"You are pre-diseased." That's the title of a CBC radio program with Alan Cassels exploring "the gestalt of our time in a world where, it seems, more and more overdiagnosis is becoming the norm, where everyone is, more or less, prediseased."
(Part one airs tomorrow night - part two next week.)
Cassels interviews Dartmouth's Gil Welch, who says:
"I think the generic problem is somewhat like the "check engine" lights on your car. Do you have check engines lights? My first car was a '75 Ford Fairlane. There were only two things monitored: my oil pressure and my engine temperature. I now drive a Volvo that is 10 years old, but it is checking about 25 different engine functions. And sometimes a check engine light comes on, and you’re really glad to know, and it leads to something you want to do something about. Sometimes the check engine light is just a nuisance, and it just keeps flashing on and off and the mechanic can’t fix it. And some of the audience might have this experience where they went to get it fixed and it made matters worse. And if you had that experience, you’ve had some of the experience of overdiagnosis and that’s what I’m worried about. We’re putting more and more check engines lights on the human body. We have to ask ourselves if that is really the best way to get to a healthy society. We’re constantly monitoring for things to be wrong. Is that really the best way to achieve health?"
re"Check Engine." Robert M. Kaplan, Ph.D, Wasserman Distinguished professor and chair of the Department of Health Services in the School of Public Health and Professor of Medicine at the University of California Los Angeles has a great new book out on this topic. The book, "Disease, Diagnosis and Dollars, argues that the overuse of medical care by health providers and patients is driving up costs and placing patients at unnecessary risk without any real health benefit. The driving force is not better health, but more profit. In such a system, preventative care has become focused on the selling of expensive drugs and procedures to healthy people. Instead, Kaplan contends, preventive care needs to be focused on the prevention of disease. It's worth a look