”Everyone should understand that there are tradeoffs in screening. It’s not a simple it-can-only-help-you kind of story."
A predictable irony of the never-ending Affordable Care Act (ACA) debate is that the one provision that the Republicans should be attacking -- free "checkups" for everyone -- is one of the few provisions they aren't attacking.
Better screening tools are detecting more cancers. Women's lives have been saved. These same tools are identifying more cancers that won't result in any harm.
The signers of a new open letter are concerned about excessive psychiatric treatment, excessive dosing, careless polypharmacy, and unnecessary hospitalizations. And so am I. But I am equally concerned about inadequate funding of mental health care and lack of access to treatment for people who need it.
The evidence is compelling that we in the developed countries (especially the US) are overtesting for disease, overdiagnosing it, and overtreating.
It took me a decade -- first as a caregiver to my mother, and then as a practicing physician and patient advocate -- to figure out that the story is absolutely fundamental to medical practice. Indeed, it can save your life.