There is an old adage. A Cold will get cured with medicine in 2 days, or without medicine in 48 hours.
I have always wondered whether our doctors err on the safer side, prescribe unnecessary medicines, which does more harm than good.
I know of a paediatrician who rarely gave medicines, and his patients were none the worse for it. Then there was the case of another acquaintance, who returned from London, set up practice in Calicut, refused to give unnecessary medicines, and found he had no patients. When he enquired, he found out that his target market was predominantly families whose bread winner was in Gulf, and they expected the Doctor to write at least 2 tonics and 3 capsules for any ailment. The poor guy could never reconcile to this. Another anecdote is from rural Tamil Nadu, where the common folk have an obsession with 'oosi', which translates to 'injection'. The doctor is no good if he doesnt give an injection ("Doctor ayya sariyillai. Avar oosi podalai" - Doctor is no good, for he did not give an injection - is a common refrain).
With the concept of family doctor (I had written about it before) almost vanishing, we are in an era of 'Speciality Doctors' working in Super Speciality Hospitals. The problem with these Specialists is that they tend to have tunnel vision, looking at all problems through the prism of their specialization. Then there is the commercial angle also. Unncessary tests and unwanted procedures, diagnosis aimed at increasing repeat business for the hospital is a norm than an exception ( I am not discounting that these doctors and hospitals do a stellar job).
My above perception was validated when I read this report on TMT,
The ECG Tread Mill Test commonly used to identify people who are prone to heart attacks is not a fool-proof procedure to know the condition of heart especially among high-risk professionals like pilots, according to a latest study. The study is an eye opener and probably the established criteria for positive Tread Mill Test (TMT) needs revision in order to avoid treating healthy persons as heart patients, its author Colonel M J Jacob, head of the department of Nuclear Medicine, Army Hospital Research and Refferal said. The study has been published in the Journal of Associations of Physicians in India.
With increased prevalence of coronary artery disease, people especiall the young are anxious to find out about their risk of suffering from a heart attack in near future and hence, undergo TMT to clear the doubt.
ECG TMT is one of the main tests routinely used to detect the adequacy of the blood supply to cardiac muscles during rest as well as at times of higher stress. All those who test positive for ECG TMT are put through further tests and procedures.
"A total of 152 people including airline pilots, millitary personnels making it to higher altitudes, submariners and executives who reported positive for ECG TMT were analysed in order to ensure their cardiac fitness in stress conditions.
"It was found that the test grossly over-estimated the presence of cardiac problems and put healthy persons through unnecessary tests and procedures," Colonel Jacob said.
Chest discomfort could have been due to other minor problems unrelated to heart like acidity, chest wall muscle main etc, he said.
He said, "ECG TMT is one of the very common investigations being used in the periodic medical examination of high risk professionals.
"It's time we revise the test criterias. It's time we revise the test criterias in order stop person from being unduly being subjected to coronary angiography," he said.
