How medical screenings cause harm
Most people take for granted that an ounce of prevention is worth a pound of cure. Today, a routine trip to the doctor is essentially a visit for numerous screening tests. The idea is that problems caught early can be treated and cured early. High blood pressure may indicate a risk for heart attacks in the future; mammograms may catch early breast cancers before they metastasize; blood routinely taken from newborns may indicate metabolic problems before brain damage results.
But the truth is that screening tests are just like any other drug or medical procedure, with potentially deadly risks that must be balanced with the potential benefits. The same people who would agonize over the decision to take estrogen-replacement therapy, for example, don’t think twice before getting a mammogram. However, as the data indicate, they sometimes should. Screening tests can cause harm in two major ways: false-positive diagnoses and unnecessary treatment of benign conditions. Unfortunately, these problems can be masked because a little-known but vital error pervades almost every major study involving screening for deadly diseases, especially cancers—and makes the tests appear better than they really are.
#1: Did you read the whole article?
Ok, so my 5-month-old daughter came down with a fever. They checked her white blood cell count and found it to be high. (That took one stick.) Then they checked her urine and found it to be normal (that was two sticks with the cath since the first didn’t work…) And then they wanted to check her blood for a bacterial infection. That took 3 sticks since the first 2 didn’t work, and a trip to the hospital to get the blood drawn. The insurance paid about $120 for that bit of phlebotomy. Then we went back to the doctor for the seventh stick – an antibiotic shot in case she really did have a bacterial infection. THEN the next day, no results so another shot of antibiotics and another check of the white blood cells (which was normal). And on Monday, we get a scrip for oral antibiotics even though the bacterial infection test came back negative! </rant>
“Most of the times you HAVE to decide whats the lesser evil: a medical procedure (tests, surgeries, treatments) or leave an illness go rampant or not have the exact nature of an illness (have a confident diagnosis)”
And yet, the majority of people don’t know enough medicine to decide if what the expert (the doctor) is telling them is the right course. And even if they do, they may still be required to take a test to get treatment because the doctor, clinic or hospital requires it for their insurance in case you decide to sue or they do screw something up.
What I see worthwhile in the article is essentially a call for patients to not always accept what they’re told and ask more questions. YOU may feel it’s obvious or whatever, but I guarantee there are plenty of people who don’t.
#4, pedro,
Good argument and I like the way you put it. Another factor is that most medical tests come about because of some indication or suspicion.
As Jim Scarborough pointed out above, his child had a fever so the Doctor ordered tests. Why? I can only guess, such as there might have been meningitis around. His point about the seemingly needless blood samples is very valid however. And that is where Uncle Dave’s opening reply in #5 comes in, deciding which is worse, the test or the disease.