Waiting too long to seek medical care can be one of the worst things you can do. Allowing an infection to take hold too many days before seeking care can be deadly or lead to amputation. Allowing what you think is a simple cold to linger until you get so sick that you seek care, only to find out you have pneumonia, can have dire consequences. On the other hand, being overdiagnosed also has its share of negative effects. In fact, a recent conference was held just to discuss this issue.
A Modern Dilemma
Overdiagnosis is a modern problem, an issue of Western conventional medicine. In ancient systems of medicine like traditional Chinese medicine (TCM), the diagnosis system itself doesn’t lead to overdiagnosis. Why is that? It’s because the various signs and symptoms presented by a patient are coupled with tongue and pulse diagnosis. When taken together, they’re used to investigate a “pattern of imbalance.”
It’s the pattern that’s treated, not the signs and symptoms. So while conventional medicine might treat several of your health issues individually, each symptom managed with a different drug or procedure, TCM would view all the symptoms as different aspects of one root imbalance problem. This single pattern of imbalance is believed to be the root cause of all or most of the presenting health issues. When that imbalance is treated to restore internal balance in the body, the issues go away. (Occasionally, there’s a pair of imbalances.) In the hands of an inexperienced practitioner, this method of therapy may result in underdiagnosis; but it rarely leads to overdiagnosis.
How Modern Medicine Tackles Overdiagnosis
A few days ago, Dartmouth University hosted the Preventing Overdiagnosis Conference, where conferees set out to tackle the expensive and harmful issue of patient overdiagnosis.
The issue of overdiagnosis is a worldwide problem. It leads to too many medical tests, too much treatment, unnecessary medication (and wrong medication) and wasteful misuse of medical resources. Participants in the conference also discussed the fact that doctors have a hard time persuading patients that less treatment is often the best course.
At the same time, doctors sometimes feel that doing quick tests and prescribing remedies is easier than telling patients to make more difficult, but healthier, choices. Therefore, both doctors and patients contribute to overdiagnosis. In addition, insurance companies and lawsuits only make the issue worse. Doctors practice defensive medicine, running batteries of tests before diagnosis or treatment to forestall the possibility of malpractice suits and to make sure they are reimbursed adequately by health insurance companies.
Solutions for Overdiagnosis
It is a sad state of affairs when the patient and the insurance company dictate the doctors’ practice of care. But there are solutions.
On the physician side, the conference was a huge step in the right direction. Its purpose was to focus on the science of overdiagnosis, and set forth proposals to wind back the harms of too much medicine, safely and fairly, consistent with people’s values. It was intended to deal with overtesting and overtreatment, such as the Less is More, Choosing Wisely, Selling Sickness, and the Right Care initiatives.
Patients Need To Be Responsible
The conference represents a strong step forward but only addresses the physician side of the issue. Patients need to take more responsibility for their own health and well-being, while trusting in the professionals they seek to manage their medical needs.
Eating properly, exercising, getting sound sleep, securing ample rest, enjoying life and reducing stress are all things that are within the control of most people. If you suffer stomach cramps, for instance, you can often figure out if it derives from constipation, drinking too much, nervousness or anxiety. You can then take simple steps to control these problems and control your symptoms. It is not necessary to run to the doctor every time something is not right.
Fear
Many doctors are afraid of being sued by patients for not calling for tests or procedures the patients request. So they order them to help alleviate patients’ fears about the disease they think they may have (and also to reduce the risk of a lawsuit). But remember, doctors have protocols in to guide diagnosis and tests.
Control For Underdiagnosis And Overdiagnosis
Underdiagnosis can be as bad as overdiagnosis. To prevent these kinds of issues:
- Lead as healthy a lifestyle as you possibly can to promote better health.
- Try to be more mindful of what you are experiencing and try to find basic remedies for your health issues before seeking medical care.
- If your issue doesn’t get better when you treat it yourself, seek the advice of a healthcare provider.
- Do not tell your provider what you think you have, but be open with what you are experiencing and start a dialogue with him about potential causes and methods of care.
- Allow your provider to do his job, and do your part to implement the changes or methods prescribed.
- In all cases, don’t wait too long before seeking care or withhold potentially important information that may lead to underdiagnosis.
- Don’t tell your caregiver what to do and induce him into overdiagnosis.
Taking personal responsibility for your own wellness is essential. Seeking care when needed is essential. And creating an environment of open dialogue about it with your healthcare provider helps ensure proper care is given, neither too little nor too much.
