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.”