Medicalizing of America

[Ceicei]

This is an article expressing Americans seek for problems early, even before the symptoms show. There is this statement in the article I think pretty much sums this all up:

Americans live longer than ever, yet more of us are told we are sick.

There are pros and cons for doing this. Is the process of finding diseases before they "happen" causing undue worry? Just because they didn't happen or aren't impeding our lives yet, doesn't mean the diseases WILL happen. What does it mean to be healthy, to be normal? What can we do about this societal attitude of needing to know now? Is this a solution seeking a problem?

- Ceicei

http://www.deseretnews.com/dn/view/0,1249,650219648,00.html

 

[mrhnau]

Americans live longer than ever, yet more of us are told we are sick.

Great topic... one of my huge pet peeves. I think technology has gotten to the point that even if we don't feel sick, we can still find something wrong. We have also gotten the the point that we can maintain a state of living for quite a long time. We can get someone to 100 w/out really asking about the quality of that life. I'd rather die at 70 and happy than 100 and laying in a bed for the last 20 years. Perhaps that just me though...

There are pros and cons for doing this. Is the process of finding diseases before they "happen" causing undue worry? Just because they didn't happen or aren't impeding our lives yet, doesn't mean the diseases WILL happen. What does it mean to be healthy, to be normal? What can we do about this societal attitude of needing to know now? Is this a solution seeking a problem?

Well, the advent of technology has given us alot of benefit. I think we can be aware of potential problems, thus giving us the ability to be proactive. Have a family history of diabetes or have a high blood sugar level? before you get seriously ill you can start dealing with it. Is that a case to worry? I imagine alot of people would worry... especially if you are diagnosed with something nasty even though you felt fine. Or potentially something nasty in the future...

What does it mean to be healthy or normal? thats the thing... everyone has some kind of problem, even if its minor... there is no perfect human. we all have issues. I fail to think "normal" exists these days. We also all have family history thats going to potentially be a problem. Our ancestors all died from -something-...

I do tend to think its a solution seeking a problem. well put!

 

[Ceicei]

The main part of this article that bothers me is we are doing this with our children. More and more children now have different conditions. How much of that is truly a factor of our lifestyle/environment and how much is from our own contribution telling them and causing more worry physically, mentally, and emotionally?

- Ceicei

 

[mrhnau]

The main part of this article that bothers me is we are doing this with our children. More and more children now have different conditions. How much of that is truly a factor of our lifestyle/environment and how much is from our own contribution telling them and causing more worry physically, mentally, and emotionally?

*nods*

Perhaps most worrisome is the medicalization of childhood. If children cough after exercising, they have asthma; if they have trouble reading, they are dyslexic; if they are unhappy, they are depressed; and if they alternate between unhappiness and liveliness, they have bipolar disorder. While these diagnoses may benefit the few with severe symptoms, one has to wonder about the effect on the many whose symptoms are mild, intermittent or transient.

So so true... if life is not perfect, we need to be analyzed, diagnosed and medicated...

One of my favorite ones... ADHD. Kid can't sit still or pay attention, so we give them drugs. How about less television? Less sugar? Some exercise? how about a spanking when appropriate? I'm sure that will not "cure" everyone, but I do know its way overdiagnosed these days.

 

[Ping898]

The main part of this article that bothers me is we are doing this with our children. More and more children now have different conditions. How much of that is truly a factor of our lifestyle/environment and how much is from our own contribution telling them and causing more worry physically, mentally, and emotionally?

- Ceicei

I think you hit the nail on the head very well with that one CC. I have a medical condition that has no cure and best I can do is control the symptoms and I can remember more than once when I was growing up being told by my mom that I had a choice to control it or let it control me. Now it took until I was well into college before I could control it, but I did and for the most part I now do and a lot of it is cause though my parents were understanding, they took me to the doctor, we did lots of tests and got a diagnosis and they let me stay home from school when things were really bad, they also didn't coddle me and told me in not so many words at times to suck it up...

I think this medicalizing of America is why we as people are becoming resistant to certain antibiotics....kid sneezes, give him penacilian (sp?). I think you need to be willing to test for things and willing to take your kids to the doctor, but just cause the doctor says your kid has X, put him on Y drug, doesn't mean you have too. I think too many people take doctors word as law and never question them on it or get a second opinion. I think people also forget that you can outgrow things. You had asthma as a kid, great, get retested, you might not have it anymore and may be medicating yourself needlessly.

One of my favorite ones... ADHD. Kid can't sit still or pay attention, so we give them drugs. How about less television? Less sugar? Some exercise? how about a spanking when appropriate? I'm sure that will not "cure" everyone, but I do know its way overdiagnosed these days.

Ohh I hate that one!!! I swear half the time the kids just end up getting medicated to make life easier for the parent or the teacher...

 

[Ceicei]

The perception I am getting from society is that many seem to feel that diseases are an absolute--either cure it, or you have it for life. Like you mentioned, sometimes things could be "outgrown" or may no longer be a problem that needs continued treatment.

Can this perception be changed? How many of us are actually proactive with our treatments and willing to challenge the doctors if needed?

I once had a doctor four years ago who wanted to perform a surgery on me, stating the type of condition I had was progressive, it would only get worse and surgery was the "best solution". I did much research about the condition, types of surgeries, and even joined a "support group." I challenged him, saying that I believed the human body is a lot more resilent than that, and returned to martial arts. The support group turned against me, saying doing any exercise, especially the martial arts, would make it worse. Funny thing is, the martial arts put me in a better physical health, and when I returned to him for a follow up check, the condition I had actually regressed to the point that surgery cannot be considered any more. I no longer see that doctor, but it does make me wonder whether the almighty dollar or my physical health was his focus.

There is such a thing as following one's instinct, I think.

- Ceicei

 

[Ping898]

I think part of the problem may also be that you (and maybe even MA-ist's) in general are the exceptions to the rule, so even if the doctor had your best interest at heart, he may not have know how to deal with you as a patient cause your responses were so foreign from what he usually got/gets

I mean the reality of it is more the other side of things, like the man my mom worked with who opted for back surgery over loosing 50 lbs, surgery was "easier" for him then going on a diet and starting to exercise.....

I don't know....one of my biggest problems with doctors is I always have unusual reactions to stuff, medications or diseases, so my doctors have to think "outside the box" to be able to treat me or help me. I ended up at one point having a bad mix of allergy drugs and I was just lucky I noticed the changes to my personality, and I related it to the drugs based upon a comment I heard about a possible reaction on one of them but allergist didn't believe me, so I went to a new doctor who believed me, changed up my meds and boom, personality disfunctionality was gone (at least the drug induced changes ). If your medical professionals can't help you and are constantly telling you X when you think it is Y, after a while you begin to doubt yourself and get sucked into the vicious cycle of always thinking or acting like you are sick even when you are not.
I go back to the point that I think people don't question their doctors enough, they take a doctor's word as gold, but they are as falliable as the rest of us. I am lucky, my mom is one to push doctors, so I always push doctors to make sure I can answer her questions when I tell her about something....but my dad never questions a doctor and I know if I was like him that there would be several things different in my life and I would have ended up having at least one surgery that now would be unnecessary or at least less helpful if I had had it done...

 

[Ceicei]

Ping,
You've made several good points. Since many martial artists generally have an awareness of their health and how their physical bodies work, would we look at health differently when compared to the general non-MA society? Intriguing thought.... and maybe good one for a separate thread.

- Ceicei

 

[Xue Sheng]

They scare the hell out of you here at the doctor’s office when you bring your child in. They tell you about the vaccination your child needs and why and you are terrified NOT to get it, even with some of the side effects.

But it is interesting that when you compare this to medicine in Beijing, first there are virtually no psychologists most disorders that would fall under the care of a psychologist in the US fall under traditional Chinese medicine and it is treated with Herbs and or acupuncture.

However if you are given a medication for a disease or illness by western medicine in Beijing you are prescribed about half the dose you would get here, meaning what an MD here would give you for 2 weeks in Beijing you get for one week. And they do not appear to have a major problem with relapse.

Don’t get me wrong they have people that are ill or have chronic diseases or conditions but then again most chronic conditions fall under TCM not Western Medicine.

But the diagnosis is in TCM in China that you would see it diagnosed here, basically they call it something different and in some (certainly not all) cases illnesses and conditions that are considered incurable here are curable there. But then there is a flip side some things we think nothing of here are major issues there, some surgeries for example. But they just do not seem as preoccupied with medication as we are here in the US.

 

[Ceicei]

Four main points I see:

One of my favorite ones... ADHD. Kid can't sit still or pay attention, so we give them drugs. .... I'm sure that will not "cure" everyone, but I do know its way overdiagnosed these days.

I swear half the time the kids just end up getting medicated to make life easier for the parent or the teacher...

I no longer see that doctor, but it does make me wonder whether the almighty dollar or my physical health was his focus.

But they [TCM in China] just do not seem as preoccupied with medication as we are here in the US.

All of these points may be somewhat related. How much of the push in medicating America comes from other than altruistic motives for better health? Are we a nation so fearful of being less than perfect that we need to be repaired, and if so, at what cost?

- Ceicei

 

[Ping898]

CC - I think a lot of it also comes down to education....American doctors are educated about western medicine and Chinese doctors (I assume) eastern medicines and they practice what they know. I see a chiropractor and any time I have to find a new one and need a recommendation, the recommendation I take most seriously is if a R.N. (especially one over the age of 40) recommends a chiropractor because so many doctors and nurses and people in the U.S. think chiropractors are quacks or harmful, and compared to some things found in eastern medicine the work chiropractors do isn't far-fetched...so when a person educated in western medicine has a recommendation for a chiropractor, I listen and take it seriously, because usually if I ask I get a look of disdain in response...

I also have to wonder about the way China does things and I will admit a total lack of knowledge of anything China but stamps, but my perception is that it is only recently like in the last decade or two that the proliferation of cars and technology has come to China. And I have to wonder if the US and other industrialized nations have brought a lot of their problems on themself just through those. And isn't a lot of China still villages or farm country....where I hear talks about obesity I don't hear much about about fat Chinese people. If we look back 40 or 50 years ago in the US, things weren't anywhere near as medicalized as it is now...

 

[Carol]

All of these points may be somewhat related. How much of the push in medicating America comes from other than altruistic motives for better health?

For one, malpractice lawsuits have shaped how doctors treat patients. If Doctor #1 doesn't offer a clinical solution to a patient's issue and Doctor #2 does, Doctor #1 faces a higher liability risk than Doctor #2.

The way money flows is also a factor. Many health insurance plans will offer unlimited coverage for physician's office visits, while offering no or limited coverage for treatments such as chiropractic care and behavioural health counseling. Most flexible spending plans will not allow monies to be used for weight-loss plans or exercise programs.

However, perspectives are changing. Some insurance plans offer partial reimbursement for preventative steps. The FDA is starting to consider some homeopathic treatments as over-the-counter "drugs", which qualifies them for reimbursement under flex spendng plans.

 

[exile]

Are we a nation so fearful of being less than perfect that we need to be repaired, and if so, at what cost?

- Ceicei

Ceicei, that might be part of it, but I think there's something more going on. I see two main factors at work behind this `something more':

(i) fear of new and terrifying ailments that can remain latent for years and years, which have begun to emerge as far more menacing threats to our health than the old, pretty in-your-face infectious diseases, the former major killers like typhus, cholera, diptheria, rheumatic fever—stuff that was killing our great-grandparents and even, in some quarters, our grandparents, but was stopped cold by the discovery of antibiotics. This is stuff that we don't have `magic bullets' for and therefore increasingly keep many of us awake at night, afraid. I'm thinking now of stuff like variant Creuzfelt-Jakob syndrome, the human analogue of `mad cow' disease, which is showing a steady and ominous increase in frequency in the western world, or ALS, better known as Lou Gehrig's disease, once extremely rare, but again, showing up more and more—both of these being virtual death sentences; Alzheimer's is another one. And there are many other neural and neuromuscular illness that we get `too much' information about—stuff that seems to be waiting up the line, if we live long enough. And more and more of us are doing that. We don't know if Alzheimer's disease is actually reaching epidemic status, as some people think; what's happening is that more and more people are living to an age where the triggering factors for Alzheimer's are satisfied. So our picture of illness is, I think, subtely but crucially changing: once upon a time, say up to about half a century ago, it was like lightning striking you; these days, it's more like a very long, creepy dark alley, filled with psychopaths, that we can't avoided walking through. People are much more anxious about their health, and need much more ongoing reassurance, because of this change in the nature of the illness (ignore the fact that cancer and heart disease, the big killers, are heavily implicated in lifestyle choices; things related to lifestyle are less likely to worry people, for some reason).

(ii) huge publicity placed on esoteric cutting-edge technological medicine, like in vivo gene therapy, or microimplantation of radioactive slivers which, like shaped charges, are able to deliver the bulk of their lethal radiation to malignant cells, sparing the healthy ones. With all these new fancy diagnostic tools and microtechnological aids, it seems that we have an almost limitless range of means available to defeat our ailments. People have that kind of picture, and they also have heard over and over again about `early diagnosis'—very true, no question; if everyone started getting colonoscopies at regular long-term intervals from age 40 on, colorectal cancers could probably be virtually eliminated. But given (i) above, people want more than this; they believe that if they're scanned at an essentially microscopic scale and bad cells/bad proteins/bad anythings are found, some obscure advanced technological fix will be there to save them and they can get on with the business of living forever.

(i) and (ii) are both products of a tremendous and accelerating progress not just in medicine but in science generally, one that has many potential health spinoffs. But the brutal fact is that if people in the western world stopped smoking, got a lot more exercise, and ate a bit more sensibly, it would prolong the average lifespan way, way more than breakthroughs on the frontiers of nanotherapy. But our cultural model seems to be, wait till something's broken (or till you discover it's broken) and then fix or replace it, rather than looking after it so it doesn't break in the first place...

 

[MA-Caver]

It's a trend that I've been noticing as well as everyone else here and I'm glad that I'm not alone with it. It's damned scary and has great potential for getting out of control.
Everyone here touched on great points and great reasons why this is happening. Fear is probably the primary motivator for all involved; the doctors and the patients (and their parents).
Money is another powerful motivator and this is on the physicians and the pharmicutical companies....(the hell with my spelling... they deserved to be mis-spelled.)
As I ranted on another thread about the blatant greed displayed by the drug-manufacturers in this country and how they encourage doctors to take the easy way out... simply prescribing a drug in about 15 minutes into the visit and get another patient in... more patients more money, more patients prescribed X, Y, or Z pill the more benefits these drug makers are offering the dispensing physcians.
Yes parents worry about their children and worry about them getting sick... normal right? But to go running to the doctor the instant the child coughs or sneezes just even once ... is extending it. Or as mrhnau pointed out parents don't want to deal with an over active kid so pop an amphetamine aka ritalin and they'll be just fine. SIGH!

My parents have to shell out a lot of money each month to their respective physcians and the prescriptions they take each day. They got insurance ... sure... but there's still a $20.00 co-pay for each visit. In Dec. they saw 4 different doctors 7 times and that's 20 bucks a pop, then shell out more bucks (even for generics) to the pharmacy.
Granted they're old and have real health problems (my dad with a pace-maker and chronic back-pain and my step-mother with diabeties), but still the BCBS still doesn't help relieve the added burden of their monthly visits. Plus my father hasn't seen his heart doctor in several months... he's got so many patients to see. I recall thinking that if more doctors would get out of the pill dispensary business and into REAL medicine then there'd be more physcians for more patients and more patients would get to SEE their physcians. Right now the only people my dad talks to are the nurses, nothing wrong with them !! it's just ... well, are we paying for the nurses or are we paying for the doctor?

I don't think I have a regular primary care doctor. I've checked myself into the emergency room (with a good book) for when I'm just seriously sick (severe flu symptoms, or whatever!) or injured. Otherwise I take care of whatever ails me by myself. Main reason is because I know how to and also I just simply can't afford it.
But another reason is there's no need. I'm not going to see a doctor for a minor cold, or a small laceration. I've had a jammed thumb from sparring with a friend once and simply just wrapped it up with an ace bandage and took it easy for a while.
I also when seeing a doc at the E.R. always ask for non-narcotic pain killers if necessary.

People do need to wean themselves off of their doctors (but of course this may drive their fees up because they're not earning as much as they used to) ... (being sarcastic... kinda). The FDA needs to stop those medicine ads from appearing on television... particularly and especially since they come with warnings and naming all kinds of side-effects it's brain-washing the public that there's a pill for every ill.
It's got to stop and that right soon.

 

[Rook]

Part of this, however, is just our knowledge of human biology improving. A couple decades ago, alot of these things wouldn't be dignosed because people didn't have the means to test for them or treat them. A huge part of this is simply what diseases we are now able to try to catch early that in earlier years we would have found out about in much later and more severe stages.

Cancer was something that might be operated on if a large tumor was known, but that was hard to find and didn't always show up on X-Rays; today we have lots of screenings that keep people scared of cancer, especially if they have a family history as I do, but they also make it possible to save lives. The same thing is true of screenings of things like diabetes and high cholesteral - things which in the past might have only become apparent when a limb needed to be amputated or when someone suffered a sudden heart attack.