|Alan Cassels: I have this ad in my hand: A Body Scan Can Save Your Life. For a reality check, I talk to Dr. Gilbert Welch, who works at Dartmouth Medical School in Vermont and is currently on sabbatical in Montana. He's working on a new, as yet untitled, book that seems to me like the next chapter to the book of his I'm holding in my hands called: Should I Be Tested for Cancer, Maybe Not and Here's Why. He is a little cagey about the substance of the book-in-progress, but he tells me that it's about overdiagnosis: the fact that the way medicine is practised, we get far too many diagnoses of disease without substantive improvements in patient care. He uses an analogy that captures the gestalt of our time in a world where, it seems, more and more overdiagnosis is becoming the norm, where everyone is, more or less, prediseased.
Dr. Gilbert Welch: I think the generic problem is somewhat like the "check engine" lights on your car. Do you have check engines lights? My first car was a '75 Ford Fairlane. There were only two things monitored: my oil pressure and my engine temperature. I now drive a Volvo that is 10 years old, but it is checking about 25 different engine functions. And sometimes a check engine light comes on, and you're really glad to know, and it leads to something you want to do something about. Sometimes the check engine light is just a nuisance, and it just keeps flashing on and off and the mechanic can't fix it. And some of the audience might have this experience where they went to get it fixed and it made matters worse. And if you had that experience, you've had some of the experience of overdiagnsosis and that's what I'm worried about. We're putting more and more check engines lights on the human body. We have to ask ourselves if that is really the best way to get to a healthy society. We're constantly monitoring for things to be wrong. Is that really the best way to achieve health?
Should I Be Tested For Cancer Maybe Not, and Here's Why, by Dr. Gilbert Welch, published by University of California Press, 2004.
Know Your Chances, Understanding Health Statistics, by Steve Woloshon, Lisa Schwartz and Gilbert Welch. Published by Unviersity of Californina Press, 2008.
Worried Sick, A Prescription for Health in an Overtreated America, by Nortin M.
Hadler. Published by University of North Carolina Press, 2008.
Prostrate Cancer Screening, Some Men Say No - MSNBC article.
Cancer Screening: Is it Overdone? - Interview with Dr. Barry Kramer, Minnesota Public Radio.
Is Screening And Early Detection Always Good? - Interview with Dr. Barry Kramer, HealthDot.
The Science of Early Detection by Dr. Barry Kramer, ScienceDirect, only available with a subscription.
A Patient's Viewpoint on a Current Controversy by Dr. William Casarella.
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