The Hindu : Opinion / Open Page : Health check-up: how healthy is it?
With the advent of myriad tests, everyone can be made' a patient'
by detecting insignificant abnormalities which do not call for any
intervention
One of the first duties of the physician is to educate the masses not to take medicines. Sir William Osler
While the hi-tech, modern medicine has done a lot to take care of the sick, it seems it is causing injustice to the apparently healthy by over-investigating and over-treating. Extensive, needless health check-ups may reveal insignificant abnormalities in many healthy persons. With the advent of total body scanning' and the myriad laboratory tests and procedures of investigation, everyone can be made' a patient' by detecting insignificant abnormalities which do not call for any intervention. Detection of these abnormalities' causes jubilation to the technological, pharmaceutical and medical industry from the commercial point of view! Hippocrates, the Father of Medicine,' should pardon me for associating medicine with the word industry,' for he doesn't know what happened to medicine since he left this world in 377 BC! The present-day consternation about health check-ups' is not so much about the rationale of it as about its marketing and application with ulterior motives mostly of the murky commercial deals and monetary exploitation of patients. The erosion of standards and values in research, reporting, marketing and application of the science to humanity calls for critical comments to stem the rot.
It is shown that to prevent one stroke' we will have to treat 850 normal people unnecessarily with anti-hypertensive drugs (which are not without side effects) for well over five years. The big business bosses have continuously been trying to reduce the normals (normal lower limits of blood pressure readings, blood glucose levels, etc.) through paid research so that many millions of normal people could be labelled as patients, which means filling their coffers! And we gullible doctors simply swallow these scientific reports as gospel truth, which are pumped in by their high-powered marketing strategies.
They brainwash the medical profession, and condition their brains through other unethical means. Beware the endless efforts of these industries to make' new patients out of the healthy population by creating' a scientific basis to change normal limits of blood sugars and blood pressure and a host of other parameters so that more of the normal' population is brought into the net' of diseases out of their vested interests. They even create new diseases on paper to make more money. Awareness of these abnormalities and the inescapable further investigations' deprive happiness and produce ill-health due to anxiety, depression and even neurosis.
Just a few basic investigations and a thorough clinical examination will do in most of the apparently healthy individuals to detect significant problems and common diseases, or just to have the psychological satisfaction of being in good health.
It has become a fad in the higher socio-economic strata to run to specialists (not family doctors a tribe which is almost extinct) for every trivial symptom, have needless investigations done, and get a long laundry' list of drugs. Some of my patients, with great pride and satisfaction, show bulky files of periodical health check-ups and tell me that they have routine check-ups and routine medication with Aspirin, Atorvastatin, Alprazolam (the 3 A's considered a panacea against heart problems !) and a host of other drugs, thinking that these compensate for all the bad lifestyle they live with. Many of them receive a premature divine call.
Meera it is her pseudonym had cold and headache for a week and went straight to a neurologist. He promptly ordered a CT scan of brain which revealed some age-related changes. Worried a lot after reading the abnormalities' in the scan report, Meera lost appetite and started losing weight. Later, she was referred for an ENT check-up which revealed the presence of a small polyp (insignificant) in the nose. On seeing the endoscopy report, she lost the remaining appetite and got depressed. The loss of weight prompted a referral for a pulmonological check-up which included all tests from CT scan of the chest to pulmonary function tests and beyond.
Severely stressed, Meera got admitted to a huge hospital where all the specialists descended on her like eagles and took away their pound of flesh. The team included a psychiatrist to whom we doctors usually refer finally to wash of our hands. Finally, no significant abnormality could be found except the stress (doctors' induced psychological and financial stress)-induced loss of appetite and weight. The original problem of cold and headache, perhaps, subsided naturally, for treated cold lasts for one week and untreated cold lasts for seven days! Meera, a graduate in Arts, should consider herself lucky to get out without her abdomen or skull opened in the name of evidence-based' treatment.
Pritham Bhattacharjee, Editor-at-Large of Pentasect and Founder & Chief of Wordsmith at Wordsmith Communication, while narrating incidents connected with this subject, wrote to me: In Edinburgh, I went to register myself in National Health Service. Once all paper formalities got completed, I was told to come next week for a Health Check-up. I sincerely told the lady: I pray to Lord that I may not need to come again after that. The lady's brows twisted, and then I said: Don't you think my prayer is sincere? She understood and burst out in a laughter of understanding.
Certain studies revealed increased morbidity in places where there are more number of doctors!
(The writer is a pulmonologist at the ‘Pay what you can' Clinic, Perundurai, Erode district, Tamil Nadu. His email ID is drtramaprasad@gmail.com)
