It's only fair to share…

That medical science has advanced over the last century and that it has provided benefit for many is a statement of fact and of the obvious. It is also possible to have too much of a good thing. More to the point, as with most industries, and yes healthcare is an industry, there is always mission creep. President Eisenhower’s famous speech waring of the risk of the military industrial complex has wide applications.

The medical industrial complex advances by expanding the number of people who qualify for treatment with medications by lowering thresholds and broadening disease definitions to include more people. We have seen this in high blood pressure and high cholesterol levels to name but two. When thresholds of “normal” are lowered one can literally overnight reclassify a whole group of people from being healthy to having a “medical problem” needing treatment generally with a pharmaceutical agent.

The other expansion is the medicalisation of life whereby emotions such as sadness are rebadged as depression or shyness as social anxiety. There are many examples and again, the solution is not to either address the issue (if it is a problem to the individual) or accept that people have emotions and are different but to offer pills.

The question must arise – are we healthier as a result of increased medical intervention?

Natasha Robinson writing in the Weekend Australian notes, ‘It’s a paradox of modern medicine that many of today’s most prevalent health conditions are capable of being fixed by measures other than pharmaceuticals, yet the rate of prescription of drugs is climbing exponentially”. Furthermore, “Scripts are doled out with alarming regularity for conditions that are likely to get better simply with the passage of time and circumstance”.

Author of Hippocrasy: How Doctors are Betraying Their Oath Dr Ian Harris notes that 60% of medical care is effective, 30% of no value and 10% harmful. Thus 40% or nearly half of medical care is of no use or harmful!  It is also known that doctors overestimate the value of their interventions and underestimate the harms. Public health is the worst offender here as we have seen in recent times.

In the UK there has been a move to “deprescribing” a fancy way of saying stopping medications. A particular push here has been with SSRI antidepressants which have been shown to be no better than placebo in mild and moderate depression.  One in seven people in Australia were taking an SSRI in 2021 according to the Australian Institute of Health and Welfare. Exercise and lifestyle or social measures have been shown to be equally effective.

Weight and type 2 diabetes are other areas where medication or surgery is seen as the answer whereas dietary change is largely ignored. Worse than that low carb diets which have been shown to put type 2 diabetes into remission, and lead to significant weight loss are often actively discouraged.

Around 85% of those with type 2 diabetes are on medications which neither treat nor cure the condition. Political correctness in many medical institutions all but ban the use of terms obese or overweight due to fears of “fat shaming” and “hurt feelings” Of course tact and civility need to be applied but one cannot help a person if you cannot even name the issue they need to address.

Underlying this is an antithesis, in medicine and especially public health, to the notion of personal responsibility. If society is to blame then you are absolved of needing to make the lifestyle changes necessary and can look to society to pay for your pills.  It also fosters a dependency on the medical industrial complex which profits from this.

When personal responsibility rests with you then you are the one who needs to make the changes (with advice and support as needed) and accept that your actions have brought you to where you are.

We all have the capacity to change if we want to. Our health is our responsibility. The medical industrial complex needs to be reined in.