Too much medicine; too little care

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f4247 (Published 02 July 2013) Cite this as: BMJ 2013;347:f4247

Re: Too much medicine; too little care

A timely series, so well done the BMJ. My own concern is not of any fellow doctors over-investigating, but of the rise of commercial high st 'mole checking' shops, equipped with a machine to photograph moles and possibly a nurse to run the machine. If this considers the mole suspicious, customers are given a print out and advised to see their GP and request referral to a dermatologist. None of this has been tested for sensitivity, specificity, predictive value or any of the other essentials for a screening test that we would use in medicine. It takes a brave GP to ignore an official looking print out saying that this person should be referred. I am seeing an increasing number of these patients in my clinic, but have yet to find a melanoma. This all puts an increased demand on our already stretched service and carries all the potential downsides of over-investigation and unnecessary biopsies; but I suspect a good commercial proposition.

Competing interests: No competing interests

14 July 2013
Richard B WELLER
University of Edinburgh
Lauriston Building, Lauriston Place, Edinburgh, EH3 9HA