What is medicalisation?
BMA council member speaks out about unnecessary medical interventions
Deputy chair of the BMA council Dr Kailash Chand has identified a recent trend within healthcare for medicalisation, which he identifies as patients seeking medical treatment for lifestyle problems.
Key signs of medicalisation include the increasing use of medicines and hospital tests, rising hospitalisation rates, more visits to both GP surgeries and A&E departments as well as unnecessary interventions, for example risky surgical procedures that could be life threatening. Speaking to the HSJ, Dr Chand explains “Medicalisation is now one of the greatest threats to the universal healthcare model’s sustainability.”
Too much medicine?
There are many factors that are driving the popularity for medicalisation or overmedicalisation forward, including a patient culture that more intervention is better, reflected in doctors who ‘play it safe’ by prescribing additional tests or treatments to meet patient demands. Dr Chand also notes that he feels patients are not adequately spoken to about the possible risks and benefits of various treatments, and that all options are not always laid out clearly. He comments that aggressive marketing from pharmaceutical companies can also take the blame for this new trend. Even recent antibiotic resistance discussions can be pinned to medicalisation.
Dr Chand explains that medicalisation has touched many areas of medicine to impact on patients. For example, the unwanted intensive care for dying patients who would prefer to pass away at home or in a hospice. He reports that 40% of older patients take unnecessary medication. 20% of hospital beds are used for end of life care, which currently costs the NHS around £20 billion. Dr Chand also deplores the use of statins in treating cardiovascular disease, saying “This is bad medicine. Statins give the illusion of protection to many people who would be better served by doing more exercise, not smoking, reducing alcohol intake and eating a Mediterranean diet.”
Although doctors may contribute to medicalisation, Dr Chand also points the finger at the public, media, politicians and patients for all playing a part. “At best patients may engage with their treatment but, for the most part, it stops them making long term lifestyle changes. The doctor’s role is crucial in educating patients, treating by clinical need and not giving in to inducements or pharmaceutical, medical or financial targets. Our goal must be to do much for patients and as little as possible to patients,” Dr Chand concludes.