Yes we are.
Reuters health editor Ivan Oransky begins his talk with the story of Billy Beane, the failed baseball player turned manager who was depicted in the film, ‘Moneyball.’ According to Oransky, the medical system is statistically as bad at predicting what will happen in the future as the scouts who told Billy he’d be a star player.
Oransky’s major bugbears are the prefixes, ‘sub-clinical’ and ‘pre’. We have pre-cancerous cells, pre-hypertension, sub-clinical diabetes; the list goes on. If you refer to a website on sub-clinical acne, it will tell you this is the easiest form of acne to treat; unsurprising, as the ‘sufferer’ has no pustules or other signs. Billions of dollars are spent on preventative medicine yearly, which causes more problems than it stops in many cases.
Oransky says society as a whole is at fault. One cancer research group launched an awareness campaign calling everybody with a risk factor for a certain type of cancer who hadn’t contracted it to call themselves a ‘pre-vivor.’ Pharmaceutical companies fight to widen the spectrum of disease treatment yearly to improve their bottom line. Doctors are incentivised to diagnose and prescribe more to avoid loss of patients or litigation. The media is full of horror stories about the rise in certain diseases. Nobody in any faculty of health sciences or medical school teaches ‘thinking sceptically’ or ‘how to order tests.’
So what to do? Maybe stop treating any pain as something that will become chronic, stop medicalising normal conditions like pregnancy and menopause, start prescribing simple exercise to those patients with obesity and slightly high cholesterol rather than reaching for the statins. Not all medicalisation is a bad thing, but Oransky believes it should be treated like baseball.
‘Just like baseball, the healthcare system needs to decide if something is a good pitch, or should they let it go by and not swing at everything. ‘
Yes we are.