Doctors do so many tests for many of the wrong reasons; concerns about malpractice, excess reliance on the clinical significance of the test, and inadequate clinical time with their patients. This is exactly what I've feared for many years.
Operating a health system like a business might seem reasonable in a world of free market, but we are finding that it doesn't work that way. Yes, doctors need to use good business models to run their practices, but those same systems don't translate well into the arena healing.
In days past, a doctor would use testing to verify or "rule out" his/her impressions and probably diagnosis. That seems rational. However, using a test report to make the diagnosis opens the door for problems, especially when the test is inappropriate.
One example centers on the mania in medicine to "treat" high cholesterol, regardless of the patient's situation. I personally know of people in their 80s and 90s who have been prescribed a statin drug because their blood cholesterol levels were slightly elevated.
Another is the growing practice of identifying "pre" diseases (pre-diabetes, pre-hypertension, pre-cancer). Some test identifies that a person MIGHT develop one of the diseases. The modern response, then, is to treat it as if it already existed. That ends up requiring drugs or surgery to treat something that has not yet happened. I recall a case where a woman had a genetic connection to breast cancer (sister), meaning there was a greater than normal statistical chance she would also get it. A nurse suggested she to have a mastectomy "just in case". Sounds crazy, but I witnessed it.
Doctors are smart. They know what's going on, but they seem helpless when it comes to changing anything. If things continue on this track, we will all suffer. Our health will not be improved and our finances will be depleted.
*Referencing an article by Nancy Walsh, Staff Writer, MedPage Today
Published: September 27, 2011
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