New York Times Article
Today's Science section of the New York Times has an essay focused on an important question: should you seek treatment after suffering from a disabling and possibly deadly health problem or should you proactively seek safe and scientific ways to prevent the problem in the first place? I'm not sure a NY Times essay is a place where the intricacies of such an issue can be sufficiently discussed, but it is nice to see the issue placed into the press for people to consider.
The underlying issues may seem to focus on whether you would want to take medicines to treat high blood pressure, cholesterol abnormalities and/or diabetes, but it is much more than that. Sure I am a part of the traditional medical community, using prescription drugs prior to nutritional supplements. Why not, the drugs are studied so I know the safety and effectiveness while dietary supplements are marketed based on logic and assumptions. Countless times studies have proven that logic and physiologic assumptions such as these are in fact in opposition to data when scientific studies are finally performed. So my fault is not that I believe in pharmaceutical therapy, it is that I follow data.
With that said, I consider the comparison between my views and those of Dr. Gilbert Welch. Dr. Welch is funded by grants that appear geared to prove that we are over medicalized; that diagnostic tests are overdone. He's right. In cardiovascular medicine, tests are aften used to substitute for clinical judgement, and I think this happens too much. But the article allows the reader to conclude that testing is overdone in all of medicine, according to Dr. Welch, and I don't believe that would be his point at all. Any good epidemiologist knows that diagnostic testing is invaluable for specific groups of people but not necessarily for everyone.
In my book, I make the case that treatment is ideal for many American adults, but not everyone. It just so happens that when you live in a country where 90% of people over the age of 50 have or will have high blood pressure, we have a lot of people who can benefit from blood pressure treatment. Look around. With most American overweight, it's obvious that lifestyle changes are not going to be enough. It is the same thing for high cholesterol and diabetes.
What my book also says about how to work with your doctor to get ideal care may be more important than anything I say about blood pressure, cholesterol or diabetes, more important than the risks I describe for suffering a heart attack or stroke. We need to be self-advocates, because the health care system will not look out for any of us as individuals. It is concerned with cost effectivness for society and not the risk benefit ratio for any of us as people who may be at risk.
I would be interested to hear your thoughts on the article. It is available at:
http://nytimes.com/2004/11/16/health/16essa.html
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