In the same “Minerva” column, we learn that annual health checks on everyone between the ages of 40 and 75 are likely to be useless, at least as carried out in Britain, except possibly as a mild Keynesian stimulus to the economy. When the records of 130,356 people who had undergone such checks were examined, it was discovered that only about 20 per cent of those at high risk of cardiac disease were prescribed statins and even fewer of those with high blood pressure underwent treatment to lower it.
Since the beneficial effects of treatment with statins are a matter of controversy anyway, as being of value mainly to those who already have ischemic heart disease or have had a stroke, and since the treatment of high blood pressure is only marginally beneficial in the first place, so that the benefit of treating fewer than 20 per cent of those with high blood pressure is likely to be minuscule from the public health point of view, we can safely conclude that annual health checks as carried out in Britain are a waste of time — unless wasting time by occupying it is the whole object of the activity, in which case wasting time is not wasting time but using it gainfully. Gainfully, that is, to the person who wastes his time (the doctor) rather than has his time wasted for him (the patient). His time is well and truly wasted.
Part of the problem is the assumption that doing something must be better than doing nothing. Doctors of the past, because there was so little they could in fact do, employed a technique known as masterly inactivity: they assumed an alert watchfulness, giving the patient the impression, which was false but reassuring, that they would do what had to be done in the event that anything untoward happened. Since most people got better anyway, this seemed to confirm the wisdom of the doctor.
Masterly inactivity, however, is no way to increase your fee for service or gain a reputation for technical mastery. Patients too prefer to think that they are doing something rather than nothing to preserve themselves. That is why some of them are not merely surprised, but aggrieved when illness strikes them: for they have done all that they were supposed to do to remain in good health, from eating broccoli to regular bowel biopsies.
Theodore Dalrymple, “Dubious Cures”, Taki’s Magazine, 2014-11-30.
January 11, 2016
QotD: “[A]nnual health checks as carried out in Britain are a waste of time”
Filed under: Britain, Health, Quotations — Tags: PublicHealth, SocializedMedicine, TheodoreDalrymple — Nicholas @ 01:00
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