Tuesday 24 May 2016

Medicalization of Society: is everyone out there sick?

   Sometimes I wonder, is everybody out there sick?  Now, that may seem a strange question coming from someone who has made his living out of treating sick people and teaching others how to look after sick people.  However, I think I can count the number of times my siblings and I saw a doctor in our childhood and adolescence.  I don't believe it was because we were healthier than kids are today, I think it was because most parents could determine when their healthy kid with a cold was becoming a sick kid and needed something more than the home remedies that worked most of the time.  They recognized that a healthy kid with a stuffy nose or a mild sore throat was a healthy kid with a 'normal' affliction and they were usually right.  They were sufficiently confident in dealing with these minor disorders to recognize that their natural history was that they subsided within a few days.  Most of the time they did, but if they didn't then they wanted expert advice, then they called the doctor.  An old fashioned family doctor, which is what I was, knew most of his families and when a mother phoned up to see if she needed to bring the kid in, or if the doctor needed to make a home visit, the answer was usually apparent.  Often all that was needed was a word of advice, but sometimes the kid needed to be seen,  Those were the days when a patient could actually get to talk to the doc on the phone and when the patient needed to be seen the doc saw the patient, he or his staff didn't send the patient to the ER.  That was also in the days before the industrialization of medicine and before walk-in clinics and before it was considered quite normal to bring the child with 104 degrees temp to the emergency room, to crowd in with a couple of dozen patients all sneezing and coughing and dispersing their germs. Pretending that all the danger was neutralized by a little germicidal hand gel and occasionally a paper mask.  Unfortunately, along with the industrialization of medicine came the medicalization of society, that vital piece of social engineering that is necessary to make the industrialization work.  After all, if there are not enough labelled sick people around how are the Health Care Czars and their administridiots going to justify their outrageous salaries and bonuses.  New diagnoses, mental and physical have had to be generated to produce figures to make it look as though all of the population are in constant need of those services that so successfully win votes.  I am not proud of the role my own profession played in this.
   Turn on your television any mealtime and you will see that we are all ill.  Indigestion, stomach discomfort, constipation, diarrhea, low testosterone, lack of libido, incontinence (indeed, you are offered an amazing variety of catheters of all sizes, shapes and colours, more than on the urology wards!) and a myriad of other complaints that were once considered the minor disorders that normal healthy people deal with.  You are offered medications for your heart, lungs, joints, brain and any discomfort they can think of.   You are informed that no discomfort is acceptable and that there is a pill for everything.  You are told about their side effects by smiling actors walking through green meadows, including the occasional sudden death!   Once the entire popularization is diagnosed, labelled and on the appropriate medication, the government will decide what merits treatment and will be able to cherry-pick appropriate measurements  on  the basis of  cost and votes garnered.  Assisted suicide and legalized drugs will  be popular ways to keep some quiet or at least happy.  Most physicians  will be financially bullied into going along, and don't have what it takes to set medicine on the right course again, though I note that these days the women in medicine seem to have more balls.  Our pathetic professional organizations do little to  ameliorate the  situation.
    The decline continues. 

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