What’s Making Us Sick Is an Epidemic of Diagnoses (1 Viewer)

[RightinNYC]

http://www.nytimes.com/2007/01/02/health/02essa.html?ref=health

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

You might think this is because doctors make mistakes (we do make mistakes). But you can’t be a victim of medical error if you are not in the 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.

This epidemic is a threat to your health. It has two distinct sources. One is the medicalization of everyday life. Most of us experience physical or emotional sensations we don’t like, and in the past, this was considered a part of life. Increasingly, however, such sensations are considered symptoms of disease. Everyday experiences like insomnia, sadness, twitchy legs and impaired sex drive now become diagnoses: sleep disorder, depression, restless leg syndrome and sexual dysfunction.

Perhaps most worrisome is the medicalization of childhood. If children cough after exercising, they have asthma; if they have trouble reading, they are dyslexic; if they are unhappy, they are depressed; and if they alternate between unhappiness and liveliness, they have bipolar disorder. While these diagnoses may benefit the few with severe symptoms, one has to wonder about the effect on the many whose symptoms are mild, intermittent or transient.

Second, the rules are changing. Expert panels constantly expand what constitutes disease: thresholds for diagnosing diabetes, hypertension, osteoporosis and obesity have all fallen in the last few years. The criterion for normal cholesterol has dropped multiple times. With these changes, disease can now be diagnosed in more than half the population.

Most of us assume that all this additional diagnosis can only be beneficial. And some of it is. But at the extreme, the logic of early detection is absurd. If more than half of us are sick, what does it mean to be normal? Many more of us harbor “pre-disease” than will ever get disease, and all of us are “at risk.” The medicalization of everyday life is no less problematic. Exactly what are we doing to our children when 40 percent of summer campers are on one or more chronic prescription medications?

The epidemic of diagnoses has many causes. More diagnoses mean more money for drug manufacturers, hospitals, physicians and disease advocacy groups. Researchers, and even the disease-based organization of the National Institutes of Health, secure their stature (and financing) by promoting the detection of “their” disease. Medico-legal concerns also drive the epidemic. While failing to make a diagnosis can result in lawsuits, there are no corresponding penalties for overdiagnosis. Thus, the path of least resistance for clinicians is to diagnose liberally — even when we wonder if doing so really helps our patients.

Yes, yes, a thousand times yes.

This is the reason we have a "health care crisis," the reason why Medicare is ****ed, and the reason why medical costs have skyrocketed. Every damn thing is a disease nowadays.

One of the better articles I've read in a long time.

 

[7thKeeper]

http://www.nytimes.com/2007/01/02/health/02essa.html?ref=health


Yes, yes, a thousand times yes.

This is the reason we have a "health care crisis," the reason why Medicare is ****ed, and the reason why medical costs have skyrocketed. Every damn thing is a disease nowadays.

One of the better articles I've read in a long time.

Got to agree with you on this one. While I haven't quite seen things taken that far where I live, the medication of kids (well everyone as well I think) seems to move towards that direction here as well. I guess the attitude is "better safe than sorry", except here erring on the side of safe can have some very bad consequences as well. Hopefully doctors and parents will be able to "keep their pants" on and not panic at the first sign of their child being overactive or anything and put them on pills.

 

[jujuman13]

Well spotted, a very good article.
Although one might think it an opinion and not strictly speaking, breaking news?