Too Much Medicine? The problem of overtreatment

Glasgow GP, columnist in the British Medical Journal, and regular contributor to 'Inside Health', Dr Margaret McCartney, investigates the controversy of medicine's search for traces of disease in people who would otherwise never know about them, or suffer any ill effects.

There's growing world-wide concern about the extent to which screening programmes and advanced diagnostic tools are finding signs of serious diseases, particularly cancer, in people who are outwardly healthy. For example, in South Korea, a mass screening programme for thyroid cancer has detected 15 times more cases than before it started - yet there's been no improvement in death rates from the disease.

The fundamental problem is that the harder doctors look for disease in people who are apparently well, the more they will find. Yet most of it will never matter to those people.

As a result, there is a movement towards Slow Medicine - echoing Italy's Slow Food campaign - that puts more emphasis on shared decision-making between doctor and patient, not always prescribing every possible test and treatment, and keeping people "in the kingdom of the well" as long as possible, rather than moving them prematurely into "the kingdom of the sick".

Produced by Mike Hally

A Square Dog Radio production for BBC Radio 4.

BBC programme page
(available to listen online after tx)