Protect Yourself From Overdiagnosis!

Have you noticed lately some of the medical news that is actually making the mainstream news? Stories like, Properly Prescribed Drugs Are Causing 200,000—300,000 deaths annually? And that these prescription drugs plus all medical and surgical practices combined are the number one cause of death in America.

Today everyone feels that his or her diagnosis is critical. Yet diagnoses are simply medical names Doctor and patientput on a set of symptoms. They have nothing to do with treating the cause of the problem, because all medical treatment by definition is symptom treatment based on the diagnosis. And half the time you will get at least a partially incorrect diagnosis. Medical experts admit that you stand a 50% chance of being misdiagnosed in a hospital. 1

Today scans and screenings are part of the modern medical era of early diagnosis. And they are making a lot of news lately as a real secret—is leaking out.

Most medical screenings are big money scams that cause untold damage. They turn healthy people into sick patients, who then succumb to the pitfalls of medical and prescription drug treatments. Scans and screenings are notoriously inaccurate. They swell the already bloated costs of medical care. And in the end, they statistically do absolutely nothing to prolong life for the average person. 2 The name of this new medical secret? Overdiagnosis.

In fact, a new book called Overdiagnosed—Making People Sick in the Pursuit of Health. by three physicians, researchers, authors, and professors at the Dartmouth Institute for Health Policy and Clinical Practice, sums this mess up as well as I have: “Overdiagnosis has led millions of people to become patients unnecessarily, to be made anxious about their health, to be treated needlessly, and to bear the inconvenience and financial burdens associated with overdiagnosis. It has added staggering costs to our already overburdened health care system. And all the forces that helped create and exacerbate the problem [make the problem worse] like financial gain [money], true belief [many physicians truly believe in all the screenings and scans], legal concerns [protection from lawsuits by patients], media messages [the TV, radio, and the press love this stuff, and self-reinforcing cycles [once it starts it is hard to stop]    are powerful obstacles to fixing it.” In other words, for all the reasons given, overdiagnosis is not going to go away. Instead it will get worse.

More Diagnosis, More Treatment, More Drugs, More Surgery, More Money

Here’s how it works. Medical “experts” get together and ratchet down guidelines for the numbers considered abnormal for say, high blood pressure, osteoporosis, blood sugar, and cholesterol. So a healthy person, who was normal 20 years ago under the old guidelines with a cholesterol level of 250, would now be sick under the new guidelines and in need of treatment. These folks, along with the millions of others now pronounced sick under new guidelines for other health problems, bloat the number of healthy people now deemed sick and ready to be fleeced mostly for little to no benefit, but for lots of cost, worry, and risk.

According to the old guidelines there were about 11.5 million diabetics. Under the new guidelines there are now about 13.3 million, or close to 2 million new patients. In the past there were about 39 million people with high blood pressure. Now there are more than 52 million, or almost 13 million new patients. In the past there were about 49.5 million people with high cholesterol. Now there are over 92 million, or almost 43 million new patients! And in the past there were about 8 million people with osteoporosis. Now there are 15 million, or close to 7 million new patients. 3

That is close to 65 million new patients, with all the accompanying drugs, surgeries, office visits, hospitalizations, and treatments for drug side effects. And for what? If, indeed, all these 65 million people were saved a health crisis, we could say that we have done a great job. But the medical statistics tell a story that is just the opposite. For example, if 100 patients are diagnosed with osteoporosis under the new, “expert,” bone density guidelines, and all are treated for life with drugs, here are the real medical statistics on the results: There will be 5 winners (treatment for life prevented one fracture); there will be 44 people treated for naught (they had fractures despite the lifetime treatment); and there will be 51 losers (these people will suffer through the trouble, expense, worry, and potentially serious side effects because they were overdiagnosed   treatment could not help them because they were never going to have fractures)!

And it does not stop with just osteoporosis, cholesterol, high blood pressure, and diabetes. There are millions more to be fleeced. There is PSA testing for prostate cancer. There are scans and testing for all kinds of cancers, joint problems, gallbladder problems, and more. Since the 1990s, the per capita use of head scans has doubled. Abdominal scans have tripled. Brain scans have increased fourfold. Chest scans have increased fivefold. Spine scans have increased sixfold. And hip and knee scans have increased tenfold! The problem is, when an abnormality is found on a scan, too often no one really knows whether it means anything at all. But in most cases, further testing and treatment ensue anyway.

For example, when healthy people are scanned, about 10% of those with no digestive problems have gallstones. In people with no knee problems or pain, about 40% have meniscus damage. And in people with no history of back pain, about 50% have bulging discs in the low back. What is common here is that these people are not sick and do not need treatment. Yet further testing, treatment, and even surgery, with all their bloated costs, side effects, and dangers            all caused by overdiagnosis—is not uncommon!

Even mammography becomes part of the overdiagnosis problem. When the recommendation to not screen women before age 50 came down, the world of women, health, medicine, and even politics, went ballistic. Women’s groups, medical groups, radiological groups, the pharmaceutical industry, and even politicians said that the new recommendations were trying to kill women to save money. In reality, the exact opposite was true.

Here’s why: Screening women between the ages of 40 to 50 provides no statistical benefit but lots of harm.4 All the evidence shows that for every 2000 women in this age group screened with mammography every year for 10 years, one death from breast cancer will be avoided (or at least put off for a few years). However for every 2000 women screened, 10 healthy women will be misdiagnosed with cancer. This overdiagnosis will result in six extra lumpectomies, four extra mastectomies, and untold damage  even early death from the surgeries, chemotherapy, and radiation. Furthermore, two hundred of these women will suffer significant psychological harm from the anxiety caused by the additional investigation of “abnormal mammography findings.” So, in fact, the experts making the recommendations to end mammography for healthy women aged 40 to 50 are simply trying to save women from overdiagnosis, which can cause severe harm, mental anguish, maiming, and even death.

That this can be hurting us so badly seems impossible because the concept of early diagnosis seems to make so much sense. But in one of the most statistically accurate analyses of the entire process, we now know that, at least statistically, scans and screenings are a monumental drain on our health budget, and they do not save lives.5 Still both you and I probably know someone who was “saved” by a mammogram, or a heart scan, or some other screening. Unfortunately, for every one of these, another person or more has been injured, maimed or killed by medical procedures they endured following errant results or interpretations of scans and screenings.

Screened to Death

Melinda was a loving grandmother who never had a health problem and took no drugs. She went to a free blood pressure and cholesterol screening at her church and was told that she had high blood pressure (140/90) and high cholesterol (265). This was in spite of the fact that, contrary to conventional medical wisdom, high cholesterol levels in older people add, not subtract, years of life. The doctors also conveniently omitted the fact that 140/90 is normal blood pressure for a woman in her 80s.

Nonetheless, treatment she got in the form of Lipitor”’ and Topror. She immediately became sick, dizzy, weak, and out-of-sorts. Worried about his mom, her son took her to another doctor who never even asked about her prescriptions. Instead he prescribed Zoloft”‘ for depression that she did not have. She languished on these three drugs until one day she fainted, fell, broke her hip, and landed in intensive care. There it was determined that she had osteoporosis, and she was prescribed Fosa­max” again, in spite of the fact that bone drugs like Fosamax do not help build healthy bone mass.

By now Melinda was in a life-threatening situation. She struggled along in the hospital, made it through surgery with a brand-new titanium hip, and ended in excruciating pain. So what did her doctors do? They prescribed painkillers, which became the final stage in her tragic downward death spiral. Barely able to breathe, Melinda was put on oxygen and then later ventilated and intubated. It was a sad and terrible end for a once active and vivacious grandmother. Unable to fight any longer, she took her last breath and died. It was later discovered that at her death her blood pressure was 80/40!

No one was sued. Melinda’s death was not recorded as any medical mishap, misdiagnosis, overdiagnosis, or malpractice. The side effects of the drugs went unrecorded. Neither her death nor the hospital became a statistic in the dangerous drugs database because nothing was ever reported. Her doctors continued on and continue now to prescribe Lipitor, Toprol, Fosamax, Zoloft, and hundreds of other drugs like they were candy. Her son was devastated. Her grandkids cried for days. And all this was due to overdiagnosis!

Medicine is getting smarter, with lots of great books being published, like the ones mentioned in this article, about the pitfalls of scans, screenings, and overdiagnosis. Still, the only one you can count on to keep yourself safe from these practices is you.

NOTES

1. Journal of the American Medic al Association. Vol. 258. No. 3.

2. Hadler, Nortin M., MD (2008). Worried sick: A prescription for health in an overtreated America. Chapel Hill, NC: University of North Carolina Press, 2008.

3. Welch, H. Gilbert, MD, Schwartz, Lisa M., MD, Woloshin Steven, MD (2011). Overdianosed: Making people sick in the pursuit of health. Boston, MA: Beacon Press, 2011

4. Hadler, Nortin M., MD (2008). Worried .sick: A prescription for health in an overtreated America. Chapel Hill: University of North Carolina Press, 2008.

5. Welch, 11. Gilbert. MD, Schwartz. Lisa M.,MD, Woloshin Steven, MD (201 1). Overdiagnosed: Making people sick in the pursuit of health. Boston MA: Beacon Press.