Dr. …NO

“No! One word that will save your life” says an article in the Newsweek’s latest edition. It was surprising to note that the entire article was centred round how one did not need to take test upon test in order to be able to live a life free from illness.

The article begins with Dr. Stephen Smith, Professor Emeritus of Family Medicine at Brown University, School of Medicine, telling his physician not to order a PSA blood test for prostate cancer or an annual electrocardiogram to screen his heart for irregularities, since neither test has been known to save lives.

In another analogy the article uses, Dr. Rita Redberg, Professor of Medicine at the University of California, San Francisco and Editor of the prestigious Archives of Internal Medicine, has no intention of having a screening mammogram even though her 50th birthday has come and gone. That’s the age at which women are advised to get one.

“But,” says Redberg, “they detect too many false positives (suspicious spots that turn out to be nothing, upon biopsy) and tumours that might regress on their own”.  She also says that there is little if any evidence that these tests save lives.

Newsweek goes on to say that these physicians are not anti-medicine. “They are not trying to save money on their copayments or deductibles. And they are not trying to rein in the nation’s soaring health care costs, which at $ 2.7 trillion, account for fully one sixth of every dollar spent in the US. They are applying to their personal lives a message; they have become increasingly vocal about their roles as biochemical researchers and doctors: more health care often means worse health.”

This is a complete turnaround from what we have been hearing for years, from these very magazines i.e. Time, Newsweek and the like. What about that visit to the dentist once a year, having a physical every one to five years or the annual mammogram, which was deemed a must for women who are 50 and over, thyroid tests and diabetes checks for people up to 35 and bone density scans, colonoscopies and endoscopies for the different ages.

For years we have read articles that have cautioned us and told us that these tests are necessary if we are to survive in the modern world and then suddenly we are told that in fact, “for many otherwise healthy people, tests often lead to more tests, which can lead to interventions based on a possible problem that may have gone away on its own or ultimately proved harmless. Patients can easily be fooled when a screening test detects, or an intervention treats an abnormality and their health improves, says cardiologist Michael Lauer of the National Heart, Lung, and Blood institute. In fact, says Lauer, that abnormality may not have been the cause of the problem or a threat to future health: All you’ve done is misclassify someone with no disease as having disease.”

Most often in this column, I would venture to arrive at a conclusive answer to most of the issues I raise; but here I must admit that I ’m left dumbfound!

One should read this Newsweek article, which even says doctors are now counselling low risk patients against having cardiac CT, echo cardiograms, and even tread mill stress tests, as studies show that they produce many false positives leading to risky interventions. They even say that a clean scan can lead to worse health if it makes people believe that they can eat whatever they want and encouraged them to stop exercising.

After reading this article I’ve become the investigative journalist once again and cannot help but ask the question – for whom has this really been written? Is it possible that this article is not for our consumption? I mean, us Sri Lankans! As I flip through the pages of this Newsweek edition, I see an article on the American economy titled the ‘Road Ahead’.  The article alludes to the mess the country is in financially, and one of the areas stressed on is medical care and the figures mentioned are trillions of dollars, which the American healthcare system is supposed to be costing.

George W. Bush’s mistakes in giving free pills for seniors when this entitlement had no balancing tax revenues to pay for it; and there was no so-called fiscal neutrality, is also discussed in the article.  Even Barack Obama’s 2010 Medicare legislation is said to have threatened to increase the burden on the country.

The question is, are these two stories connected? Are the American people being told not to do their medical checkups because it’s no longer affordable? If this is the case, this is one of the best PR spins on the subject that I have ever had the privilege of seeing.

(The writer, a PR consultant and head of Media360, was previously a mainstream journalist in print and electronic media. He also edits a new media website.)