Tuesday, May 19, 2015

Are We being Overtested,Overdiagnosed and Overtreated?

Go to any hospital,nursing home,diagnostic centre or chemist shop;chances are,you will find a jostling crowd there.Is it population explosion or disease explosion?Point to ponder.

In the years decades gone by,people used to ignore minor hiccups in their body systems.If the problem persisted they would first try home remedies and then go to a doctor.The doctor also relied on clinical diagnosis rather than ordering a battery of tests.

Today everything has changed--the patients as well as the doctors.The average person today is better informed about various diseases and their outcomes.An ever-active media has ensured this.There is a kind of disease phobia in many of us.We rush to the doctor at the first hint of a cold because we are afraid it might be Swine Flu, which has already claimed many lives.This fear even spurs us to request the doctor to carry out some tests even if he did not find it necessary to do so in the first place.

We all have a fear of disease but in some it is so pronounced that they exaggerate their complaints significantly while consulting a doctor.As a result they are saddled with stronger and more medicines than they need.They also end up getting more investigations done on their bodies.

Some,who have health insurance,voluntarily ask for excessive healthcare.This gives only marginal benefits and can even be harmful.

Advanced diagnostic tools like CT scans,MRIs and ultrasounds have made it easy for the doctor to nail down the cause of the patient's distress but excessive use of these tests can be harmful.CT scans expose patients to radiation which is a known cause of cancer.More testing also means more false positives,more unnecessary invasive procedure,more patient stress and higher costs. 

Indeed,according to  Medical Daily :--  

 Unnecessary tests and treatments, while they may appear helpful, are often nothing but money-makers for the hospital and increase a patient’s anxiety (after which anxiety is treated with more pills — a vicious cycle).

Obviously,medical malpractice can generate paranoia about a disease and cause untold harm to a family's emotional and financial status.A news report in The Times of India revealed an alarming trend in private hospitals--that of giving false adverse reports in the hope of getting "more business like further tests,procedures,or even surgeries and prolonged treatment."According to this news item an officer was advised angioplasty following a treadmill test at a private hospital.He went to the A.I.I.M.S for a second opinion and there he was told that there was no need for angioplasty,nor any cause for worry.

I certainly don't mean to imply that the whole fraternity is manipulative or dishonest but since such things are happening,it is up to us to be vigilant and avoid being taken for a ride.
  • Firstly learn to ignore petty problems.The Body Knows How To Heal Itself.
  • Adopt a healthy lifestyle incorporating exercise,nourishing diet and a good work-life balance.
  • If any ailment like headache,back pain,spondylitis,joint pain, allergy,dyspepsia or I,B,S,presents itself off and on;determine what sets it off and avoid it in future.For example many pains can be cured by simply correcting the posture or exercising, and a delicate digestive system can stabilize with proper diet.
  • Don't dramatize your symptoms when you consult a doctor.
  • Take a check list along with you when you visit a doctor so that you can better explain your condition.
  • Do not hesitate to ask the doctor about the adverse effects of any medicine or procedure he may have prescribed.
  • Keep yourself informed about your disease.
  • It is better to start a new medicine in the morning so that ready help is available in case of an adverse reaction.
  • When in doubt,or if advised an expensive/invasive investigation;go for a second opinion.
Just as I was winding up this piece I read a heartening news in The Times of India,Jaipur edition dated May 18.It says that the Society for Less Investigative Medicine (SLIM ) will prepare a list of the investigations which ought not to be done in normal circumstances.This is a very good start,hope it goes far.


http://timesofindia.indiatimes.com/india/Doctors-across-India-join-hands-to-stop-practice-of-unwanted-tests/articleshow/47313607.cms




27 comments :

  1. Ha! I thought of myself as a dinosaur since going to a doctor is the last option I consider. Good to know that it is better this way :)

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    1. It is best to avoid them if you can.Thanx for treading Suresh.

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  2. An eye opener to those who are unaware of this doctors-hospitals-drug companies-pharmacists racket!

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    1. We used to have a blind faith on them once upon a time.

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  3. Yes, yes and yes, Indu. And also,mis-tested, mis-diagnosed and mistreated. I am a living example of all the three. SLIM had warned people, but I think it is not an official body. I hope its recommendations are taken up seriously by the health ministry and directives issued to private hospitals. It is a racket out there and most doctors are falling prey to it. SLIM or no SLIM, people are so paranoid about illnesses that they rush to the doctor at the slightest sniffle and subject themselves to unneccesary investigations and medication. The drugs sometimes do the opposite of what they are supposed to do -- cure.

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    1. Yes Zephyr ,it is yet to be seen what SLIM can achieve.At the end of the day it depends upon the person's conscience.
      Love n hugs.

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  4. You are very correct Indu. today's diagnostic process is like the experiment s you do in a chemistry lab to find the name of the salt...try various procedures and keep eliminating all possibilities till you arrive at the answer .... and too much information is available these days .... Google generation thinks they are half doctor's by reading all ( including nonsense) on the world wide web...

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    1. Even i was thinking this Jaishree.Google p[rotects us from misadventures,but it can also heighten our anxiety.
      Lots of love.

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  5. You are very correct Indu. today's diagnostic process is like the experiment s you do in a chemistry lab to find the name of the salt...try various procedures and keep eliminating all possibilities till you arrive at the answer .... and too much information is available these days .... Google generation thinks they are half doctor's by reading all ( including nonsense) on the world wide web...

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  6. very sane advice..Unless the doctors stop this taking cuts from the test, greed of money will nevr let the over testing stop..
    Govt and society both should do something to be vigilant and stop this practice of giving holidays, gadzets all free to the practicing doctors so that they advise more tests, medicines from that particular co..even if they are not required.

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    1. Yes Renu,free holidays and colossal gifts--these should be nixed.
      By the way Renu have you sanitized your blog--i get warning of a mal URL when i click it.

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  7. if you go to any corporate hospital,they do unnecessary diagnostics coz major revenue comes from that and doc fee is negligible for them. so hospitals can never give up this practise coz its their major cash flow.corporate hospital docs are given a target to prescribe certain number of tests in a month,if a doc doesn't indulge in unethical practise to meet the revenue target,he will be sacked next day.so this is how a corporate hospital business runs,people who speak of ethical practises are individual docs who don't have much practise.

    i din't see honest or ethically right doc for a long time.you may find in small towns in the form of general physician with their own clinic if they don't have any commission based diagnostic centre link-up.

    docs in corporate hospitals are as scary as police wallah who preys on haftas. i think the real meaning of doctor profession has lost its real value long back .

    in the end ,we can't blame one medical profession for its unethical practices,its influenced by general society behavior which has gone rogue long back.a rogue society will have rogue hospital and docs,rogue restaurants and multiplexes who charge more than needed ,rogue government officials ,businesses and politicians.why to point out at one profession when whole society has turned into rogue in india.

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    1. You have filled in many blanks.Yes it is true that the whole value system has gone awry--why blame them alone ?

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  8. I have had my share of bad experiences with the biggest hospitals in Bangalore...the horror of horrors where they exploit our need our anxiety...being well informed works surely :)

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  9. It is really a shame that inspite of so much technological advances people are still being mis-diagnosed... Real pity when such a noble profession being used for just one thin MAKING Money...

    I still cant believe when the first thing a Doctor told me was he needs to give me a injection for a MINOR COLD...


    Bikram's

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    1. This is astounding-injection for a minor cold ?
      Technology is being misused so often.

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  10. I blame Google fuelled paranoia.

    I avoid Doctors and hospitals as much as it's possible. Like you said, it's better to resort to better diet and let the body self heal.

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    1. No doubt,that is the best way.
      Thanks for your feedback Purba :)

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  11. About a year back I read a small news item which said that ..... It was noticed during a certain period of time that the death rate in a certain foreign country had suddenly gone down in a particular hospital ...a study was conducted and on investigation it was found that the doctors were on strike during that period " ----incidently Indu ji the only medicines used in my house are dispirin, crocin and gelusil and of course Vicks vaporub which is used only if there is no mustard oil at home :)

    love and hgz

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    1. Really?This is a telling testimony on the disease which is consuming the medical profession.
      I agree with you simple remedies are best.

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  12. I am very wary of excessive and strong medication. I prefer to treat the common illnesses with home remedies. Better diet and exercise builds immunity. Yes, google has made us more paranoid. You have put some wonderful tips there, Indu.

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    1. Thanks a lot Rachna,it feels nice that my thoughts resonate with yours.
      Love.

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  13. Well written and I too second your thoughts in this post. In places like UK, even kids are no given antibiotic at first instance for any cold, fever or infections unless it gets worse. It is believed that the body that fights more and defend more in future. That's called power of immunity. There were even many natural home remedies used in the past but now it has either been forgotten or erased. Thanks for this post Indu!

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    1. I am so glad you liked this post Uma,nice to be in touch with like-minded friends.Thanks for reading.

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  14. Such a pertinent post. Sharing this with someone who is a hypochondriac and worried about her health all the time.

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    1. Thanks for the share Alka,I am very happy you found it useful.

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