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Don't Blame Aging Boomersby Kimberlyn McGrail
Don't Blame Aging Boomersby Kimberlyn McGrail
Don't Blame Aging Boomersby Kimberlyn McGrail
ca
http://umanitoba.ca/outreach/evidencenetwork/archives/5006
Or is all this testing simply a response to the wider availability of the technology itself, a kind of defensive medicine, standard practice or even the outcome of seeing many different doctors (who may all feel they need to do something)? Further, were increased referrals to medical specialists necessary, or the predictable outcome of a poorly organized and overly-burdened system of primary care? Unfortunately, we dont routinely collect information on diagnostic outcomes and quality of life in health care so these questions are sometimes difficult to answer. But there are some important general cultural facts at play. We like new things and we seem to have a general assumption that if something is good, then more of it is better. New tests, screening devices and procedures are invented and we expect that they will be adopted immediately into the system. But we too often forget that care itself comes with certain risks all drugs have side-effects, many forms of imaging expose us to radiation, surgeries may have complications, even the fact of being diagnosed with a chronic condition can have a negative effect on peoples outlook on life. There is plenty of research to show that more use of specialist services, tests and imaging do not necessarily create better outcomes. More care is not always better care. Matching innovation with improved health outcomes People who need care should absolutely receive what they need. The trick is in defining and understanding that need. There is a lively ongoing debate about whether earlier and earlier screening, detection and labeling actually improves quality of life and outcomes for patients. The fact is, we dont often know. We need better ways of measuring the outcomes of increased diagnostic testing beyond our now somewhat crude measurements of morbidity (the number of people with a specific disease) and mortality (the number who die of the disease). In other words, we need to put our efforts toward tracking more subtle changes in health and quality of life over time, particularly given that much of our health dollars are now spent in addressing chronic health issues. It is time to shift the conversation from finger pointing at boomers to a much broader discussion about technology, the value and potential dangers of increased diagnostic testing, and whether we are getting value for money from our ever increasing utilization of health services. Kimberlyn McGrail is an assistant professor at the University of British Columbia and associate director of the UBC Centre for Health Services and Policy Research. She is also an expert advisor with EvidenceNetwork.ca.