Dr. Margaret McCartney, a Scottish family doctor and regular contributor to the BMJ, is the author of "The Patient Paradox" a book with a critical scientific view written in the office. I regularly follow Dr. McCartney’s contributions and two of her tweets have already been selected as tweet of the week in this blog. "Cancer: Are military metaphors appropriate?" and "If we don’t die of cancer, what do we die of?". On June 17 I had the opportunity to listen to her at the inaugural conference for the Catalan Society of Clinical Pharmacy seminar. The thesis of her speech: "Too much medicine for the well and not enough for the sick" seemed very much to the point, therefore I decided to read her book; and I must say that I liked it so much that if I was an editor, I would order a Spanish translation right now.
What is the paradox that Dr. McCartney refers to?
This paradox is no more or less than the thesis of her speech in Barcelona. If one is sick one must be persistent in order to receive the appropriate care (booking an appointment with the family doctor, limiting oneself to a little timeframe to explain what's wrong, putting up with long waiting lists to receive specialty care, etc). But if one is well, then the situation is reversed and the risk of overacting prevails, such as that in a screening or a health review, one is placed in the patient’s or in the pre-patient books thus occupying the position of a patient at risk and therefore, to receive preventative treatments for pathologies that may never occur or to be treated to combat a disease that one does not have.
