Thursday, March 1, 2012

Medicine's shift from treatment to testing questioned

A new book -- Overdiagnosed: Making People Sick in the Pursuit of Health -- and a corresponding op-ed in the New York Times, raises the intriguing philosophical question of how to approach preventative health care. H. Gilbert Welch contends that the growing emphasis on testing versus treatment is obscuring the bigger picture, that the fundamentals of good health are nutritious food and exercise, not screenings, drugs and preemptive procedures.

The reductionist desire to apply a simple yardstick to complicated problems is seen everywhere in society, not just in medicine. When we evaluate marketing, is it all about clicks and followers, rather than the legitimacy of the message and whether the company's unseen practices actually match up with the rhetoric? Do employment statistics or a business's bottom-line take into account that what people really need is gainful employment that allows for healthy, personally enriching lifestyles, families and communities as well?

We are in an age when the sheer glut of information often overwhelms legitimate answers to legitimate questions.

Michael Pollan famously remedied this "can't-see-the-forest-for-the-trees" affliction toward food, when he told eaters to throw away their diets, scales, food lists and calorie charts and adopt a common-sense mantra: "Eat food. Not too much. Mostly plants."

Modern medicine is capable of miracles. It is also capable of becoming a distraction from the bigger goal of life well-lived and makes a blunt substitute for the need to balance prudence with pleasure and curing with caring.