Medical variation

All healthcare systems and doctors are not created equal DRUG BUST by Alan Cassels Let’s compare doctor A and doctor B. A 70-year-old man with … Read more

The looming epidemic of overdiagnosis

Where are the leaders in eliminating waste in health system spending?

DRUG BUST
by Alan Cassels

Lately, I’ve got overdiagnosis on my mind.

Currently, we’re living through a perceived doctor shortage in BC, a crisis affecting as many as 600,000 British Columbians. In 2010, the governing BC Liberals promised that, within five years, everyone in BC who needed a family doc would get one. They even made this promise part of electioneering in 2013. How’s that plan worked out?

Well, it hasn’t. A few people may have been helped by a dating service set up to connect doctors and patients, but it was universally considered a bust. Despite promised government fixes, we have about 100,000 more people today without a doc they can call their own than we did five years ago. In early 2015, the government basically acknowledged it was a failure.

Read moreThe looming epidemic of overdiagnosis

Leave our prostates alone

Healthcare must engage in a wider discussion about preventive medicine

DRUG BUST
by Alan Cassels

• “Preventive medicine displays all three elements of arrogance…Aggressively assertive…Presumptuous…Overbearing.”

Dr. David Sackett wrote those words over a decade ago in a neat little column in the Canadian Medical Association Journal. He was, in this case, talking about hormone replacement therapy, after the publication of one of the world’s largest studies in preventive healthcare. The results of the Women’s Health Initiative showed that giving estrogen and progestin to healthy women going through menopause, on the assumption that this was vital preventive medicine, did not protect them from cardiovascular disease. In fact, it increased rates of some forms of cancer, heart attacks, blood clots and strokes. In trying to preserve and protect health, the recommended therapies were harming women. On a massive scale, I should add.

Read moreLeave our prostates alone