Too much medicine?

Prescription drugs have made news over the last couple of years with some sobering statistics – accidental prescription drug overdoses are the leading cause of accidental death and kill more people in the US than cocaine and heroin combined.  This seems to be indicative of trend in the US towards overreliance on medical solutions to solve problems that may be better solved by nature.  We often do not understand the full context of an illness and rush to treat without taking into account the long-term consequences of doing so.

Atul Gawande broaches this question of when medical treatment becomes unnecessary in this New Yorker article examining end-of-life care.  He finds that for terminally ill patients, forgoing the hospital for hospice care that focuses on quality-of-life improvements can extend their life expectancy by weeks over even months.

Even healthy patients that undergo inpatient care may be exposed to scary antibiotic-resistant infections that can prolong their stay and endanger their lives.  These infections are transmitted in hospitals by well-meaning healthcare providers, with some estimates putting the transmission rate at 1 in 20 hospital inpatients.

Even scarier, some commonly-used medication, including over-the-counter painkillers, anithistamines, and psychiatric medication has been linked to impaired cognitive function and a higher risk of death – patients in one study that were on more than one of these acetylcholine-inhibiting drugs were found to have a 68 percent higher risk of death.

We hear so much about health disparities and lack of access to care.  But for those that are lucky enough to access care, a more nuanced approach might be appropriate for choosing whether to treat, with a bias towards not treating patients that are not at danger of becoming critically ill or dying.  The potential risk associated with many medications (even those that seemingly safe) makes it more appealing to treat with lifestyle changes whenever possible.  And, as so many have pointed out already, the incentives in the US healthcare system must be fixed to ensure that this infographic does not become the norm.

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