October 17, 2012

Care: Less is Often More

I'm addicted to trying new ventures, so I have to remind myself of the dangers of overdoing it. Fortunately, this neophiliac usually -- not always -- has enough self-awareness to remember KISS ("Keep It Simple, Stupid").

After experimenting with acupuncture, reiki, injections, medical pain patches, and chiropractic, I've returned to simpler but harder remedies: diet and exercise. After overdoing supplements recommended by a nutritionist, I'm down to two: a vitamin D supplement recommended by my internist, and curcumin -- the most-studied, most-promising supplement.

I always need reminders of KISS, and I found one in yesterday's Washington Post “Consumer Reports Insights” article titled “Too much care can do you ill.” Here are just a few of the key points:
  • 46% of primary care doctors in America think their patients receive too much care. Only 6% say “too little.” 
  • Doctors are driven by financial reward and malpractice threat to over-prescribe tests, medicines, and therapies. 
  • The more doctors and specialists you see, the greater the risk of complication. Adverse reactions from various drugs -- prescribed by different physicians who do not collaborate on a patient’s care -- is just one common example. Patients often fail to tell one doctor what another doctor has prescribed for them. 
  • Tests often signal false alarms which in turn lead to more tests, often of increasing invasiveness and danger. 
  • The Journal of the American Medical Association (JAMA) estimates that overtreatment of Americans in 2011 created between $158-$226 BILLION in wasteful spending. JAMA put the waste that same year created by the failure to coordinate care at between $25-$45 BILLION. 
There’s no question: we need to dramatically trim the cost of health care in America. Experts have weighed in on what tests and procedures might be cut to save money without jeopardizing (and perhaps even helping) patients’ health. Those debates continue.

Think about this: the amazing human body has spent millions of years evolving. There is a natural chemistry in play that’s indescribably complex. If an organism’s key function is to protect itself – to prolong its own life – and if the species has been fine-tuning itself since the beginning of our time on Earth, it’s easy to see how tinkering with that delicate natural chemistry using powerful, alien drugs (or even simple vitamins and supplements) might wreak havoc. Yes, there are drugs and medications that have brought giant improvements for us; penicillin comes to mind. But it’s also no wonder that the warning “POSSIBLE DEATH” often appears among the many other small-print warnings accompanying our prescriptions from the pharmacy.

So very often in life, less is more. Is there a better -- more important -- example than this?

Have you -- or your doctors -- chosen to overtreat, one way or another? Please fell free to leave a comment below. My guess is that many of us are in this club together.

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