Friday, March 26, 2010

Too Much Medical Care? A doctor speaks out about his own profession and my thoughts

In todays star ledger, in the opinion column, there was an article written by H Gilbert Welch, an internist in the Department of Veterans Affairs titled Are we getting too much medical care (This has been printed by numerous newspapers because it says many of the things I have been talking about for quite some time http://www.projo.com/opinion/contributors/content/CT_welch_03-19-10_7EHQ2QT_v14.3f8b13f.html).

In todays health care environment, we have used fear quite effectively in getting people to undergo many tests and screenings of dubious value and placing them on substances all paid for by a system that is slowly going broke by this.  The worst part of it all, is that people are not necessarily leading better lives because of these interventions and periodically have procedures done at great cost that left them worse off with no benefit, all paid for by us.  I question all the people on cholesterol meds who would likely feel better and have fewer problems in their muscles and bodies without them.  I question all the people taking Dexxa scans and being put on bone forming meds which have their own side effects which is done because there is a remote possibility that they will have problems when they are in their 80's from compression fractures maybe.

Of course, in the article it also raises the point of when to use technologies.  At the end of life, we still die yet many of us die in the ICU rather than in the comfort of our homes and at great cost as well.  As your parting gift, we drain your bank account for you and you die miserably.  Is this an intelligent and even humane paradigm (pardon my sarcasm).

Maybe, we need the wellness model after all, where people are taught how to stay healthy vs. obsess about weather we are going to be sick or not.

What do you think?  I welcome your thoughts and comments.