What if I Told You Your Doctor Visits Might Be Unnecessary?
The brand new issue of the medical journal PLoS One published a study called Overtreatment in the United States. Those of you who have been following my blog long enough know that I’ve shared my opinion on this phenomenon of OVERDIAGNOSIS & OVERTREATMENT before. When you see “overdiagnosis,” think unnecessary diagnostic imaging, tests, doctor visits, etc. And when you see “overtreatment” think unnecessary medications and surgeries.
In this study from the prestigious Johns Hopkins University, researchers surveyed over 2,100 physicians from around the country, determining that, “From the physician perspective, overtreatment is common.” How common unnecessary medical care? From the numerous data listed in the study, they admit to about one third. And while the number one reason given for said overtreatment was “fear of malpractice,” over 70% admitted that it had to do with money.
What’s my opinion of the results of this study? Firstly, in light of what we know from decades of previous research, their figure of one third is low. For example, when the giant actuarial firm ROBERTSON & MILIMAN was hired by the United States government to determine how many surgical procedures were unnecessary, the figure they came up with back in 1995 was about 6 of 10 or 60%. Trust me when I tell you that things have not improved much since then. In fact, it’s possible they’re worse.
Furthermore, when we look at what the “best evidence” actually says concerning our current EVIDENCE-BASED GUIDELINES for various testing procedures, treatments, physical examinations, blood work, mammograms, female annuals, etc, etc, etc, what we find is that according to peer-review, we are not even in the ball park as far as a practicing based on current evidence is concerned (see link).
The dirty little secret of Overdiagnosis & Overtreatment is that while the testing procedures mentioned in the previous link can sometimes lead to early detection of certain diseases that saves some people; in about the same number of cases, early detection ends up killing them via overtreatment.
In other words, health issues (many pertaining to CANCER) that are slow-growing or even dormant, and would never present a problem in the average person’s natural life-span can be awakened / provoked / stimulated, leading to the equivalent number of deaths on the back end as lives that were saved on the front end. It’s just that the front end of this scenario is heroic-sounding and plays well in people’s minds, as well as in the media. To better understand what I mean, take a look at the EBG link in the earlier paragraph.
Another proof of overtreatment has to do with a brand new 80 page study by Alan Krueger of Princeton called Where Have All the Workers Gone? An Inquiry into the Decline of the U.S. Labor Force Participation Rate. Krueger begins his paper by saying, “The labor force participation rate in the U.S. has declined since 2007 primarily because of population aging and ongoing trends that preceded the Great Recession.” With approximately 7 million young American men that could be working but are not, I’m frankly interested in what these ongoing trends are. Listen to what Dr. K says.
“Labor-force participation has fallen more in areas where relatively more opioid pain medication is prescribed, causing the problem of depressed labor-force participation and the opioid crisis to become intertwined.”
Just how big is this “intertwining” as related to OPIOIDS? An extremely similar 2016 study by Dr. Kreuger showed that about half of all “prime-age” working males that have dropped out of the work force are addicted to opiods (for the record, the only Westernized country with a higher rate of “non-participation” of young, healthy, males in the work force is the PIGS nation; Italy). Who is prescribing these opiods? Certainly not me.
If you want to see how freaky this problem really is in your county (my county is the tall one in the center of southern Missouri that borders Arkansas — as you can see, things are bad here concerning addiction to prescription pills), just take a peek at Fred Dews’ How the Opioid Epidemic has Affected the U.S. Labor Force, County-by-County, writing in an issue of last week’s issue of Brookings — the official publication of Princeton’s Brookings Institute.
I’ve written scores of posts showing why it’s tenuous accepting our biomedical community’s research findings as fact (“EVIDENCE-BASED MEDICINE“). What do I like instead? For almost six years I have been doing (when I’m not too busy) VIDEO TESTIMONIALS. While it’s not exactly peer-review, I’m not sure there’s better “proof,” that what I’m doing clinically works; and some of these probably pertain to the very same problem(s) you yourself have been dealing with.
So, before you head to the doctor, ask yourself whether or not it’s really necessary (same goes for your kids as touted by DR. RM). The truth is, most acute problems are self-limiting, and what the heck is a doctor really going to do to change your chronic issues anyway? It’s time to face the music.
No matter how much you believe in that new drug that was touted on channel 10 last evening (HERE), you doctor can’t do it for you. You’ll have to knuckle down and make some serious lifestyle changes yourself. The cool thing is, however, it’s not impossible. In fact, considering I’ve given you a great place to start and haven’t charged you a nickel for it (HERE), isn’t about time to sit down and create your own EXIT STRATEGY?
