Mass medicalisation is an iatrogenic catastrophe

by James Le Fanu. BMJ 2018;361:k2794 (June 28, 2018)

Profligate prescribing has brought a hidden epidemic of side effects and no benefit to most individuals.  [All of us who drift into physicians’ offices are subject to over-medicalization by overworked, ignorant, well-meaning, but  often autocratic, physicians. DJE]

Excerpts:

“Tis impossible to separate the chance of good from the risk of ill,” wrote David Hume presciently, anticipating, by 250 years, medicine’s current existential crisis. There is no drug or procedure with its “chance of good” that may not harm some. The more doctors do, the greater that risk. And doctors are certainly doing much more with, over the past 20 years, a dizzying fourfold rise in prescriptions for diabetes treatments, sevenfold for anti-hypertensives, and 20-fold for the cholesterol lowering statins.

There is a hidden epidemic of anxiety-producing symptoms such as fatigue,

muscular aches and pains, insomnia, and general decrepitude, a 75% rise in emergency admissions to hospital for adverse drug reactions.  Le Fanu feels that this was driven by sophistic public health research that played into the drug industry’s goal of mass medicalisation.

This ‘close alignment of the priorities of public health with the marketing practices of this most profitable of industries’ has been achieved by lowering the threshold for initiating treatment to include those whose physiological variables are only marginally elevated, if at all. The simple expedient of redefining diabetes, hypertension, and hypocholesteraemia in this way increased their prevalence in the US by, respectively, 14%, 35%, and 86% -- an additional 56 million cases, more than a third of the total adult population of 187 million.

The population was not “sick” after all, but has certainly been made sick by the iatrogenic consequences of that profligate prescribing.