A Stitch in Time?

If it seems like your doctor isn’t as interested in your yearly screening exam, annual physical, or regular blood work as they used to be, you’re not alone. Patients are increasingly coming to the clinic to ask for tests to be done that their MD’s won’t do anymore.

This is part of an increasing trend in conventional medicine toward abandoning the screening tools used to determine if there is a potential problem in otherwise “healthy” people.

The Conventional Rationale

I’ve spoken with my medical doctor colleagues about this. For them, the evidence suggests that finding a problem earlier (when there are no symptoms) doesn’t change long term outcomes any more than just waiting until the patient has symptoms, and treating the problem then. The only thing that changes, according to one colleague, is that when you use screening, the patient ends up on drug interventions (with all the risks and side effects) for much longer then had the patient simply waited.

The result of this evidence is the trend to test less often, or simply wait until there is actually a problem and then deal with it. That’s what you’re seeing more of now in conventional care.

The Naturopathic Approach

As many of you know, we test, screen and assess a great deal, and continue to do so. But why do we do it if the evidence suggests we shouldn’t?

There are a couple of key reasons:

  1. Our philosophy leads us to individualize. If a study of a thousand patients suggests that doctors should stop screening, that doesn’t mean there won’t be patients who are worse off by abandoning screening. It means that in aggregate, the data supports abandoning it. But patients aren’t aggregates, or averages. They’re people. It’s hard to talk about “averages” and “overall population benefits” to someone who lost a spouse or parent to a disease that could have been prevented.
  2. We believe in, and see the results of, prevention. When a patient comes into our office, she might in fact be on the diabetes or heart disease track. Her diet might be full of simple carbohydrates and inflammatory foods. She may never exercise. She may have an imbalance in hormones or a toxic body burden. All of these things contribute to disease processes like diabetes or high blood pressure, for example. And most are all correctable before the disease fully develops. In other words, the disease can be prevented.

But to properly do both of those things—individualize and deliver preventative medicine—we need a level of understanding of the patient that’s difficult to achieve without testing and screening and monitoring.

When we do screening blood tests, for example, we’re trying to find out what future track the patient might be on, not so we can treat them on that track earlier, but to get that specific individual on an entirely different track so the disease never arrives.

The great strength of a publicly-funded health care system is that it’s designed to benefit the whole group. But that strength can also be its weakness when individuals suffer as a result.

A stitch in time saves nine. That’s math that works just fine for big groups. But what if a stitch in time saves just one?

For us, it’s still more than worth it.