Diagnosis: Overdiagnosis

A thought provoking essay in the New York Times on our diagnosis-happy culture:

What’s Making Us Sick Is an Epidemic of Diagnoses

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. [full text]

2 thoughts on “Diagnosis: Overdiagnosis

  1. Gosh, we couldn’t have a case of profit motive here, could we? MDs don’t get paid if they don’t see patients, so expanding the number of available diagnoses expands your customer base.

    Ain’t capitalism great?

    And the real kicker is that Bush is telling us we have too much insurance. Right. What we have is too many MDs digging for ways to grow their practice–and their profits.

  2. if we were not so profit-driven, and we had a system that paid md’s for good results, rather than number of visits, then we would be able to compensate our primary care practitioners as they deserve. klaus, if you were ever having a problem that needed your doctor to take more than 15 minutes to care for you they were probably operating at a loss.
    sure, there are greedy doctors, but as it stands now, greed is rewarded and caring is not. all that we have for patient protection is a bunch of lawyers eager to make money off personal injury suits. this contibutes to the piles of paperwork that kill countless trees and to the ordering of countless unecessary diagnostic tests. everyone practices ‘cover your ass’ medicine. in the real world people have complicated problems and sometimes need time and individual treatment plans. the practitioners who give this are not in it for the money, because they aren’t maximizing their output that way and they are not ‘growing their profits.’

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