Is eliminating the presence of all disease a worthy goal?
Gilbert Welch is part of the Dartmouth group of physicians and policy experts who advocate that we’re doing too much testing and finding too many diseases. He asks, what exactly does “health” mean, and should it be defined as the absence of disease?
Over time, the definition of “normal” has narrowed. For instance, more patients are being diagnosed with hypertension or hyperlipidemia, simply by moving the goalposts of what “normal” means. The result? More people are being treated for a variety of conditions, either through drugs or undergoing procedures, and because of this, “it has been a disaster for health-care costs.”
Worse, striving for complete absence of disease has led to other, widespread repercussions:
Doctors who are overwhelmed by the number of ailments their patients allegedly have (and who are often distracted from the most important ones); doctors in training who are increasingly confused about who is really sick and who is not; lawyers who increasingly have a field day with the charge of “failure to diagnose”; patients who get too much treatment or lose health insurance because they been given a new diagnosis; and a frazzled, fearful public adrift in a culture of disease.
We need to redefine the goals of our health, and stop striving for perfection.
Or, as Dr. Welch puts it, “you have to take back responsibility for deciding what health really means, not surrender that decision to ‘experts’ with strong financial incentives.”
