Medicalization of Everyday Life!

How we manage our daily tasks is evidence of the unrelenting effects of our smartphones on our everyday life. For our quest of an easier (better) life, we've synchronized many, if not all, aspects of our life to the tunes of the bits-and-bytes of our digital mobile world. Among others, our medical care is one aspect that is being "short-circuit" by "the medicalization of our everyday life." As patients, we're "claustrophobically" inundated with messages about the latest diagnoses & treatments. For our attention we're promised proper access to care. This is a care which is purportedly delivered with high-accurate lab tests, robust treatments of little side effects, same day surgery with little post-op pain, pain management treatment without discomfort or addiction, among others.

Our everyday discomforts and sentiments like "insomnia, sadness, twitchy legs, or impaired sex drives" are now ICD_10 or DSM-5 classified as illnesses or disorders. In turn, these conditions are identified as sleep disorder, depression, restless leg syndrome, and sexual dysfunction. Only when these conditions are coded into their CPTs for reimbursement, then procedures and treatments are provided. Obviously, there are many convoluted parts to our new world of medical & health care. Very likely, some outcomes of such complex world might clash with the Hippocratic Oath of "First, do no harm."

Dr. Schwartz - A Critic of Medical Excess: An advocate of "medically necessary" provision of medical services, Dr. Lisa Schwartz was a proponent of shielding "patients from the dangers of unnecessary medical tests, diagnoses, and treatments." As the director of the Center for Medicine and Media at the Dartmouth Institute for Health Policy and Clinical Practice, part of the Dartmouth College's Geisel School of Medicine, she created awareness about the "benefits and risks" of the various medications, treatments and interventions. In her work (as a medical doctor) and in her personal life (as a cancer patient), she consistently underscored the importance of being "critical and skeptic" about the "claimed scientific breakthroughs and miracle cures."

Her pursuit "to demystify" the risks of sickness let to the development of the National Cancer Institute "Know Your Chances" website. In such efforts, she supported lobbying campaigns to mandate a "drug fact box" label on all prescription drugs. She expounded on the limitations of diagnoses and treatments, by eliciting the "benefits and risks" identified in clinical trials. She asserts, the medicalization of symptoms & ailments is directing over-diagnoses based on "lower thresholds for detecting abnormalities." Even if such diagnoses benefit the few with severe symptoms, she debates the resultant effects on the many with mild, intermittent, or transient symptoms.

For wise decisions about their medical & healthcare services, patients must evaluate "the trade-offs between little diagnosis (missing problems that might benefit from earlier treatment) and over diagnosis (harming people with problems that never needed to be found)." She surmised that three in four adults in the US might be classified as "diseased," if we all follow the recommended annual checkups and tests like blood cholesterol and sugar, body mass index and diabetes. How to differentiate between sick and normal, she asked, "If more than half of us are sick." So, "what does it mean to be normal.?"

About her perspective for defensive medicine, she called for civil & criminal justice for over-diagnoses, in equal penalties, to those for flawed diagnoses. For example, some patients are diagnosed, and therefore treated, based on their CT scans. However, those scans cannot differentiate whether the cancer is progressive. She abhorred the corruption, misinformation, and lack of scientific rigor in the system, noted Dr. Robert E. Drake, a fellow Geisel School professor.

Her struggle with her illness has personified her work. After several treatments of chemotherapy over a seven-year period, she succumbed to cancer. At the end, Dr. Schwartz conveyed in her struggle that "... good people - doing all the right things - can still nonetheless develop bad diseases." This is despite receiving the proper treatments, following an accurate diagnosis.

References:

Roberts, Sam. (2018, Dec. 7). A Critic of Medical Excess, Lisa Schwartz, Dies at 55. NY Times, p. A25