Too much emphasis on disease, not enough on managing risk

Every once in a while, I swing by Wal-Mart (yes, you liberal readers, I go to Wal-Mart!) and use the machine there to check my blood pressure.  I don't take one measurement.  I take three. And, of course, I walk away with a smug relieved feeling that I am doing ok.  (Btw, it turns out that these machines typically report numbers that are higher than the ones when the nurse checks using the old style sphygmomanometer.)

I have been doing this for a number of years now.  It is because of a deep-seated conviction that physical health includes a great deal of personal decisions on managing the risks that are within our control.  One of the risks that I (and you, too!) need to manage is blood pressure. Periodic measurements then gives me an idea of that particular risk.

Once, when I told my daughter about this practice of mine, she warned me that I stand the risk of crossing over the dark side and obsessing about personal health. So, I don't tell her this anymore ;)  Well, she has a valid point there, and I am hoping to stay clear of the line that separates the light from the dark.

I worry, however, that we are increasingly living lives where we don't pay enough attention to managing risk.  The sedentary population ignores it as much as the overly active population overlooks the risks. Years ago, I asked my doctor whether he thought that people who jog and run a lot could affect their knee joints more than people who only walk a lot (like me!) because we humans are, after all, not designed to run like cheetahs but to only wander around like cows on meadows.  At least that is my risk management reason for not jogging--what's yours?

Only rarely can we truly eliminate risks, and those are often in the contexts of infectious diseases. Otherwise, it is all about managing risks.  Prevention of diseases, as the old saying goes, is immensely less expensive than curing them later on.  The expense of dollars as well as the expense via a diminished state of health.  But, could we also go overboard with this preventative approach?

Maciej Zatonski writes in the latest issue of Skeptical Inquirer (not online yet?) that a major problem with modern medicine is that it needlessly treats "everyone's "abnormal" findings" that results in:

Treatments are often expensive and can make previously healthy people feel sick--both physically (from side effects) and psychologically (due to their changed perception of their own health.

Why?  Simple: "The closer we look, the more "diseases" we find."

We scan, screen, and diagnose more and more individuals using the most advanced technology. But are we always helping our patients? Who actually benefits from early treatments? How many suffer complications? How many are harmed, physically or emotionally?

My mother has a long-running case of anemia. Recently, when father suggested that she undergo more tests, she flatly refused it, based on her own estimates of benefits and costs related to this risk management, given her age and the life expectancy at this stage of her life.  Father made the mistake of asking for my opinion--he was not happy that I supported mother ;)

Zatonski concludes:

My impression is that we need to redefine our conception and definition of health and disease and introduce the concept of "risk management of possible future health benefits."

Absolutely.