I’ve never been more concerned about the harms of healthcare. Any exposure to the health care system can get you in trouble.
It’s especially scary when healthy people enter the system–often in the name of prevention. Remember that the most likely outcome of a medical intervention in a person without complaints is harm. How can we make a person who says he is well any better?
The newest scourge is the treatment of risk factors–not diseases. It’s routine for me to see people admitted to the hospital because of side effects from drugs or procedures used to treat risk factors.
This morning, thanks to my friend Dr. Richard Lehman (University of Oxford), I found this trove of writing from Iona Heath. Dr Heath, a former president of the Royal College of General Practitioners, has written beautifully and extensively about the harms of overdiagnosis and overtreatment.
I loved her 15-minute Plenary Lecture here:
And her PowerPoint below addresses the ethical implications of excessive prevention, including the inconvenient truth of cancer screening. Pay attention to the image of how the creation of fear is like a stain in clear water–it can never be removed.
Her words inspire me to think differently, to think deeply. I hope they do the same for you.