This excellent LA Times article by Dr. H. Gilbert Welch is a few months old, but definitely still worth reading. It starts off by asking “How much medical care do we want in our lives?” and then goes on to detail the excessive care that most of us receive at the beginning and end of life.
Our own son was born at home following 45 hours of labor. For almost nine of those hours, I had what would have been described in a hospital as “failure to progress”. But I had competent midwives who checked our son’s heartbeat frequently, and patiently waited for me to give birth to him. Had I been in a hospital, there is a very good chance that I would have had a c-section. Yet our son and I both came through the birth unscathed, and a c-section would have been needless intervention. I know it’s easy to say that in hindsight, but the problem is that when it comes to the over-medicalization of our country, we aren’t learning from our collective hindsight.
Dr. Welch also writes about late pregnancy ultrasounds doing more harm than good by finding tiny abnormalities and causing needless worry to parents when it’s far more likely that the abnormalities are nothing to worry about. A good friend of mine went through this exact same scenario last year. At seven months pregnant, an ultrasound revealed a problem with her son’s intestine. She was understandably freaked out for the next two months, and was also subjected to weekly ultrasounds. When the baby was born, he was whisked away to NICU and monitored for 24 hours (no nursing or bonding time in that first day). The result of all that testing: a perfectly healthy, normal baby.
I haven’t had personal experience with the over-medicalization of end of life care, but everything I’ve read about it indicates that we are doing way too much intervening there too.
Much has been said about how we need to reign in health care costs in order for health insurance to be universally affordable. But we also need to figure out how to just use less medical care all around. We need to find ways to support health rather than react to illness (diet is a good place to start). And we need to question just how much we want our lives to revolve around medical intervention, pharmaceutical concoctions, and beeping machines. As Dr. Welch noted, some medical interventions are absolutely essential and worthwhile. But that is not the case for all medical care, and a “less is more” approach might create a healthier population and lower health care costs.
