Book Recommendation: Overdiagnosed: Making People Sick in the Pursuit of Health

[Maus]

The medical debate has been fascinating. But I remind myself that in the end we all die. Everyone is terminal! We can die well, pain-free and with some measure of control; or in varying degrees of indignity, pain and alienation.
I have a great relationship with my primary care physician. He treats me with respect and helps me to live as well as I can. And he is always candid about the limits of medical science. I don't expect to die tomorrow, but I try to live as if I might.

[Laura Ingalls]

Jason-- you are right about 100 being average. It's both the mean and the median. But 85 would also be average and so would 115. Very few people would have an IQ of exactly 100.
Chad--Really, people in the 34th percentile of intellectual ability are merely surviving? Sound pretty snobby/elitist to me.

[JasonR]

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[MichaelAndrewLo]

I think this issue is a larger systemic issue in healthcare that started when John Rockefeller started pumping his money into medical schools. Originally the research and advancements made were very beneficial but then of course greed took over and medicine became about "disease symptom management" and "treatments" instead of cures because, well, healthy patients aren't profitable. They don't want you dead, but just sick enough to need their medicines and treatments. Most diseases are caused by poor lifestyle choices and many can be cured and reversed with changes in lifestyle and diet.
The modern healthcare system places very little emphasis on proper nutrition and diet in the importance of health and two simple evidences of that are the bastardized food pyramid in the U.S. and one of the staple foods in U.S. hospitals is jello. You are what you eat and most people eat crappy processed food with little nutritional content.
I know this post was talking about overtesting, but this goes far beyong that into overprescribing and administering treatments that actually don't do a darn thing. Chemotherapy and radiation are a prime example and the statistics are manipulated to make it look successful when in reality these treatments cause more problems and deaths and new cancers but is simply too profitable to stop. The truth will be suppressed for profit in todays healthcare system so one must be educated or will be swept away into the system. At your own expense of course.
A good example is Otoo Henchrich Walburg who won a nobel prize for his discovery of the mechanism of cancer: "Cancer, above all other diseases, has countless secondary causes. But, even for cancer, there is only one prime cause. Summarized in a few words, the prime cause of cancer is the replacement of the respiration of oxygen in normal body cells by a fermentation of sugar." -- Dr. Otto H. Warburg in Lecture
It makes perfect logical sense and has a simple treatments based on simple scientific understanding. I won't go into that but ultimately this knowledge was discarded and suppressed because curing a disease makes no money, especially when pharma companies are standing to make big profits on the new "symptom management" of diseases. This is just one of many cases where real science and truth is squashed to benefit the larger business and systems that currents healthcare runs.
So ultimately this topic is part of a much larger systemic issue of which the governement health agencies, healthcare practitioners, and businesses are involved in much to their unknowing. The history of how we got to where we are is out in the open and is quite shocking in its brashness and straightforwardness. Things like the FDA, AMA, and USDA are not there to protect consumer interests but to ultimately protect business from the consumers. One simple example is ephedra vs. Vioxx. Ephedra, natural substance used for thousands and thousands of years, banned because a couple hundred people had "adverse reactions" and deaths r/t ephedra. Who knows how this was linked and the specific causes? Many of those cases were found to be treated with other mediciations and had heart issues. Vioxx, resulted in 88000 to 140000 cases of serious heart failure more than 24,000 deaths. Studies were suppressed to prevent the drug from being stopped. Made 2.5 billion dollars. CAN STILL BE PRESCRIBED.
History is a scary thing. The future even scarier. Brought to you by a U.S. RN.

[deGamba]

@MichaelAndrewLo, Certainly there are fraudulent activities that exist in medical businesses as in other parts of the economy but lets not paint everything with the same broad brush. In fact there are many glycolic inhibitors and lots of research underway on glycolysis. See the Wikipedia page on Warburg effect for a list of some: http://en.wikipedia.org/wiki/Warburg_effect . Some of these substances are subject to many clinical trials. For example, there are 28 clinical trials of DCA: http://www.clinicaltrials.gov/ct2/results?term=DCA . Given the amount of activity on this, rather than being some sort of conspiracy its much more likely that the attempts that relied on this mechanism simply did not work.

[MichaelAndrewLo]

@ deGamba It has to be painted with a broad brush because it is a SYSTEMIC issue and not some isolated incident. Of course when the government is in bed with big pharma how can you expect corruption to not happen? The system is made to profit from synthesized drugs that don't actually cure anything. As a RN I see first hand case after case how someone is diagnosed with a disease and simply prescribed a drug or treatment with no attempts to actually get at WHAT caused the disease in the first place and to actually CURE it. Curing is illegal in the U.S. Instead they want you to be a perpetual consumer of the drugs and "care". Why has there never been a large scale study of simple things like the budwig protocol for cancers? There is simply no money and no profit in cures and simple treatments.

I have worked for client of all backgrounds and have noticed 2 things. Generally the more educated upscale clients are older and healthier and they take none or VERY few medications or treatments. The much younger, poorer, and less educated patients generally have been "in the system" for a while and follow all the prescribed treatments with no lifestyle change. Now at what point did the MD or RN step in to actually help them set up and make changes and go through THOROUGH education at what the root cause is of their illnesses? My guess would be never. Healthcare costs are so high because profits are so high.
There was recently a large scale study done on cancers across china and they pinpointed specific areas of cancers and tried to identify the causes. They found a huge link to the foods people were eating and the cancers. Now don't you think if the food is causing the illness changing what you are eating would change the illness? Sorry if that is too logical compared to the "FDA science" that the government loves to practice but it makes sense to me. The best place to hide something is out in the open and I suspect Rockefeller wanted to put that to the test. He did a good job.

[orinoco]

I recently found this article interesting, & it I think paints a more positive picture for the future of US healthcare.

[MichaelAndrewLo]

@ Orinoco that was positive? Actually working in healthcare I know the true reasons for why service is so crappy at most hospitals and across the healthcare field. It is precisely because healthcare IS becoming conglomerated. That article leaves out some important points. Unlike the cheekcase factory dealing with food and maximizing efficiency by producing good food quickly, how big hospitals and corporate healthcare maximizes profits and effeciency is to give nurses and doctors more patients, all while telling them to deal with it with ever increasing standards and expectations but ever decreasing pay, resources, and help.
The only way to reduce costs is to actually cure people of their illnesses through actual evidence based science and not bought studies for pharmaceutical companies. Prevention and cures are the answer to ever increasing costs not maximizing healthcare workers and making hospitals bigger and more efficient to pump patients in and out and keeping them happy. I worked for a certian large healthcare company and they were for profit. They toted the lines of better care for less cost but it's all bull****. As far as I saw they simply gave nurses and doctors lots of patients and wanted us to keep a smile on our face. There were a few sociopaths that stayed there for a long time but for most healthcare professionals it was in and out in a year or 3 maximum. Unlike the cheesecake factory which can treat their workers as slaves and tell them to do things a certain way because it doesn't take 8 years to educate a factory worker, healthcare professionals are highly educated workers and a large proportion will be smart enough to find a way to simply leave healthcare before it ever reaches the "ideal" situation in that article. I know I will.

[orinoco]

@MichaelAndrewLo
"The only way to reduce costs is to actually cure people of their illnesses through actual evidence based science and not bought studies for pharmaceutical companies."
Did you miss the bits about evaluating the effectiveness of the replacement knee implants, the use of passive motion machines the change of emphasis in rehab which cut rehab from three weeks to one? Sounds like evidence based science to me.
"how big hospitals and corporate healthcare maximizes profits and effeciency is to give nurses and doctors more patients, all while telling them to deal with it with ever increasing standards and expectations but ever decreasing pay, resources, and help."
You are right there is no mention of decreasing salaries or increasing patient numbers (can you provide a good source for this info?), but I think strictly monitoring results & coaching staff on the best practises & increasing standards is a good thing. The ICU command centres strikes me as both adding & using existing resources more effectively rather than decreasing them.
The article talks about some doctors who resisted the changes (“The morning team can deal with that.” - seriously?!) If there are doctors who want to do it their way & can't take improvements on board it will be better for everyone if they do leave.

[MichaelAndrewLo]

@ Orinoco I generally very much enjoy taking care of knee replacement patients: in and out very successfully (and profitably) because of the advancements made. So... I don't disagree on the evidence base portion of your argument. I wonder why there isn't more research or education done on how to prevent osteoarthritis in the first place. Even a broken clock (or system) is right twice a day. What's your point?
Any of the millions of RNs in the U.S. would be a good source for the current state of affairs regarding the actual quality of care being given and the two faced perspective of healthcare. Of course I agree that quality assurance and improvement objectives are wonderful and necessary things to implement. The other side that I obviously didn't elucidate clearly enough is that education is NOT the issue. Healthcare institutions can easily hire one or two educators to run around and yell at the MD or RN staff that they are doing things incorrectly and need to change but when the RN says "I have 10 patients and don't have time to do it the new way, how about we hire some extra RNs to implement these objectives?" that falls on deaf ears. That would require REAL investment of resources. Only until ALL states implement laws to protect patients by mandating ratios or requiring evidence based RN patient assignments will things change. But of course having only 1 nurse for 4-5 patients simply isn't profitable enough.
http://nursingtrends.wordpress.com/2010 ... rovements/
There have been many excellent physicians who resisted many of the changes in current healthcare and they have gotten out of the current system. They've been ostracized because they are a threat to the system. Even when they have brilliant ideas based on real science. Much like when Adam talks about the political nature of being a researcher in his field it is magnified 10000X in healthcare because licenses, human life, and profit are at stake.
What I am talking about is common knowledge in the healthcare community and many professionals choose to simply ignore it and play along because they truly want to help people, even despite the system. I have worked in Oregon, North Dakota, California, and Florida. Calfornia is the only state to actually implement a RN to patient ratio for safety. Even this doesn't protect patients to the fullest extent because this has forced many hospitals to find other ways to proft instead of through shirking on nursing care. Though that article discussed how doctors are improving the care in hospitals through improvment initiatives it misses the most important point in that patients in hospitals are mostly there for the nursing care and as much as doctors can efficiently and accurately order care it is ultimately only as well done as the hospital supports nurses in providing care. As far as I see it can be much improved but, due to the profit incentive seen by the MBAs (most with no healthcare experience) running the instutions, mostly isn't. Nevertheless, I don't think we'll ever see eye to eye on this issue. I care strongly about patients' and have seen much about what the current healthcare system has done for their health. It's simply not impressive and we only stand to get fatter and sicker if we follow the syst

[orinoco]

@ MichaelAndrewLo
I think we do see eye to eye on the issue. I posted an article which I thought was positive for introducing improvement initiatives & I believe you have acknowledged this also. You raised a number of negatives that we both concur are not covered by the article. No disagreement from me! I think you are projecting your frustrations with the system on to me because I have dared to see something positive. I admire your passion, but I'm not going to stop being positive!

[MichaelAndrewLo]

Well stay positive at your own risk. "Death by doctor" is so common they even gave it its own inconspicuous name (iatrogenesis). That has passed in and out the medical establishments own statistics as being the 3rd leading cause of death in the U.S., just under heart disease and cancers.
History is a scary thing especially when it has so powerfully determined our present and future.
http://www.mnwelldir.org/docs/fraud/chemo.htm
One of the few studies ... was conducted by Dr. Hardin Jones, professor of medical physics and physiology at the University of California, Berkeley. He told an ACS panel, "My studies have proven conclusively that untreated cancer victims actually live up to four times longer than treated individuals. For a typical type of cancer, people who refused treatment lived for an average of 12-1/2 years. Those who accepted surgery or other kinds of treatment [chemotherapy, radiation, cobalt] lived an average of only three years. . . . I attribute this to the traumatic effect of surgery on the body's natural defense mechanism. The body has a natural defense against every type of cancer."
Good luck.

[Stahlmann]

the line between science and pseudoscience is pretty small one