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

 



Health Department Announces Annual Low Cost Rabies Vaccination Clinics

The Chattanooga-Hamilton County Health Department encourages all pet owners to get their animals vaccinated against rabies.  This year’s low-cost rabies clinics will be available at almost 60 locations around Hamilton County from April 20-28.  The price is $12 per pet.  Rabies vaccinations are required by law for all dogs and cats.   “Vaccinating our pets ... (click for more)

Morning Pointe Foundation, Parkridge Host Caregiver Café On Guilt And Grief

Dozens of family and professional caregivers attended the second “Caregiver Café” event hosted by the Morning Pointe Foundation and Parkridge Health System. The series explores the psychological impact of caregiving for someone with memory loss and aging.   Melissa Arkin, CEO of Parkridge Valley Hospital, and Amy Whipple, MSN, RN, NE-BC, associate chief nursing officer ... (click for more)

Federal Jury Finds Gillispie Guilty Of 6 Counts In Sex Trafficking Case

A federal jury on Wednesday morning found Corrie Gillispie guilty of six counts in his sex trafficking trial. Gillispie was ruled guilty of two counts of sex trafficking, two counts of kidnapping, one count of transporting a person across state lines for prostitution, and one count of money laundering.  The panel found him not guilty of another charge of transporting ... (click for more)

Attorney Says There Was No Valid Reason To Euthanize Monteagle Family's Pet Raccoon Boomer

A Chattanooga attorney who specializes in wildlife cases says there was no valid reason for health officials to have euthanized a pet raccoon belonging to a family in Monteagle. Candace Bone said the family had owned "Boomer" for three years after getting her from an approved raccoon farm. She said, "We are all devastated. He was just like a baby to us. Boomer slept between ... (click for more)

A Tribute For My Brother – Sgt. Jonathan Gardner, U.S. Army

Seven years ago today, my family and I found out that my brother, Sgt. Jonathan D. Gardner, was seriously injured by a roadside bomb, (explosively formed penetrator - EFP), while on a mission in Kuwait. The EFP went through the bottom of his seat and put a softball size hole in his upper thigh. The doctors said that if the bomb had entered the Humvee an inch to the right, he ... (click for more)

Roy Exum: Our Teacher's Pay Cut

The Hamilton County School Board will hold a “working session” Thursday afternoon as steps continue to formulate the FY2019 budget and it is a frightening process in a badly-broken system. Everybody knows it is equally embarrassing and after watching teachers who “have had enough” go on strikes in Oklahoma, West Virginia and Kentucky this spring, I guarantee you that Tennessee is ... (click for more)