We’re guilty of them all, but
there are extenuating circumstances.
1. Doctors give treatments that relieve symptoms
but don’t cure the underlying problem.
Sometimes this is the best we can do. The cure for severe menstrual cramps is
menopause, hysterectomy, or pregnancy.
Drugs only relieve the pain, but patients appreciate them. No doctor cures migraine, asthma, emphysema,
osteoporosis, or the flu, but we relieve a great deal of misery.
2. Doctors order too many tests and prescribe
too many drugs.
Correct, but partly we’re responding to
pressure. Most patients with a painful injury assume they need an X-ray, but
they don’t. Those with a high fever,
sore throat, swollen glands, cough, or clogged sinuses assume they need an
antibiotic, but they usually don’t.
Doctors hate to disappoint patients, so they lean over backwards to “do”
something like order a test or prescribe.
3. Doctors order too few tests and prescribe too
few drugs.
We can’t win. Some clinics, hospitals, and insurance plans
restrict tests and drugs doctors can order.
This infuriates doctors as well as patients, but the sad fact is that
experts set up these guidelines to discourage needless tests and wrong or
unnecessarily expensive drugs. Mostly, guidelines fail. Even the guilty doctors
agree that we do too much.
I’ll reveal three more sins next
time.
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