Who Benefits From Overdiagnosis? Pharma, Device Makers, Hospitals

October 28, 2011 8:03 am 1 comment

H. Gilbert Welch. Courtesy of Dartmouth College

In recent weeks, we’ve seen the U.S.Preventive Services Task Force recommend that healthy men not have a PSA test, and read a new study suggesting that only about 3 percent to 13 percent of  women whose breast cancer was detected by a mammogram are actually helped by the test. In the case of both prostate cancer and breast cancer, test opponents argue, vastly more people are treated in ways that damage their lives than people who are helped by the tests. One study showed that for every life saved by prostate cancer treatment, 47 men are treated in ways that will probably greatly alter their sex life, not for the better. With breast cancer, a recent study published in the Archives of Internal Medicine suggests  that 1 woman per 1,000 healthy women screened over 10 years falls into the very small sample whose life is saved. Many others a treated in ways that cause pain, anxiety, and depression. The author of that study, H. Gilbert Welch, a professor of medicine and director of the Center for Medicine and the Media at the Dartmouth Institute for Health Policy and Clinical Practice, recently told BU Today who, in his opinion, benefits from the kind of overdiagnosis that does so much harm: “A lot of people: pharma, device manufacturers, imaging centers, and even your local hospital. The easiest way to make money isn’t to build a better drug or device—it’s to expand the market for existing drugs and devices by expanding the indication to include more patients. Similarly, for hospitals, the easiest way to make money isn’t to deliver better care; it’s to recruit new patients—and screening is a great way to do this.”

Read more in Welch’s book, Overdiagnosed: Making People Sick in the Pursuit of Health (Beacon Press, 2011), written with coauthors Lisa Schwartz and Steven Woloshin.

1 Comment

  • Dr. David R. Jones

    I’m a chiropractor and see this everyday. We treat spinal pain and get great results and and keep many from risky surgeries(that have about a 50/50 chance of success).The insurance companies will pay for the all the drugs and very expensive surgeries, but will hardly pay for chiropractic services. Makes no sense, just wished we could work together for the best outcome for the patients.It would seem that the medical profession would get off their high horse and just consider a least invasive to most invasive approach,instead of going straight to surgeries.

Leave a Reply


Recent Posts

  • Pain Ibuprofen And Healing, Probably Not

    Ibuprofen And Healing, Probably Not

    Does ibuprofen, the choice of pain relievers for most athletes, promote healing, or does it just reduce pain? That’s the question that New York Times fitness columnist Gretchen Reynolds tackles, with help from  Stuart Warden, a professor of health science at Indiana University who has studied ibuprofen and tendinopathy, as tendinitis is now known. The short answer, says Reynolds, is no, ibuprofen does nothing for healing. The longer answer is more troubling: it may actually slow healing. As Warden points […]

    Read more →
  • Pain Exercise May Help Control Prostate Cancer

    Exercise May Help Control Prostate Cancer

    Researchers offer no guarantees, but it looks like regular exercise increases the chances that prostate cancer will not spread beyond the prostate. HealthDay reports on an American Cancer Society study that included more than 10,000 men, aged 50 to 93, who were diagnosed with localized prostate cancer between 1992 and 2011. Researchers surveyed the men, asking about their physical activity before and after their diagnosis. Ready? The envelope please….the researchers found that men with the highest levels of exercise before their diagnosis […]

    Read more →
  • Attitude Pain Your Brain On Tylenol

    Your Brain On Tylenol

    Acetaminophen, the active ingredient in Tylenol, does a pretty good job of relieving pain, but it also does some other things, like make it hard to spot an error that would otherwise be readily apparent. We know this because researchers at the University of Toronto gave two groups of 30 a target-detection task called the Go or No Go, in which players were asked to hit a Go button every time the letter F flashed on a screen but refrain […]

    Read more →
  • Fitness Pain Rich People Live Longer

    Rich People Live Longer

    Yes, the rich are different from the rest of us. They live longer, for one thing. The New York Times reports on research published in The Journal of the American Medical Association showing that the gap in life spans between rich and poor widened from 2001 to 2014, with the top 1 percent in income among American men living 15 years longer than the poorest 1 percent. Yikes! And for women, the gap is 10 years. Wait, there’s more. In this […]

    Read more →
  • Pain Pot, Not Opioids, For Pain Reduction

    Pot, Not Opioids, For Pain Reduction

    Smoking pot could be one answer to the country’s growing opioid abuse problem. Why do we say that? Because researchers at the University of Michigan have found that patients using medical marijuana to control chronic pain reported a 64 percent reduction in their use of more traditional prescription pain medications known as opioids. The researchers, who looked 185 patients from a medical marijuana dispensary in Ann Arbor, also found that pot users reported fewer side effects from their medications and […]

    Read more →
  • Attitude Pain Can Cat Poop Make You Crazy Mad?

    Can Cat Poop Make You Crazy Mad?

    Cat poop, coveted by dogs and loathed by most humans, is suspected of making people mad, really mad. Researchers at the University of Chicago are convinced that people who are prone to explosive bouts of rage might be under the influence of toxoplasmosis, an illness caused by a parasite found in cat feces and undercooked meat. Strange but true. HealthDay reports that the study split 358 people into three groups–those with intermittent explosive disorder, those with a psychiatric disorder other than IED, […]

    Read more →
  • Fitness Pain The Ideal Interval Length

    The Ideal Interval Length

    We’ve all heard of interval training, in which short bursts of high intensity activity are alternated with less strenuous stints. Now comes Gretchen Reynolds, fitness writer for the New York Times, with answers, kind of, to two important questions about interval training: how long should an intense burst last?, and exactly how intense is “intense?” The answer, says Reynolds, is it depends. Mainly, it depends on how much pain you’re willing to put on yourself. Reynolds cites the research of Martin […]

    Read more →
  • Attitude Pain Mindfulness Beats Pain

    Mindfulness Beats Pain

    No one is suggesting that mindful meditation could be the answer to the country’s opioid crisis, but some experts think it could make a dent in it. Researchers at Wake Forest are convinced that mindful meditation can reduce pain, and more significantly, it can reduce pain through mechanisms unrelated to our bodies’ opioid system. A Wake Forest news release reports that in a randomized, double-blinded study, 78 healthy, pain-free volunteers were divided into four groups for the four-day (20 minutes per day) […]

    Read more →