Barbara Ehrenreich: Why I’m Giving Up on Preventative Care


In this piece for Literary Hub, Barbara Ehrenreich critiques the overuse of preventative medicine and describes how our healthcare system’s emphasis on screenings and early detection contributes to the epidemic of unnecessary treatment.

“One reason for the compulsive urge to test and screen and monitor is profit, and this is especially true in the United States, with its heavily private and often for-profit health system. How is a doctor—or hospital or drug company—to make money from essentially healthy patients? By subjecting them to tests and examinations that, in sufficient quantity, are bound to detect something wrong or at least worthy of follow-up. Gilbert and his coauthors offer a vivid analogy, borrowed from an expert in fractal geometry: ‘How many islands surround Britain’s coasts?’ The answer of course depends on the resolution of the map you are using, as well as how you are defining an ‘island.’ With high-resolution technologies like CT scans, the detection of tiny abnormalities is almost inevitable, leading to ever more tests, prescriptions, and doctor visits. And the tendency to over-test is amplified when the doctor who recommends the tests has a financial interest in the screening or imaging facility that he or she refers people to.”


  1. She has hit the nail on the head once again, and unfortunately the nail was taken to the emergency room where staff will administer a brain MRI, an EEG, and an EKG and ask it to count down from 100 by sevens. If it was never the sharpest of nails and flubs it after a hearty opening “93!” things will get very difficult for the nail in the next few days as a parade of specialists is trotted in until one who will order more testing is identified. Then, more testing. Good luck, nail.

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