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Can Advances in Medical Technology Make Us Less Healthy?

Sometimes the treatment is riskier than the disease...

by
Theodore Dalrymple

Bio

July 9, 2013 - 4:00 pm
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The patients in whom such emboli are found tend to be treated nevertheless, on the precautionary principle. But in the largest study of patients with small PEs, the risk of recurrent embolus was only 0.7 percent while the risk of major bleeding caused by anticoagulation was 5.3 percent. In other words, the treatment seemed more hazardous than the disease (a common occurrence in the history of medicine), though this study did not answer the question of long-term mortality. Perhaps if the patients were followed up long enough, some advantage to treatment would reveal itself; but so far it has not.

Overdiagnosis of PE causes patients needless anxiety because they are told that they have a potentially fatal condition. If they are treated with anticoagulants, they spend possibly a liftetime worrying about the dangers of bleeding if they are injured. Moreover, some patients actually will be harmed by anticoagulation.

The latest technology tends to be used if available, and patients demand it because they think it will necessarily and inevitably benefit them. Often it will, but only if used with discretion. Patients are sometimes scanned uphill and down dale, or thoughtlessly put into what a physician friend of mine calls “the answering machine.” The sad fact is, however, that for the foreseeable future physicians will have to exercise an indefinable quality known as judgment, which one hopes grows with experience.

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images courtesy shutterstock / Alila Medical Images /  Pablo Eder

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Theodore Dalrymple, a physician, is a contributing editor of City Journal and the Dietrich Weismann Fellow at the Manhattan Institute. His new book is Second Opinion: A Doctor's Notes from the Inner City.

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All Comments   (6)
All Comments   (6)
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we should put more effort and investments in medical research nothing great have been achieved in recent years, rather more disease and infections spread.
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38 weeks ago
38 weeks ago Link To Comment
"Treatment made no great advances in those years, and the overall rate of death from PE in the United States remained more of less constant. However, the fatality rate of detected PEs fell greatly, from 12.3 to 7.8 percent, suggesting that most of the PEs that were now being detected that would not previously have been detected were harmless.""


That statement is baffling in its illogic. Earlier detection, absent any improvement in treatment techniques, leads to FEWER fatalities, and from that you conclude "that most of the PEs that were now being detected that would not previously have been detected were harmless."????

Either you just fumbled the construction of the paragraph, and are NOT saying what you seem to be saying, or you have no business writing on any subject in this field.
39 weeks ago
39 weeks ago Link To Comment
it could be both
39 weeks ago
39 weeks ago Link To Comment
ITs up to our lawmakers and us voters to see that the lawyers don't take over, whether in the form of scaring docs in to massive overkill (aghhh) in using diagnostic whats-its OR in the form of the massive government intrusion. (O-Care.) Tort reform where doctors would only have to fear lawyers if they were absolutely incompetent, neglectful or malicious would work. In the continually changing saga of O-Care, we have forgotten the litany of conservative solutions: tort reform, transportability of insurance, health insurance companies allowed to function across state lines, allow free-market forces to lower costs... and a few others that I have forgotten. Oh well. One day the adults will come back home and throw all these partying idiot fools out.
40 weeks ago
40 weeks ago Link To Comment
we certainly wouldn't want to try to improve anything. life was so much better when we didn't have pacemakers, joint replacements and antibiotics.

now we can detect subclinical disease. we wouldn't want that. and, since we currently know everything that there is in the universe to know, there is no chance that the future might bring new interpretations.

best that we cringe before the lawyers and go back to leeches, cupping and bleeding with a good dose of physic. yep, that's the ticket.
40 weeks ago
40 weeks ago Link To Comment
Us Biomedical Engineers simply invent the stuff. It's up to you Physicians to use it appropriately.
40 weeks ago
40 weeks ago Link To Comment
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