Friday, December 21, 2012

Why free medical camps can be bad for your health !

I have observed that many hospitals are starting to offer free specialty medical camps. For example , IVF clinics offer fertility camps for women who are trying to have a baby ; while urology hospitals offer camps to screen for prostate cancer.

Medical camps have always been very popular in India, especially for conditions such as cataract surgery and for performing family planning operations. Originally , the purpose of the camps was to provide medical services to poor patients who lived in remote areas where medical facilities were not available. Rather than forcing patients to travel to cities in order to get medical care, it made more sense for teams of doctors to travel to villages , where medical services could be provided to these patients at their doorstep. This was a very cost-effective way of delivering medical care, and allowed thousands of  patients to be treated effectively. A lot of these camps were paid for by philanthropists and charitable organizations , who were happy they were doing good by providing free medical services to the poor.

Today, however, hospitals seem to use these medical camps more as a method for marketing and promotion !  Providing these free camps provides them with a lot of publicity , and helps them to highlight what a useful community service they perform. However, a lot of these camps have a hidden agenda which many patients are completely unaware of. Not only do the camps allow hospitals to collect a database of potential patients to whom they can market to , they create a vicious cycle of over diagnosis and overtreatment of many patients , who would actually be much better off by having been left alone.

In a camp , multiple examinations and tests are performed for anyone who walks in through the door. It is a simple rule that the more the tests you do , the more the abnormalities you are likely to pick up. Unfortunately there is very little correlation between finding an abnormality on a medical test, and the patient's clinical condition. However patients do not have the sophistication to understand this , and whenever the doctor finds a problem on a test , the patient automatically assumes that he then requires treatment for this so-called diagnosis / condition.

We need to remember that doctors do not treat lab tests - they treat patients. Doing lots of tests does not help the patient at all, but just helps the hospital. If the test results are abnormal , you have effectively created a patient from a person who was healthy before he came to you ! The probability of this patient then coming to you for treatment is very high , because the patient feels obligated to you , since you “ diagnosed “ his problem.

Both doctors and patients are very excited when they find an abnormality on the test result. They pat themselves on the back , believing that they have now diagnosed and picked up a problem which would otherwise not have been diagnosed in time. The naïve belief is that early diagnosis of these abnormalities will help in early treatment , which in turn will help patients to live longer and have a better quality of life. Unfortunately, these beliefs are completely false and unfounded !

The significance of an abnormal test result in an asymptomatic patient ( with no complaints ) is completely different from the significance of exactly the same abnormal test results in a patient who has medical complaints for which he needs medical attention . Unfortunately, because both doctors and patients do not understand this , when they do a battery of tests for asymptomatic patients, they end up finding a lot of abnormalities , which they then feel obliged to investigate further, and treat. While this obviously increases the volume of business for the hospital and increases its profitability , it doesn't help the patient at all.
While it may be very tempting to get a consultation and medical tests free of cost in a medical camp,  sensible people will stay away from these camps, which are effectively designed to fill empty hospital beds !

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