The doctor will see you now… if you are truly ill.

31 Jan

Why is everyone scared of missing cancer? [BBC Radio 4 PM, 30-Jan-2013]
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Personally public needs to (wo)man up and face the fact we die. And most of us die from heart disease or lung disease.

Doctors know, though many politicians and public do not, that early diagnosis of cancer often fails to prolong life of patient. For example, read Prof Baum opinion about breast cancer screening

Medical industrial complex loves us diagnosing cancer early because lots of tests, procedures, and drugs will be thrown at the poor patient for “extra” disease free months/weeks. Has anyone stopped to check the ROI for the vested interests in the management of people who are diagnosed early?

Meanwhile, earlier diagnosis of depression may be useful though you know that many people with “affective disorders” and other psychiatric c condition’s are also a construct of the medical industrial complex – DSM V is an opportunity to medicalise more situations that are part of normal living.

Perhaps, earlier diagnosis of erosive arthropathy may have benefits for sufferers. This population of patients is tiny compared with cardiac and respiratory and psychiatric patients.

So to cardiac and respiratory disease.  If the politicians are to be believed, people with BMI 19-25 who never smoke will not develop heart or lung disease.  This is magical thinking. One patient at my cardiac rehabilitation class who was thin, young, with cholesterol < 4 and no family history of heart disease, and never smoked.  Apparently cardiac rehabilitation clinics see significant number of such people.

Sadly there are a large number of people with chronic lung disease who never smoke – many of these people have asthma. Even with good inhaler use and compliance, many of these people will develop COPD which is supposed to be a disease of smokers only.

So in spite of the propaganda, seeing your doctor at your time and choosing is actually not going to save your life.  Remember healthchecks are useless. Thus, the media and many public voices should stop whinging about access to primary care and GPs.

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Jim McManus blogs on public health, ethics, books, theology and more