Re: Preventing overdiagnosis: how to stop harming the healthy
5 June 2012
Medical Technology; a friend and a foe
Moynihan raised an important issue regarding medicalisation which is very valuable due to the many reasons which may cause over-diagnosis and over-treatment and in other cases the opposite, under-diagnosis and under-treatment. First, medical technology is becoming more and more advanced and sometimes we as health care providers rely on technologies more than the symptoms that patients experience. In addition, we might not do a good history taking and a physical assessment to make a differential diagnosis prior to an advanced diagnostic study. Due to advanced medical technology ( e.g. ECMO), we might keep a patient with stable vital signs. However, it doesn’t mean he or she can recover but it may be a way to give hopes to the family members and allow them to overcome the grief process.
A profound faith in clinical guidelines might take away from individual needs and lead to misuse of medication since the human body is too complicated and responds quite differently under various conditions to use a standardized guideline. The development of a guideline is still valuable because a single problem or a certain condition might be appropriate to use as a guideline and also can be useful for educational purposes.
The health insurance system has a profound impact on the health care delivery system. An inappropriate reimbursement system might be one of the causes of over-treatment or under-treatment. Lastly, a mutidisciplinary team including policy makers, general practitioners, sub-specialty experts, nurse practitioners, nurses, other health care related personnel and patients should be aware of this important issue. One way to increase awareness is to receive constant education since drug treatment and technologies are always on the move and to develop appropriate strategies to reduce unnecessary medicalisation.
Competing interests: None declared
National Taipei University of Nursing and Health Science, 365 Ming Te Road PeiTou , Taipei 112 , Taiwan, R.O.C.
Click to like: