Over-Diagnosis, Over-Treatment And Over-Anxiety

Back in November 2006, I discussed briefly the concept of Healthy Patients and the Healthily Ill. Interestingly, a letter appeared in the BMJ (letter: 03.03.09) which touches on a similar issue. By alerting to health issues that may not be an issue, there is a cynical irony in that anxiety levels can be (inadvertently) raised, especially in older people so requiring antidepressants. At best it is a Catch-22 scenario. At worst it is by design. A GP can find any number of potential problems and when the goalposts are constantly moved it becomes difficult for the non-professional (probably the majority of a GP's patients) to filter the real from the distorted. Raising awareness can create a larger number of patients 'in need' of some sort of treatment and some will doubtless benefit from the alert who may be otherwise unaware of ill-health. The subtle distinction between prophylaxis and pro-active or preemptive (seizing of the initiative) treatment is raised.