Are We Over-Diagnosed?
With genetic and prenatal screening now common, patients are being diagnosed not with disease but with “pre-disease” or for being at “high risk” of developing disease. Revealing the economic and medical forces that contribute to overdiagnosis, Welch makes a reasoned call for change that would save us from countless unneeded surgeries, excessive worry, and exorbitant costs, all while maintaining a balanced view of both the potential benefits and harms of diagnosis. Drawing on data, clinical studies, and anecdotes from his own practice, Welch builds a solid, accessible case against the belief that more screening always improves health care.
Review of the soon-to-be-released book, Overdiagnosed: Making People Sick in the Pursuit of Health.
The answer to the titular question is probably yes.
I am more nuanced than Bruce. I would say “yes” for some and “no” for others.
It has long been known (since the 1980s at least) that preventive care, and the screening that goes with it, generally increases costs.
We know that in government run health care systems government accountants are sent into a panic by the cost of preventive care. The result as we have seen in other countries, and as we are beginning to see under ObamaCare with the agitation to produce guidelines reducing mammograms and PSA testing, is less preventive screening.
Individuals spending their own money see things differently. Facing a tradeoff between $150 for a mammogram or a few nights eating out, a woman might opt to have a mammogram because she desires the risk reduction more than not having to shop, cook, and clean up.
It’s hard to say whether we are over-diagnosed; but I would have to agree that we are over-treated. When treated for problems, the fix is often the wrong one. For instance, high cholesterol and hypertension are treated with medications rather than lifestyle changes. There is only so much modern medicine can do to undo the damage we inflict on ourselves.
Over-treated yes, over diagnosed….probably in some ways.
The term “over-treated” is probably relative. The cost of treating all of these diseases is probably not.
I’ve heard some claims that autism is overly-diagnosed. Usually, within 24 hours of such claims being made by some prominent person in infotainment (talk-radio host Michael Savage comes to mind), there is a backlash and an eruption of anger from the autism awareness community.
Not enough is known about autism, but it is strange that there has been a spike in the number diagnosed in recent years. I’m inclined to believe that either a) something really strange is going on environmentally or b) some children who have something less severe wrong with them are being diagnosed with autism.