Your Doctor Likely Orders More Tests Than Needed
In today's world, medicine has started to lose their moral authority on patients and its ethics; patients are steadily becoming wary of the credibility of the medical professionals. The medical practice is starting to be seen as a dishonest “business” corporation, looking only to generate profits, keeping a hold on their patients by giving false promises. Rose in “The Politics of Life Itself: Biomedicine, Power, and Subjectivity in the Twenty-First Century” argues that medical professionals aim to create novel therapies that will, in turn, serve a small minority and generate significant profit, and unfortunately this has become the trending goal of medicine. Today, millions of Americans get medical tests, drugs, and operations that may not make them better may cause them harm, cost billions to the population while profiting our medical institutions, professionals, and pharmaceutical companies. When doing more might be worse for society’s health. When doing additional unnecessary medical test results in adverse effects similar to the already adverse-causing drugs prescribed by doctors. The harm is thus greater than the benefit. Unnecessary tests have led to lots of suffering for our health and caused us a load of financial burden.
Medical screening is a vital part of routine medical care. These screenings done by medical professionals with the aim of finding and treating a hidden or early pathology should, in the long run, prevent the symptoms from getting worse. Prostate cancer screening has been done in the United States for many years, yet most of the rest of the world has stopped prostate cancer screening because data has demonstrated that the harms were greater than the benefits. These tests are part of numerous controversial exams done without any evidence of reducing or preventing the disease, but according to the journalist Shannon Brownlee, who is best known for her research on avoidable health care, abundant evidence showed that people were treated unnecessarily as a result of diseases that would have never bothered them. In 2012, almost every major medical organization in the United States came out against prostate cancer screening including the American Cancer Society. Otis Brawley, chief medical officer at the American Cancer Society, estimated that patients are about fifty times more likely to be harmed than benefited by prostate cancer screenings yet done all the time. One in 200 men dies during prostate cancer surgery. Prostate cancer surgery increases the risk of erectile dysfunction and urinary incontinence in these men. These unnecessary tests and many others have been proven to be controversial because many of these tests are not helping the societies in the treatment of pathologies but are part of the underlying causes of additional problem and symptoms, which might result in death.
Most of these screenings have led to a false positive, after which more tests would expose the patients to unnecessary radiation or even biopsies, which has their own risks. Researchers have found that trying to make patients "normal" again or even finding out if a patient has something "abnormal" can lead to harm without changing the course of a disease or the patient's outcome. Notwithstanding “excess radiation or treatment side effects, the often debilitating anxiety that screenings can cause are also harmful”, says Rich Sagall, a family medicine physician in Gloucester, Massachusetts.
In the last few decades, medicine has changed to the extent that it would be hard to recognize it. Its practices around the world have changed in a wide range of ways, but it is the technology, innovation, and science that have changed it the most, the human body has remained unchanged, the diseases are relatively the same and the primary role of medicine has been consistent. The International Code of the World Medical Organizations says, “A doctor must practice his profession uninfluenced by motives of profit.”
Medical care has always been considered to be a social good and not a commodity. But in the last few decades, health care has become “commercialized as never before, and professionalism in medicine seems to be giving way to entrepreneurialism. The health-care system is now widely regarded as an industry and medical practice as a competitive business” according to Dr. Arnold S. Relman, journal editor, and health system critic of the New England Journal of Medicine.
Most of the time, the patients do not understand the harm of these tests. Patients often have the notion that more care is always better care. Asking questions as a patient can help better understand the treatment options, the benefits, and the side effects of the treatment as well as alternative treatment options. With excellent communication established between the doctor and the patient, both parties can reduce the risk and consequences of unnecessary medical treatments. Patients have to take the initial decision and responsibility of their lives. Understanding risk-benefit analysis of procedures as a patient can also help lessen the fear on decision-making. “Post-diagnosis is a hard time to begin that conversation because the patient is scared,” says Daniel Barocas, an assistant professor of urology at Vanderbilt University Medical Center. “If you tell someone they have what they perceive as a lethal disease, they’re going to seek treatment. This effort encourages discussions where doctors and patients can let data and evidence runs its course instead of emotionality and fear.” Barocas says he, therefore, counsels his patients before any tests for prostate cancer that they may “find something called cancer that doesn’t need treatment” because low-risk, slow-growing prostate cancer is often unlikely to harm a man before he dies of other causes.
Eliminating fee-for-service incentives would save $750 billion annually spent on unnecessary health care. “The more you do, the more you pay” practice has to change. Physicians should be paid on a salary basis, where their pay would not depend on upon how many patients seen and tests administered, which would maintain the high quality of medicine, improve safety, and control cost. The medical community can reaffirm their professionalism with sound ethical behavior and without undue concern for meeting revenue needs. The interests of the patients and the public must again supersede the self-interest of the accomplished professional.