When it comes to medical care, many patients and doctors believe that more is better.
However, an epidemic of excessive treatment (too many tests, too many blood tests, too many procedures) is costing the nation's health care system at least $ 210 billion a year, according to the Institute of Medicine, and is affecting to human and emotional pain. Suffering, serious complications and even death.
"What people are not realizing is that sometimes the test represents harm," said Shannon Brownlee, interim director of the health policy program at the New America Foundation.
"Sometimes, the test takes you down a path, a therapeutic waterfall, where you start going down and more tests, and more and more invasive tests, and possibly even treatment for things that should be left pretty good."
Have you experienced too much medicine? The New York Times asked readers to share their stories. More than 1,000 responded, with large and small examples.
Some complained that when they change doctors they are required to perform blood tests in duplicate, scans or other tests that their previous doctor had ordered recently. Others said they were caught in an endless maze of tests and specialists who seem to forget the patient's original complaint. I also heard doctors and nurses: health professionals frustrated by a system that encourages these excesses.
Terrence Power of Breckenridge, Colorado, said that after his wife, Diane, knew she had Wegener's disease, an uncommon autoimmune disorder, the couple found it difficult to refuse the tests recommended by a trusted doctor. The doctor insisted on visits to the office every three weeks, even when she felt well. She frequently asked for blood tests and x-rays, and repeatedly referred her to specialists even for minor complaints. Even when the tests turned out to be negative, more were ordered and she was hospitalized as a precaution when she caught a cold. During a period of six months, he had 25 medical visits. The couple spent around $ 30,000 a year out of pocket for their care.
"He was convincing enough that we felt we should do it," said Mrs. Power, 60, who remembers being sedated before an endoscopy procedure, one of the last tests she allowed her doctor to perform. "When they were preparing to knock me out, I was thinking, 'Why am I doing this?' But we felt that the doctor knew what to do and we trusted him."
After several years of physical suffering and almost financial ruin of medical costs, the couple began to question the treatment after consulting with other patients in online support groups. Mr. Power spoke with his own primary care physician, who advised him to find a new specialist to supervise Ms. Power's care. "It's very difficult to determine when they crossed the line," said Power. "You think he's getting the best care in the world, but after a while you start wondering, what's the goal?" He seemed affectionate, but he did not really consider my wife's time and the suffering she was going through all these tests ".
Under the new doctor's care, the regular tests stopped and Ms. Power was finally able to achieve remission. Now she sees the doctor only four or five times a year.
Sometimes, the cost of too much medicine is short, but emotional. Kara Riehman, 43, of Atlanta, was on vacation in California when she lost the fight with an ironing board in her hotel room and ended up with a black eye.
When the bruising peaked around 10 days, he called his doctor to make sure everything looked normal. But instead of seeing her, the doctor, through a conversation with the nurse, ordered a computerized tomography. He had no symptoms other than a bruised eye, but the doctor never talked to her or examined her. The exploration returned with an ambiguous finding, and the nurse told him it could be a tumor. Then they gave him an M.R.I. and for two weeks, while waiting for the results, he was worried about having brain cancer. The nurse called to tell him the M.R.I. it was good.
"It was really terrible," he said. "It was only two weeks, but there is a lot of cancer in my family. Actually, I never talked to my doctor through all of this. "
The total cost for your insurance company was approximately $ 7,000. "It changed my way of thinking about interacting with the medical system," said Ms. Riehman. "It made me much more a questioning consumer."
Jim Donohue, an examiner at the Brooklyn bank, had to intervene on behalf of his father, now 79, who suffered a stroke in March 2007. Florida doctors gave him several medications, including two antidepressants, and little then the man began to hallucinate already Signs of dementia. Mr. Donohue began investigating the medications and learned that they were associated with cognitive problems. He persuaded his father's doctors to change the medication, and his father quickly improved. Since then he has recovered and has lived alone for four years.
"All the medical professionals who saw him on the road, the hospital, two nursing homes and no one thought of this," said Mr. Donohue, who said his father should never have received a diagnosis of depression in the first place. "I do not know if we have too many specialists and everyone is trying to practice their specialty, but it should not have happened."
When Kathryn Gullo, a teacher in the Los Angeles area, gave birth to twins at 25 weeks of pregnancy, she was hospitalized in the intense medical care of the neonatal ward that saved the lives of her children. But when her daughter, Grace, was 3 months old, she was transferred to a different hospital, where doctors insisted on submitting her to a battery of tests for symptoms that other doctors had ruled out as normal for her condition. "We felt as if we were being bullied," Gullo said. "He had enough faith in his previous doctors that it was easy to say no."
The family changed hospitals and their daughter, now 5 years old and with mild cerebral palsy and some vision and feeding problems, still requires specialized care. But recently, when doctors suggested an M.R.I. That would require her daughter to be anesthetized, Ms. Gullo and her partner, Katie Ingram, said they asked two key questions: "What new information will this give us?" and "Will what we are doing change?" After talking to the doctor, they declined the MRI
"Not all mysteries must be solved, and not all problems must be solved," Gullo said. "It's hard to make your brain move."
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