From People to Patients: The "Epidemic of Diagnoses"

Do you want to know that you are at risk for heart disease? Would you medicate your seven-year-old child if your doctor said he or she was clinically depressed? The New York Times had an article by three authors (H. Gilbert Welch, Lisa Schwartz and Steven Woloshin) this week that really intrigued me and I want to share it with my blog readers – all three of you. The authors' stance is that we are over-diagnosing ourselves into oblivion. We are moving from a world of people to a world of patients – quickly. Their argument holds water – a lot of it. Drink it down and let it sit for a while before you choose to disagree.

The "medicalization" of everyday life is something that I have personally taken note of; however I can't seem to rise above it myself. I don't hesitate to complain if I have a pain in my leg or couldn't sleep last night. What it leads to is a society of people who are unable to soldier on through restless legs and run to the nearest doctors grasping for a prescription slip. Welch Schwartz and Woloshin write: "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." This I undoubtedly agree with.
Then there is the part of their argument that I am not 100% behind: the authors write that the push for early diagnosis is not always necessarily a beneficial one. Those at "risk" should sometimes remain at risk and not diagnosed. The reason more people are now diagnosed is that the thresholds for disease are lowering, such as normal cholesterol levels and what is considered obese. The authors point out that "many more of us harbor 'pre-disease' than will ever get disease, and all of us are 'at risk.'" Okay, I get their argument. However, we may all be at risk, but I still believe that we should be thankful for our ability to screen early and treat those at risk. I see the authors' point that red stamping people as "risks" may not even make a difference, but there remains a clear distinction between some early diagnoses remaining undeniably beneficial such as regular mammograms and colonoscopies.
So what do all these diagnoses lead to? A lot of treatments. The authors urge the public to be wary of whether a treatment will help or harm in the long run.
I am curious to see what readers have to say about the "over-diagnosis" of our society and whether you believe it really is harmful or doesn't matter at all. No matter what, it's important to know who has stakes in the game (pharmaceutical companies and doctors) and what their incentives may be. If nothing else, I hope this post has made you think to be a more cautious person before you become a patient.