Medicalisation and Overdiagnosis: What Society Does to Medicine

Dijk, Wieteke van; Faber, Marjan J.; Tanke, Marit A.C.; Jeurissen, Patrick; Westert, Gert P.

doi:10.15171/ijhpm.2016.121

Cited by 59 publications

(51 citation statements)

References 30 publications

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“…Sociologists have been interested in the role medicine plays in society for some time and have shown that, over the years, a number of social phenomena have come to be seen as medical conditions and alternatively some have not. There are also contested illness, where sufferers claim they have symptoms yet there is disagreement as to the legitimacy of these claims from a medical perspective, examples of these include chronic fatigue syndrome and fibromyalgia (7). The interplay between medicine and society has and continues to be fluid and dynamic.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Should UK based Physiotherapists Choose Wisely?

Copnell

2018

Physiotherapy

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In 2012 the Choose Wisely campaign was launched in the United States in order to address concerns regarding medicalisation, over diagnosis and medical consumerism. The campaign has now spread internationally and includes a number of countries including Canada, Australia, New Zealand and Germany. The primary aim of the campaign is to facilitate healthcare professionals and patients to question the overall utility of medical interventions. Professionals through their professional organisations identify at least five commonly used interventions or tests, within their areas of speciality, which they feel provided no or little benefit to patients. This paper provides the background to the Choose Wisely campaign. The paper reviews the concepts of medicalisation, over diagnosis and medical consumerism, before considering the utility of the campaign in the UK alongside other forms of governance such as NICE. The paper goes on to consider distributive justice as the principal ethical issue related to the campaign. The paper concludes by asking if UK based Physiotherapists should Choose Wisely.

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Section: Accepted Manuscriptmentioning

confidence: 99%

Should UK based Physiotherapists Choose Wisely?

Copnell

2018

Physiotherapy

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“…A medicalização social é um processo pelo qual problemas antes não médicos são definidos ou tratados como problemas médicos, usualmente em termos de doenças (Conrad, 1992). Trata-se de um processo social e cultural amplo e complexo, do qual participam vários agentes (van Dijk et al, 2016), que permeia a formação das subjetividades no mundo moderno (Rose, 2007). A medicalização transformou-se e intensificou-se no século XXI, difundindo-se na vida social e institucional, com a progressiva importância e desenvolvimento das biotecnologias, da individualização e tecnificação da avaliação e controle de doenças e riscos (Clarke et al, 2010).…”

Section: Introductionunclassified

Cuidado Clínico E Sobremedicalização Na Atenção Primária À Saúde

Tesser

2019

Trab. educ. saúde

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Resumo Este ensaio analisa a sobremedicalização (medicalização desnecessária e indesejável) gerada no cuidado médico aos adoecidos na atenção primária à saúde, discute como ocorre e como evitá-la. Articula na análise três grupos de concepções/saberes: concepções de doença (dinâmicas/ontológicas); concepções de causação (ascendente/multidirecional); eixos conceituais estruturantes do saber médico (anatomopatológico, fisiopatológico, semiológico, epidemiológico). A sobremedicalização deriva dos movimentos cognitivos dos profissionais na elaboração diagnóstica e terapêutica. Ela nasce da associação da concepção ontológica de doença com causação ascendente (fluxo causal que vai dos elementos materiais mais simples a dimensões e níveis mais complexos), em articulação com sobrevalorização do eixo anatomopatológico, geradora de excessivas intervenções diagnósticas e farmacoterapêuticas. Para evitar a sobremedicalização, propomos a associação virtuosa da concepção dinâmica de doença, com causação multidirecional e uso equilibrado dos eixos conceituais das doenças. Isso facilita: escuta qualificada; contextualização dos casos; mais criterioso uso de exames complementares; reconhecimento dos limites diagnósticos biomédicos; superação da razão metonímica (que despreza tudo o que não é saber cientificamente consagrado); amplificação da interpretação para além das 'doenças' e dos tratamentos para além dos fármacos/cirurgias, explorando os saberes dos usuários e profissionais, práticas complementares e a devolução de problemas para o manejo autônomo apoiado. Palavras-chave medicalização; prevenção quaternária; atenção primária à saúde.Abstract This essay analyzes the overmedicalization (unnecessary and unwanted medicalization) generated in the medical care to the ill in primary health care, and discusses how it happens and how to avoid it. The analysis combines three sets of conceptions/knowledge: conceptions of illness (dynamic/ ontological); conceptions of causation (ascending/ multidirectional); key conceptual and structuring ideas about medical knowledge (anatomopathological, physiopatological, semiological, epidemiological). Overmedicalization is due to the cognitive movements of the professionals in the development of diagnoses and therapies. It originates from the ontological conception of illness with ascending causation (causal flow that goes from the simplest material elements to more complex levels and dimensions), in combination with the overestimation of the anatomopathological key idea, which generates excessive diagnostic and pharmacotherapeutic interventions. In order to avoid overmedicalization, we propose the virtuous association of the dynamic conception of illness, with multidirectional causation and balanced used of the key conceptual ideas of the illnesses. This facilitates: a qualified listening; the contextualization of the cases; a more rigorous use of complementary exams; the recognition of the limits of the biomedical diagnoses; the overcoming of the metonymical reasoning (which disregards anything t...

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“…Furthermore, technological medical advancements and physicians’ cure-oriented training have blurred the boundaries of medicine. Consequently, aging and dying have recently become medicalized, which can lead to more harm than benefit for the older population (O’Mahony, 2016; van Dijk, Faber, Tanke, Jeurissen, & Westert, 2016). Thus, the conventional “cure-seeking” model of medical care and the current trend towards medicalization are not suitable for the very elderly, meaning a paradigm shift is urgently required in rapidly aging countries (Arai et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Preparing for a paradigm shift in aging populations: listen to the oldest old

Komatsu

Yagasaki

Kida

et al. 2018

International Journal of Qualitative Studies on Health and Well

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Purpose: Current healthcare systems are not suitable for serving future societies in which the oldest old are commonplace. The objective of this study was to understand what the oldest old care most about in their daily lives. Methods: Semi-structured in-depth interviews and thematic analysis were used. Face-to-face interviews were conducted in 17 elderly residents (≥ 95 years) of Arakawa-ku, Tokyo, Japan from July to November 2017. Results: Three themes emerged from the interview responses: “unshakable beliefs and social ties,” “natural acceptance,” and “my day-to-day life with precious moments.” The oldest old strongly believe in diligence and compassion and maintain strong relationships with people around them. Despite their small social networks, they are concerned about future society. They accept their selves and their lives, including their impending deaths. Despite their functional decline, they control their lives by making very small decisions. They live on a moment-to-moment basis, cherishing simple events. Conclusion: Maintaining autonomy through making small decisions and enjoying small pleasures are important to the oldest old. Understanding the needs of the oldest old is the first step towards developing optimal geriatric care for an aging population.

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Medicalisation and Overdiagnosis: What Society Does to Medicine

Cited by 59 publications

References 30 publications

Should UK based Physiotherapists Choose Wisely?

Should UK based Physiotherapists Choose Wisely?

Cuidado Clínico E Sobremedicalização Na Atenção Primária À Saúde

Preparing for a paradigm shift in aging populations: listen to the oldest old

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