Balance in Medicine

One problem facing healthcare today is ‘over-diagnosis’. This has become an umbrella term for over-investigating, over-diagnosing and over-treating people. Knowing when to turn someone into a ‘patient’ is complex. It requires of the doctor many skills and qualities along with knowledge and experience. It is an art that is being lost with our modern culture of litigation. 

GP’s in particular need to be not only knowledgeable about risk but also comfortable with uncertainty. Indeed in their role as gatekeepers GP’s

“need to be courageous enough to reassert the border’ so that people only make the journey when ‘medical care is appropriate and will produce more benefit than harm.”

Iona Heath
From her Key Note speech, Preventing Overdiagnosis Conference, Oxford, 2014

 

One technique that is important to grasp is ‘satisficing’. Applied to medicine it has been defined as “gathering the minimum amount of information sufficient to reduce risk to an acceptable level”. This is not only important for the patient but also for the doctor to prevent burnout. And with the pressures of time and money it is also pragmatic. 

RADIO INTERVIEW: Dr Iona Heath: Too much medicine is making us sick

Role of fear in overdiagnosis and overtreatment—an essay by Iona Heath

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