Overtreatment

I heard a comment on the radio yesterday that part of the problem with healthcare costs is that we have overtreatment in medicine in America. In essence, every little complaint is taken seriously and treated. It becomes overtreatment when the complaints are minor or even nonexistent. I should note up front that there are legitimate illnesses and disorders, and courses of treatment for them.

In town we have a university hospital where doctors are being educated and trained. If you enter the door with the tiniest complaint you will have a phalanx of doctors -- teachers, residents, and students -- investigate the complaint. It seems natural in that setting. But I also have clients who are on disability, used to The System taking care of them, lots of time on their hands, few social skills, and the ingredients are right for them to make trip after trip to medical appointments. They come up with complaints that I wouldn't bother about for myself. And it costs the taxpayers.

My daughter has braces on her teeth right now. I've survived this half century without straight teeth. But up against an oral surgeon who sees imperfection and an ex-wife who doesn't discriminate well on her own, I'm paying for braces. I will always wonder if my daughter's teeth were as bad as they were made out to be, or if the horrific possible scenarios would really have played out. Wondering about the difference between possibility and probability makes the world of medicine look kind of silly because they (and pharmaceuticals) let us know there are all kinds of terrible things that could happen. What if I questioned how likely it was that they would happen?

Did you know that the better you get at stress management the fewer medical problems you're likely to have? If that's true, why don't we ever hear about it as a method to reduce healthcare costs? Because the psychology lobby ain't spit compared to the pharmaceutical lobby. They need for us to be sick in order to guarantee profits.

I've wondered many times how much all this happens in my field, counseling. I've denied treatment after assessing people before, saying that they don't have much of a problem and not wanting to spend tax and insurance dollars unnecessarily or waste the client's time or mine, and despite having to deal with the occasional probation or parole officer who ordered them to enter treatment Or Else, the clients have been really surprised that I've not recommended treatment. Sometimes I look at clients and think, 'Where's the problem? You have enough inner gumption to handle what you're complaining about.' It's long been recognized that there is a population of 'worried well' in our culture, people who are psychologically sound but just a little anxious about something. But it's fashionable to enter treatment, or to believe that a 'professional' knows better how to handle things. How did we get along without shrinks a couple of centuries ago?

Another fault in the field of psychology is that many minor aberrations and eccentricities of yesteryear are now being called disorders, which suggests that they need treatment. Haven't adolescents and teens always had problems with adjustment to social roles and responsibilities? That's part of the path they tread. But now we list several 'adjustment disorders' in the diagnostic manual, Big Pharma comes up with a pill to address it, and kids are doped up through the period when they're supposed to be establishing an identity, learning to cope with society, and strengthening their character. Hm. What are the long-term individual and social effects of blunting their development?

Speaking of Big Pharma and overtreatment, a few years back they came up with a medication to address influenza. They promise that if you take the medicine you'll begin to notice a reduction in symptoms in 36 to 72 hours. Tell me: how long does the flu usually last? That people swallowed that one without question attests to a herd mentality without critical thinking, another of my common rants.

I haven't heard the term 'defensive medicine' in a long time, but this contributes to the rise in healthcare costs and sometimes gets ridiculous. It's the doctor testing for all possibilities for the CYA phenomenon. This brings in the glut of lawyers we are visited by, and between the two there is a lot of unnecessary treatment performed.

What is lost is a lot of common sense, a refusal to accept imperfection and other realities, a doubt of your own better judgment about what's happening with your body, and higher costs all around. Is there a chance that sanity can be restored as we get more and more specialized, compartmentalized, and litigious so that the forest is lost in the trees?