Several physicians contribute regularly to BMJ. One of my favorites is a GP in Glasgow named Des Spence. Through their writings, I have gained a glimpse of the challenges faced by GPs in the UK, and the broader culture in which they work.
In two of his columns this summer, he railed against various early detection movements in the UK. In one column, he protests against Alzheimer’s disease advocates who claim that 75% of cases go unrecognized, and who demand the “right to diagnosis.” As he so aptly writes, “Screening and more testing will only ensnare the anxious rather than the afflicted.” He supports this statement with evidence of the minimal effect of common treatments for dementia, and the influence of the drug companies on these advocacy campaigns.
In another column two weeks later, he laid out the issue more directly, exposing the lobbyists pressing for early diagnosis of a litany of diseases. He writes, “Early diagnosis is portrayed as wholesome, clean cut, apple pie medicine: who could disagree with such an agreeable concept?” He concludes the piece, “The thoughtless and emotional language of ‘early diagnosis’ is in reality just bad screening and the worst science.”
He is not alone. Another group of GPs and neurologists have launched a website to push back against the growth of independent test screening services offered by private companies in the UK that have nothing to do with the NHS (and frankly, I’m surprised they’re allowed to offer these services, but apparently they are). These companies sell tests just like their American cousins: EKGs, blood tests, and sonograms – all for a mere $300 (yes, I know it’s really in pounds). These physicians have taken the companies’ claims and annotated the claims with more scientifically sound conclusions, including explanations why the NHS does not cover these services.
The US sends Dell computers, Facebook, Google, blue jeans, and movies across the pond. Now it’s sending over useless and wasteful medical tests. I guess this is the price of international free trade. Let’s hope the Brits do a better job of sending these medical charlatans into the rubbish bin.
Early detection? I have an 88 year guy who is blind and came in and thinks he has blockage in his heart and wants a heart cath—- go figure!