Unnecessary treatment

First some media coverage. Darian appeared on Radio 4's Start The Week. If you just want to hear about our book, it is discussed towards the end of the programme.

Darian is also mentioned in passing in Rowan Pelling's article in The Independent, My part in the NHS funding crisis. This article was written in response to a television programme, Hypochondriacs: I Told You I Was Ill Last Monday.

While the Channel 4 programme estimated that one in four of GPs' patients may be hypochondriacs, other research suggests the proportion could be as high as 50 per cent. Clearly, modern medicine can't cope with an epidemic of this scale.

I have similar worries about the use of the word 'hypochondriac' here as I do about the use of the word psychosomatic. We should resist the idea that there's a sharp distinction between the true organic illness and the false all-in-the-mind one.

But, that understood, the article raises the important question of how much of the treatment provided by the health service is unnecessary. Now, of course, 'unnecessary treatment' doesn't include every test which proves negative. It's clearly important to rule out possible conditions.

In our book we mention government research in the US, which reckons that over 7 million surgeries a year are unnecessary. It would be interesting to carry out a survey of health professionals to assess how much medication and how many medical tests they rate as unnecessary, and the reasons why they still persist with these treatments.

A book co-authored by Michael Balint in 1970, Treatment or diagnosis: a study of repeat prescriptions in general practice. London. Tavistock publications, gives useful insight into arrangements doctors and patients can enter into, without the doctor necessarily believing a medication to be medically efficacious.