Has Prevention Gone Too Far? Nobody enjoys being sick. That fear of bad health drives people to do whatever they can to prevent a disease or spread of infection. However, how necessary are all of the preventative measures we take to stay healthy? Should medical personnel and patients being treated make an effort to cut down on the number of medical screenings? Would such an act lead to a more effective health care system or are these numerous screenings essential to saving lives? Considering that I hope to be a physician assistant in the future, I felt that this issue was something I should investigate since one day, I will be the one ordering tests for patients. In order to determine which route is the correct one to take, I read two opposing articles discussing the topic.
In his article, “PSA Testing Controversy Reignites ‘Over-Screening’ Debate,” published on PBS.org, journalist Jason Kane begins with a story about Denham Kelsey, a man who would never had known he was developing prostate cancer if it was not for his routine screenings. When the U.S Preventive Services Task Force released news that it was no longer going to require regular PSA Testing (prostate-specific antigen test), a heated battle reignited. Kane claims that people would not get the routine tests if they are not considered necessary or are not covered by insurance. He argues that preventative measures like PSA screenings do help prevent some diseases because early diagnosis is key.
In H. Gilbert Welch’s article, “If You Feel O.K., Maybe You Are OK,’ the professor of medicine at the Dartmouth Institute for Health Policy forcefully states that over diagnosis and overtreatment is a major problem in the healthcare system. He argues that the process makes people mentally sick, causing them to overthink symptoms and notes that people are automatically turned into patients as soon as they go through medical screening. Although Kane and Welch both agree that medical tests, in some cases, can help save lives, they disagree on the degree of effectiveness. Kane believes that people will not go for the tests if they are not required or recommended to, since people generally do not go to the doctor if they are feeling healthy. Kane cites a quote from Dr. Raoul, the president of the Large Urology Group Practice Association, which in his article states, “If the test is not being covered by insurance, many would choose not to have it done even though they feel strongly they need it.” Basically, Kane is saying that these tests should be required because they help diagnose the sick and motivate the healthy to stay healthy. Welch contrasts, saying “It’s easier to develop new ways of testing than it is to develop better treatments.” He thinks the healthcare system comes up with more ways to test than treat. Welch protests that it is easier to transform people into patients, therefore getting their money, than it is to treat those that are truly sick.
That is not the only issue they disagree on. They discuss whether the price you pay for a medical test is actually worth it. Kane states, “To many men, any amount of discomfort or risk would be worth it if it meant they’re less likely to die of cancer.” If we get rid of tests just because they are expensive, we throw out 20 years in the diagnosis and advancement of medicine. Kane’s ideas are very complex in that he looks at the whole picture. He notes that most insurance companies have stated that they will continue to pay for preventative tests like mammograms and PSA tests because of their ability to save a life. Kane thinks that any price you may pay for a test is worth it, but in reality money should not be a major concern. However by contrast, Welch states, “By turning people into patients, screening makes a lot of money for pharmaceutical companies, hospitals, and doctors. One hospital can make around $5000 from each free cancer screening, thanks to ensuing biopsies, treatment, and follow up care.” Welch thinks treating healthy people is just a scam to make more money. He thinks we would all be better off if the medical system stuck to its original mission of helping sick people and letting the healthy be. In a time of cutting back, people cannot afford to go through numerous tests to find out they are perfectly healthy. Yet, in his article, Welch fails to provide prevention alternatives for those who want to get tested but cannot afford it. He does not seem to realize that sometimes you cannot tell if you are sick.
Welch’s attack on unnecessary medical testing compared to Kane’s advancement of testing to save lives elucidates the positives and negatives of the topic, pushing me to consider the need for routine screenings. After reading through both articles with an open mind, I have come to agree with Kane. I understand how this can be an issue in an economy that always wants to cut back, but I also see the major need to catch things early. Early diagnosis of something such as cancer may be the only way to treat it without it becoming terminal. Of course there is always room for scamming, such as charging too much for a test, but wouldn’t you be willing to pay the price if your life was at risk? Wouldn’t you want to rule out severe diseases so you could feel a little bit better about going on with your day? Kane shows us the benefits of medical screening and the uproar resulting from a decision to no longer require some important tests. He reveals quotes from doctors, experts in their field, who scientifically and medically can prove that we need these tests. Because of this, Kane’s facts are so much more appealing than Welch’s argument. Welch tends to just complain about the healthcare system. Even when Welch concedes to say that early diagnosis is not always wrong, he states that the individual should be the one knowing if they are healthy or not. He describes the appointments, tests, insurance forms, drugs, needles, and operations as all “needless.” If someone close to me, or myself was suddenly in an unexpected, yet preventable medical crisis, I would be angry at myself for not taking the means to avert it. Reading the articles has led me to conclude that you cannot put a price on good health. Medicine has come so far and even more advancements are made every day. The tests were created for a reason. If you feel chest pain or have trouble breathing, there is a chance you have a heart condition. If you feel a lump, there is a chance a tumor is growing. You and I both get that. If we feel pain, chances are something is wrong. But, something needs to tell us we have a problem if we cannot feel it ourselves. My grandmother is a breast cancer survivor. The only reason she found out that she had a tumor was through her routine mammogram. If she did not routinely go for it, she may not be here today. Welch makes important points to cause us to be cautious of what tests we get and how it’s easy to be consumed by anxiety of bad health—from drug side effects to complications during surgery. Nevertheless, I was more intrigued by the survival stories Kane incorporated into his article. The people who went for their tests when nothing was wrong are alive and well today. Kane and Welch offer interesting and educational opposing views on the idea of medical screening. I would encourage each and every person to go through recommended medical tests to ensure that they can live a long and healthy life. Even if it costs money or you are cautious of what you may find, it will be worth it in the long run. Medical tests and screenings might be necessary to save your life.

Works Cited
Kane, Jason. “PSA Testing Controversy Reignites ‘Over-Screening’ Debate.” Pbs.org, 17
October 2011. Web. 12 September 2013.
Welch, H. Gilbert. “If You Feel O.K., Maybe You Are O.K.” The New York Times.
NYTimes.com, 12 February 2013. Web. 12 September 13.