Message from Dr. Winnifred Cutler on op-ed article for NY Times; on the risk of defensive medicine, unecessary tests and false positives.

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A Message from Dr. Cutler...

I read with great interest the recent New York Times op-ed piece by Dr. Sanjay Gupta, "More Treatment, More Mistakes" (7/31/12) and appreciated his sharing personal experiences. As a behavioral endocrinologist and research author, I do not perform surgery nor see patients like Dr. Gupta, but my published studies and books reflect the similar, important message about overdiagnosis, unnecessary tests, alternatives for surgery, and defensive medicine as conveyed in his article.

The op-ed quotes; "Herein lies a stunning irony. Defensive medicine is rooted in the goal of avoiding mistakes. But each additional procedure or test, no matter how cautiously performed, injects a fresh possibility of error. CT and M.R.I. scans can lead to false positives and unnecessary operations, which carry the risk of complications like infections and bleeding."

It is supportive to read; and in my 2009 book, Hormones and Your Health, I devote portions of the first chapter encouraging women to 'Take Ownership' of their health -- including choosing the right doctor.

"...your doctor may practice 'defensive medicine' by ordering redundant, expensive tests for you. Or sometimes doctors may stick to defensively postured practice guidelines that serve their, rather, than your, best interest in order to minimize their liability. You need to take charge of your own health and well-being; consult with the best medical people you can find and decide which recommendations to accept..."

Recent headlines and current events have addressed the significant problem of overdiagnosis and challenged the efficacy of screening for both prostate and breast cancer. I share Dr. Gupta's concern about false positives of repeated screening tests; even if those results do not lead to unnecessary surgery the experience of stress, fear, and radiation are very real. In my extensive review of current research, the studies suggest that detection outcomes from clinical examination are equal to those from mammographic screening, but without radiation, stresses of false positives, overdiagnosis and call-backs.

" It is not enough to stop defensive medicine, but when doctors are asked by their colleagues to justify the tests they ordered and the procedures they performed, perhaps they will be reminded that more is not always better."

Again I appreciate this last quote,of Dr. Gupta's and would add that as patients we are 'consumers' of healthcare and as such should be informed -- so we, as well as their colleagues, can ask our doctors to discuss (and certainly justify) tests and procedures they prescribe.

 

-- Winnifred Cutler, Ph.D.

Founder, Athena Institute for Women's Wellness

 

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Click here to watch the recent video interview of Dr. Cutler
discussing her new book; Hormones and Your Health

Click here to read more on the topics from chapter excerpts of Dr. Cutler's new book; Hormones and Your Health