PSW 2314 Over Diagnosed Making People Sick in the Pursuit of Health | Gilbert Welch

Friday, March 8, 2013
H. Gilbert Welch, Professor of Medicine, Dartmouth Institute for Health Policy & Clinical Practice

Over the past several decades, there has been a growing enthusiasm for early diagnosis - engaging many physicians in a systematic search for abnormalities in people who are well. Partly as a result, diagnoses of a great many conditions, including high blood pressure, osteoporosis, diabetes, and even cancer, have skyrocketed over the last few decades. Yet many of the individuals given these diagnoses never develop the symptoms from their conditions. They are overdiagnosed. And, while overdiagnosed patients cannot benefit from treatments for these conditions - there is nothing to treat - the treatments themselves can be harmful to them. Because of this it is critical to understand the trade-offs between diagnosis and over-treatment, and to be sure that health care systems don't narrow the definition of normal so that - ironically - people are needlessly turned into patients and subjected to treatments that do harm instead of good.