Feeds:
Posts
Comments

Posts Tagged ‘prevention is better than cure’

            No one will disagree, this is the most celebrated medical quote of modern times 

It is so unfortunate, the quote has almost become a silly cliche for every one of us including the physicians, and patients. Preventive medicine always struggles to prevail over its starry-eyed colleague, curative medicine in spite of the fact that cure is an assumption in many illnesses. Classic examples are diabetes, hypertension, and atherosclerotic disease. Many of the chronic diseases that afflict human beings have no complete cure. At best we can control them. All that we do is symptomatic and supportive treatment.

Overlaps between preventive and curative medicine

Meanwhile, we must also understand preventive medicine is not only about sanitation, nutrition, and a good lifestyle. Most facets of curative medicine are actually preventing complications of the disease. So in reality curative medicine works by preventing events. There is a big overlap.

The cure is often a mirage except in treatable medical emergencies. Still, we strongly believe every disease listed in the ICD code has a cure. It would be unbecoming of a medical professional if we don’t try for a cure. We are repeatedly sensitized that cost (& effectiveness too )should never be an issue. The Insane world of medical merchandise does this propaganda perfectly. How many of us realize PTCA and CABG are essentially poor palliative procedures in our attempt to conquer atherosclerosis and CAD? No surprise, 90% of the global cost of medical care is spent on prolonging the last one month of human lives.

Preventive medicine is less popular, primarily because it demands more effort, perseverance, and also wisdom. On the other hand, curative medicine gives a sense of accomplishment and also the glamor of modern medical modalities. Of course, one of the new chapters to be added in the current preventive medicine books is the public health dysfunction due to incongruous tertiary care.

We are caught in a vicious cycle of poorly administered preventive medicine and indiscriminate usage of curative medicine, with the former under siege, by the latter with its bigger design. It is almost certain, that the malignant growth of curative medicine is indirectly preventing the“preventive medicine” to reach its desired goals. 

Preventive medicine has its own issues. One ingenious way to increase the glamor quotient in preventive medicine is to increase the cost and mode of administration of (Apple watch!) No, It didn’t work. What about five-star preventive master checks? Maybe, it works on an individual patient level, but still, a suspect value on a global scale. The problem with master health checks is their skewed priorities. It aims to catch the disease very early in the asymptomatic or subclinical stage and try to administer the cure on a large scale, with an illusion of an intervention. (Recall the PSA times on the prostate, now the breasts armed with BRACAs may end up in the same story.)

 

Final message

 

No doubt “Prevention is better than cure” will be an immortal medical quote. Two things are essential. 1. The term preventive medicine is to be understood in proper context. 2. We may need to clip the redundant wings of “curative medicine” and divert the wasted resources to resurrect the much-maligned specialty of preventive medicine, for human goodness.

Counterpoint

There are fundamental gaps between the two limbs of treatment. It sounds like a crazy regressive statement to criticize curative medicine. Both shall grow and prosper on their path.

 But … why is it not happening?

 

Read Full Post »

Healthy heart syndrome (HHS) . This is  essentially a state of mind  , being in constant worry  that something  will happen to their  heart , in spite of  having  normal parameters.

HHS is a new age medical entity  of   the mankind   .  Here  the heart suffers   because  of excessive  knowledge  , affluence and entry of market forces into health care .

  • It is often a media driven frenzy . Having an insurance policy is the biggest risk factor
  • May be cured after taking few scans and some times end up in invasive Angiograms or even a PCI
  • In a  few it takes a course of  malignant anxiety disorder . Those afflicted indulge in daily BP check weekly cholesterol check , monthly cardiologist visit and yearly  64 slice CT scan.
  • Curiously ,   the definite cure  occurs only    after they suffer a heart attack .This makes them less anxious as the inevitable  has  been experienced .
  • There are occasions when too much anxiety  (for not developing a heart problem !)  will trigger a real event .
  • Some of the   medical institutions and health care providers   are also part of the problem as  many  of them perpetuate the condition as  they  keep these vulnerable  people (with healthy heart) guessing  and  do not fully disclose the reality .
  • The incidence of HHS seems to be rampant  as  there are  recurring instances of multiple stents deployed  in  apparently healthy hearts  .

Final message : Let us suffer from disease not from health !

While , many  patients with  multiple blocks ,  bye -pass surgeries   and  half- functioning  hearts  ,  lead  a   near normal life  ,  it is  ironical ,  a substantial number suffer    with  HHS and inappropriate  interventions .

Let us hope ,  modern medicine  which  goes deep into Nano medicines  and bio Robotics look  into this issue also !


Read Full Post »