What’s Making Us Sick Is an Epidemic of Diagnoses

New York Times ^ | 2 January 2007 | By H. GILBERT WELCH, LISA SCHWARTZ and STEVEN WOLOSHIN

[shrinkermd]

For most Americans, the biggest health threat is not avian flu, West Nile or mad cow disease. It’s our health-care system.

You might think this is because doctors make mistakes (we do make mistakes). But you can’t be a victim of medical error if you are not in the system. The larger threat posed by American medicine is that more and more of us are being drawn into the system not because of an epidemic of disease, but because of an epidemic of diagnoses.

Americans live longer than ever, yet more of us are told we are sick.

How can this be? One reason is that we devote more resources to medical care than any other country. Some of this investment is productive, curing disease and alleviating suffering. But it also leads to more diagnoses, a trend that has become an epidemic.

This epidemic is a threat to your health. It has two distinct sources. One is the medicalization of everyday life. 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

[najida]

I'm an RD and when I was training back in the dark ages, folks had to go to the Dr.s office to have their blood sugars checked...

Like once a week at best?!? I remember when the glucose monitors came out and the insurance companies at first didnt' want to pay for them! HELLO!

And when the pump came out, it was the size of a shoe. Yeah, diabetes treatment alone has come lightyears!

Everytime someone mocks what medicine is doing now, I remember those wonderful old days when more folks suffered, developed complications and died.

[najida]

I agree about the ulcers....
I just remember when everyone with an ulcer....
ate pureed food,
a bland diet,
and drank cream.

Now its "Erm, well....lets see why first".

[widowithfoursons]

I was trying to discover who initially used the "snake pit" practice, and it looks like it dates to the middle ages, but not thereafter. I guess I was thinking in terms of snake oil as being the "cure all for what ails ya", which would cover all diagnoses.

[Kimmers]

I have been working as a school nurse for many years. I am so excited about the improved treatment for diabetics. Betweenthe pump and the improved diet monitoring I am seeing kids with a lot steadier blood sugars and therefore I think these kids are going to grow up to be healthier adults.....

[najida]

Yeah,
I work in psychiatrics now, so snake pit is still used as a metaphor for 'how they used to try and cure these folks' :)

[tubebender]

bump

[Kimmers]

This article is so spot on. We have the population wanting to fix everything with a pill and we have doctors wanting to make money prescribing treatments that do not work. People are impatient.

Give somebody antibiotics for the flu symptoms and they will be better in 7-10 days or not give them anything and they will be better in 7-10 days.

[APFel]

Perhaps you could add your perspective on something I have observed. This isn't particularly covered in the article, but one thing I have noticed while working around teen aged kids in a work environment is many of these people are prescribed Ritalin or other behavior altering drugs.

I came to the conclusion that these drugs are prescribed blanketedly, to kids that have excess energy, are socially awkward or are simply nerdy. Having gone to school in the pre-Ridalin days and attending some high school reunions, the kids that WOULD have been prescribed these drugs back in my day (probably myself included) have mostly grown to be fully functional adults.

So, my thoughts are that these kids are medicated in order to make them easier to deal with for the parents / instructors rather than actually treating some actual ailment.

Since you probably see these kids come through your door, what is your opinion?

APf

[najida]

I do believe that ADD/ADHD exists.

I do believe that behavoir mod AND meds can make a world of difference. As well as self acceptance.

I also believe that too many kids are wrongly diagnosed by caregivers who are not educated.

We have a repeater on our peds unit that is now 6, and been diagnosed as ADHD since he was 5. To see him, his behaviors and his total inability to focus is like night and day from the usual 'very active, energetic' kid.

This kid needs all the meds and help he can get. Sadly, because of the term being overused, it cheapens the needs and problems of kids who really do have the condition.

[Petronski]

Agreed!

[Petronski]

I am glad that petronski and I never paid attention to the drugs prescribed for internet addiction! :D

[AmericanChef]

I think we, as a people, need to embrace more natural deaths once again. It's not easing suffering to be on drugs 24/7, it's merely prolonging an artificial life. I'm surprised so many religious folk have decided to beat God at his own game and refuse the trip to heaven.

[Tax-chick]

LOL!

[Hardastarboard]

there will be a terrible reckoning concerning these drugs

Wouldn't surprise me one bit.

there are REASONS for synthesizing cholesterol.

Yes, and there's a reason for the acid in my stomach. Without it, my food wouldn't digest properly. However, for some reason my body makes too much of it, and Prilosec puts a stop to that petty foolishness that causes me so much distress. While I agree with you mostly(see above), a lot of the modern "miracle drugs" do have a very useful purpose.

One final note, to emphasize your point about why our bodies create cholestrol. Cholestrol is what insulates your nerve cells. That's why animal brains have so much cholestrol in them, and why it's recommended that you not eat them. If our bodies couldn't synthesize cholestrol, we would die.

[uncitizen]

Chronic Fatigue Syndrome isn't as big as it was in the late 80's early 90's. I think it failed because of how ludicrous it was. It was basically a diagnosis for laziness. My sister in laws sister in law was actually out on permanent disability for this.

[Kimmers]

I am 100% in total agreement with you and it is mostly boys I see on these meds. Now with the onset of Concerta which is taken once a day who knows how many kids are on these drugs. I look at it this way if a kid can concentrate for hours playing a computer game he should be able to do the same with homework.
My eldest sons 2nd grade teacher wanted to put him on Ritalin and we declined. I admit he was a handful but these days teachers and parents want kids to be drones. In my observation boys cannot sit and color for a half hour like girls can. Now my eldest is a 2nd LT in the USMC and if he was Ritalin dependent he would not be allowed in the Corp.

Another problem is kids being raised by daycare, where every moment of their lives are scheduled and I think kids need to be kids and run and play. Parents have also taken that away from them. I do not see any pick up games of baseball or football. I go by the park in our home town and the play is organized with uniforms and parent coaches.

My second son has a lot of energy and has figured out that he needs exercise to get rid of that. If he does not exercise he does not concentrate as well on his studies and bugs those around him....he makes the Deans list @ Ga.Tech...He just knows he has to keep busy doing something productive.
To be honest their are exceptions and there kids who's lives are greatly benefited from psychotropic drugs and I have personally seen that.
After all good dog is a tired dog and that may be true with kids.

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[freedomfiter2]

I think you meant to say "snake oil" days.

Where do you think they kept the snakes used to produce snake oil?

[freedomfiter2]

Yeah,
I work in psychiatrics now, so snake pit is still used as a metaphor for 'how they used to try and cure these folks' :)


Did you see the Farside cartoon of the Dr. who simultaneously treated for claustrophobia, fear of heights and fear of snakes?

[nascarnation]

"The Last Well Person"
outstanding book IMHO by a maverick MD

highly recommended

http://www.amazon.com/Last-Well-Person-Despite-Health-care/dp/0773527958

also if anyone has read it and finds significant flaws in his conclusions would love to read that also