Routine Screenings: Blessing or Curse?

The link below addresses the value of illness screening, in this instance breast cancer. The essential questions are these: Are all of the routine screenings (e.g., mammograms, colonoscopies, prostate) really necessary? Are they effective in saving lives? Are they cost efficient? Do they contribute to over-diagnosis with its associated costs, both human and financial?

The answers are complex, critical, complicated, and full of surprises. The issue, though, is far greater than just the worth of routine screenings. If we don't reform our "healthcare" system, we are going to go broke. It's as simple as that.

I put healthcare in quotes because our system actually has little to do with health. At its best, it provides treatment for disease (interesting word, dis-ease) and does almost nothing to promote health. Most illnesses that require costly treatment are related to lifestyle and can be prevented, delayed, or minimized by good health. Yet what we call the health care system simply does not focus on health. Why? The short answer is money. The long answer is comfort. I'll explore this at some length in future posts.

For now, let me just say that health care providers of all types are currently rewarded for the procedures they perform. The more procedures, the more complex the procedure, the greater the reward. So the incentive is to do more discrete, billable procedures. There is no incentive - really, there is a disincentive - for promoting health. No physician can maintain a practice by taking the time to explore with a patient the variables that influence their health, exactly what they can do about it, and exactly how to do it. Six ten minute visits/procedures generate far more revenue than one or two consults with patients designed to help them take charge of their health. That's the reality. Medical people are not being greedy here; they are just working the way the system is designed.

Frankly, most patients like it that way. They would rather have doctors be responsible for fixing them than take responsibility for their own health. Why? It's easier. It's easier to take a pill and expect it to fix you than it is to take responsibility for your health and do what is necessary. More to come.....

Cancer Screening: Blessing or Curse?