Old Times
Section titled “Old Times”Time was, 75 years ago, you only went to the doctor if you were sick.
The doctor did not have all the miracles we do today, but he could usually see you the same day and would come to your house if needed. You wouldn't have to get a home loan to pay him. Most of the time, you would feel better as a result.
Back then, medical ethics prevented advertising. Now the media are full of doctors’ ads. Because of this, you often go to the doctor when you are healthy. It doesn’t always turn out well. Here's one story.
When Cancer Screening Goes Wrong
Section titled “When Cancer Screening Goes Wrong”Let’s call her Emma. She came to me for a second opinion about mammograms. Her doctor had just ordered another one. Her problem was exceptionally lumpy and dense breasts. This meant that most of her mammograms had been abnormal, and her doctor insisted on a biopsy each time. These weren’t needle biopsies, which leave no scar, but inch-long incisions to remove the lump. Not one of the lumps showed any cancer.
Emma concluded with “I don’t have a family history of breast cancer. Do I have to get all this surgery on my breasts?”
On physical examination, her breasts had numerous lumps. On each breast she had about four or five surgical scars with a dimple underneath. She had matted, lumpy and tender tissue in each breast. Her doctor’s approach to breast cancer screening, in the setting of her severe fibrocystic breast disease, was harming her.
Maybe her doctor had been trained too long ago; fibrocystic breasts used to be a worry for future breast cancer. Now we know they aren’t. Nowadays, those in the know call it fibrocystic breast changes rather than a disease.
First, I gave Emma the catechism. The risk of breast cancer runs about 12% here in the U.S. and about 2% of all women die from it.
Next, I suggested she consult a breast cancer specialist in Seattle. That doctor would be thrilled to see someone without cancer, could check for any genetic risk factors such as BRCA genes, and could then give her a plan tailored specifically for her.
It was an easy sell.
Less Medicine, More Health
Section titled “Less Medicine, More Health”Dr. H. Gilbert Welch tells stories of many other people, like Emma, harmed by today’s aggressive health screenings. Please don’t think I’m an RFK, Jr. I’ve had every immunization known to man. When it’s clear people have a problem, I question, probe and prod, order the tests, call whoever I need to, and repeat as needed until they are on the far side of trouble. People who don’t need the full court press don’t get it
Dr. Welch’s book is titled Less Medicine, More Health. The library has a copy.
Why This Subject? Why Now?
Section titled “Why This Subject? Why Now?”A company that sells medical screening is coming to town. They want to sell you blood tests, ultrasound tests, and a test for osteoporosis. If you are tempted to go for that health screening, please remember Emma. Unless you are uninsured and sick, you’ll get better value from your own health care provider. They can give you personalized preventive care with less chance of a false alarm or missed diagnosis.