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Are we Being Overtreated And Overdiagnosed?

11/17/2015

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I purchased Overdiagnosed along with Overtreated (written by Shannon Brownlee). Brownlee’s book was published in 2007 and Dr. Welch’s book in 2011. Both books discuss similar issues. Americans are in love with testing and screening. Originally, the intent was to detect diseases faster and prevent deaths with earlier treatment. It may have seemed to be a good idea at the time, but things haven’t actually worked out well.

Both authors review our massive screening programs. One man’s expense is another man’s income — and a huge income it is. Americans are spending hundreds of billions of dollars yearly. Treatments are not without risks and potential damage to the patient — it is common that some patients do not gain any additional health benefits.  

Overtreated begins with the work of John Wennberg at Dartmouth Medical School. He studied national statistics and found that some areas of the U.S. have conducted a greater number of particular medical procedures, even though the incidence of disease was about the same. How much surgery was done seemed to be a way of local life. Patients were undergoing many procedures with little, if any benefit and often much harm.  

Both books talk about back surgery, prostate cancer, breast cancer, and genetic screening. Overtreated also discusses overtreatment of thyroid cancer — interestingly, it holds as a shining solution, the VA’s system of enforcing the use of Electronic Medical Records (EMR). Since 2006 (when the research was initially conducted), the VA has been overwhelmed with disabled veterans from Iraq and Afghanistan, old and sick Vietnam era veterans — the VA is severely underfunded to treat all of them. The system is now falling apart. I wonder what Shannon Brownlee thinks of the VA now?

Having read and reviewed How We Do Harm by Dr. Otis Brawley and The Great Prostate Hoax by Richard Albin, Amazon had also suggested these two books — they are older and the information is not new. The problem has been growing for a long time and both Brownlee and Welch have warned America for at least a decade. In the last few months (2015), it is amazing that some of the issues concerning over diagnosing breast and prostate cancer (along with recommended treatments) have begun hitting the news. If you want to protect yourself from unneeded, dangerous tests and treatments, Overdiagnosed and Overtreated are good reference books.
 

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The Sugar Box

11/9/2015

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There is a popular PBS show called, Antiques Roadshow. It's a combination of history, exploration and scavenger hunting. Antique owners bring in old, unusual items to be appraised by experts — they also discuss the history, origin and value of the item.

I watched an episode that was filmed in a Southern city. The dealer brought in a wooden box that was about 2 ½ feet wide, a foot high and a foot deep. It had a heavy top with a big, strong padlock and stood on legs about two feet high. The owner had used it for an end table, unaware of its original purpose.

The appraiser said it was a sugar box. The design was made in a time that segregation even included separating the white sugar from the brown. Inside, there were two sections — white sugar was kept on one side and brown sugar in the other. The owner of the box would open the padlock to remove just the amount needed for the daily cooking and relocked the box to prevent possible theft. Sugar was expensive — cakes, pies and other sweets were considered luxurious treats and reserved for special events.

In 1905, it was estimated that the average American ate five pounds of sugar a year. In 2005, that estimate has risen to 195 pounds a year! Times have changed and so has the shape of the average American.

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    Robert P. Goldman, M.D.

    Dr. Robert P. Goldman provides guidance for female and male hormone balance, menopause management, holistic therapies and routine gynecological care.

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