that medical technology can deliver us from the realities of uncertainty, aging and death.

We're all ill now

A growing body of evidence shows that when it comes to health care, we may simply be getting too much of a good thing. In the United States, it's estimated that more than US$200 billion a year is squandered on unnecessary tests and treatments. In the United Kingdom, senior medical groups are calling on doctors to reduce all the wasteful things they do. And in Australia, the Choosing Wisely campaign recently kicked off with lists of unnecessary and harmful health care.

Not only are we overusing pills and procedures, we're creating even more problems with "over diagnosis" by labelling more and more healthy people with diseases that will never harm them.

Screening programs targeting the healthy can detect potentially deadly cancers and extend lives. But they can also find many early abnormalities that are then treated as cancers, even though they would never have caused anyone any symptoms if left undetected.

The common ups and downs of our sex lives are often re-labelled as medical dysfunctions. Older people who are simply at risk of future illness - those with high cholesterol, for instance, or

reduced kidney function, or low bone mineral density - are portrayed as if they were diseased.

The doctors expanding disease definitions and lowering the thresholds at which diagnoses are made are often being paid directly by the companies that stand to benefit from turning millions more people into patients. …

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