Adapted from the MD Mama blog on Boston.com.
Let’s say your kid is gassy. She seems OK, but you’re not sure, so you decide to take her to the doctor, who, after listening to your story and doing an examination, says: “Your child is suffering from eructation and flatulence.”
And here you just thought she was gassy. Having heard this diagnosis, you are hoping that the doctor will do something — because some sort of test or treatment is necessary, right?
We doctors do this a lot, actually, this medicalizing of things that really aren’t medical conditions. We’re not so much doing it to sound smart or alarm people, it’s just how we talk. And sometimes, making something a condition is easier for us because then we can offer tests and medical treatments, which is what we know how to do. The problem is, not all of those tests and treatments are necessary.
A less silly example: baby fussiness and spitting up. Lots and lots of babies have this. With rare exceptions, it’s normal and goes away by itself; parental reassurance works as well as — actually, better than — any medications or other interventions. That doesn’t stop us, though, from giving it a medical name — Gastroesophageal Reflux Disease, or GERD — and prescribing medications, which mostly do nothing.
In an interesting study just published in the journal Pediatrics, researchers from the University of Michigan had parents read a clinical scenario about a fussy, spitty baby and then answer some questions. What they found was that if the fussiness and spittiness were referred to as “GERD” rather than “a problem,” parents were much more interested in medication, even when they were told that the medication likely wouldn’t work. It wasn’t that they thought that the term “GERD” meant that it was more serious, either. It truly seemed that for the parents, once there was a medical term involved, there should be a medical treatment involved.
In this case, medical treatment isn’t a good idea.
To help patients and families, and to help those well-meaning, busy doctors who may not have time to read all the latest studies, the ABIM foundation has started the Choosing Wisely Initiative. They have asked specialty societies to submit lists of five tests or treatments that doctors and patients should question, and to date more than 35 organizations (including the American Academy of Pediatrics) have done so. They also have patient-friendly resources from the specialty societies and Consumer Reports. Check it out, and spread the word.
It’s all about asking questions, really. Which is what all of us should be doing — patients and doctors alike — if we want quality health care that everyone can afford. The science and technology of medicine is amazing these days, but sometimes less, and simpler, is better.