Over-Diagnosis: When Over-Achieving Isn't Always Good

Tuesday, February 19, 2013 - by Debra Chew

When I was in the first grade my parents learned that my teacher considered me to be an over-achiever.  They found that when I was given my classwork, I was given twice the amount of work the other students received.  That was because I hurried through my work and finished it long before the other students and then I started talking to them.  Yes, I have always talked too much!  

Looking back, I think I was seeking recognition as the fastest and smartest, or maybe trying to achieve some award by doing more than was necessary. Today, I recognize that there are good and not-so-good outcomes as a result of being an “over” anything.  Take MDs, for example.  In their quest to help people, they can, even with the best of intentions, fail to get the desired results from their labors.  Recent studies indicate that the medical field could be regarded as over-achievers, too, when it comes to the over-diagnosis of cancer and other diseases. Diagnosing those who are sick is a big part of a doctor’s job.  One challenge is that a diagnosis may identify something that will never become a serious health problem.  The Dartmouth Institute is studying this issue.  They have announced an international conference later this year on Preventing Overdiagnosis, where they will discuss their research about how overdiagnosis harms people with problems that never needed to be found.   

It’s certainly a “catch 22”:  Overdiagnosis has the potential of making people sick in the pursuit of making them healthy.   But that brings us to the question – what makes someone healthy?  Is it because they have a scan or screening that says they are disease-free?  Then, what makes someone diseased?  Is it because they have a scan or screening that says they have cancer? 

In April of 2012, The New York Times carried an article entitled Endless Screenings Don’t Bring Everlasting Health.  In this article, the physician authors wrote, “But, overdiagnosis – the detection of cancers never destined to cause problems – is arguably the most important harm of screening…..When screening finds these cancers, it turns people into patients unnecessarily.” They went on to say, “People on the receiving end of overdiagnosis can only be harmed – sometimes seriously – by unnecessary surgery, radiation, and chemotherapy.” Even the United States Preventive Services Task Force judged that harms outweighed benefits in P.S.A. screening for prostate cancer, and recommended against its routine use.  They found the tests result in a “disturbing” amount of overdiagnosis.

So, what is someone to do?  Since February is “Wise Health Consumer” month, let’s elaborate on how to make good and wise decisions about screenings, procedures, doctors, etc. Over-screening leads to overdiagnosis, which then often leads to over-medicating, etc.  Too many “overs” for sure. As a result of these reports and findings, physicians, hospitals, the public and agencies that regulate medical care are re-thinking how to avoid this conundrum. If the goal to achieve the “best health outcome” – which it is for all of us – access to such information certainly helps a patient make better health choices.  

People today are choosing a wide variety of approaches to maintaining good, health. More and more, people are discovering that their thought affects their health.  And, studies show medical institutions are now trying to catch up with the public demand for a “whole” – mental, spiritual and physical – approach to health. It’s an approach that definitely flies in the face of a model that uses whatever technology is available to look for the minutest evidence of disease.

And it’s a shift that, to me, speaks to re-discovering some ideas about health that come from the greatest healer the world has ever known, Jesus. His counsel was to:

    • clean up our thinking
    • focus on God (here and now)
    • love our neighbor
    • turn away from the body (food, clothing, etc.)

He just didn’t spend a lot of time diagnosing illness. And, even without a diagnosis or any technology, he healed.

In fact, I think we could say, when it came to healing, he was by all fair measures the right kind of over-achiever.

----

Debra Chew is the media and legislative representative for Christian Science for Tennessee.  She can be contacted at Tennessee@compub.org

 


Fourth Annual Tucker’s Trek 5K And One-Mile Fun Run Is May 18

The fourth annual Tucker’s Trek 5K and one-mile fun run benefiting Emily’s Power for a Cure Neuroblastoma Foundation takes place Sunday, May 18, at 2 p.m. at Baylor’s new Tucker Hunt '16 Memorial Lacrosse Field.  Mr. Hunt loved Emily Ransom and her battle with cancer had an effect on him -- and he loved Emily's Power for a Cure, said officials.  Tucker's Trek was ... (click for more)

Groundbreaking Ceremony For Morning Pointe Of Chattanooga At Shallowford Set For April 22

Independent Healthcare Properties (IHP) and Morning Pointe Assisted Living will kick off the groundbreaking celebration for the new Morning Pointe of Chattanooga at Shallowford on April 22 at 10:30 a.m. Already, the building is being framed in and the construction project is on target for an early 2015 opening. While construction started earlier this year, better weather has work ... (click for more)

City Applies For $27 Million Federal Grant On $52 Million Wilcox Tunnel Project

The city is applying for a $27 million federal TIGER 6 grant for a $52 million complete reworking of the narrow Wilcox Tunnel through Missionary Ridge. The project would leave the current tunnel in place for westbound traffic with a single lane and build a new two-lane tunnel for eastbound traffic. There would be an emergency egress cross passage between the two. Final ... (click for more)

NAACP Recommends Staying Away From Planned Protest By Neo-Nazi Group

The president of the Chattanooga Chapter of the NAACP, urged local residents to stay away from a planned rally here by the Nationalist Socialist Movement in August. James R. Mapp said the group seeks to provoke incidents and said counter-protests could lead to problems. Mr. Mapp said, "On April 8th, 2014, reports surfaced throughout the Chattanooga-Hamilton County region that ... (click for more)

State Moving Forward In Educational Improvements

The State Collaborative on Reforming Education released the following statement from President and CEO Jamie Woodson regarding the 2014 legislative session in Tennessee and HB1549/SB1835, which passed the General Assembly Thursday: After a year of extensive public and legislative conversation regarding higher academic standards and related strategies to improve student learning, ... (click for more)

Roy Exum: Some Really Funny Tweets

I am not on Twitter so I don’t tweet. Difficulties with my right hand don’t even allow me to text and when you blend in the fact I am now a bonafide senior citizen, it is ample reason for me to live a life where I am lacking in what otherwise might be achieved through social networking. Twitter has done real well without me. It is one of the 10 most visited websites in the world; ... (click for more)