^îortlanh (Obstruer
N o vem b er 24, 2010
Page 5
More Medical Care isn't Always Better
Key is trying to
strike a balance
(AP) — More medical care won't
necessarily make you healthier— it
may make you sicker. It's an idea
that technology-loving Americans
find hard to believe.
Anyw here from one-fifth to
nearly one-third of the tests and
treatments we get are estimated to
be unnecessary, and avoidable care
is costly in more ways than the bill:
It may lead to dangerous side ef­
fects.
It can start during birth, as some
of the nation's increasing C-sec-
tions are triggered by controversial
fetal monitors that signal a baby is
in trouble when really everything's
fine.
It extends to often futile inten­
sive care at the end of the life.
In between:
Americans get the most medical
radiation in the world, much of it
from repeated CT scans. Too many
scans increase the risk of cancer.
Thousands who get stents for
blocked heart arteries should have
tried medication first.
Doctors prescribe antibiotics
tens of millions of times for viruses
such as colds that the drugs can't
help.
As major health groups warn of
the limitations of prostate cancer
screening, even in middle age, one-
third of men over 75 get routine PSA
tests despite guidelines that say
most are too old to benefit. Millions
of women at low risk of cervical
cancer get more frequent Pap smears
than recommended; millions more
have been screened even after los­
ing the cervix to a hysterectomy.
Back pain stands out as the No.
1 overtreated condition, from re­
peated MRI scans that can't pin­
point the trouble to spine surgery
on people who could have gotten
better without it. About one in five
who gets that first back operation
will wind up having another in the
next decade.
Overtreatment means someone
could have fared as well or better
with a lesser test or therapy, or maybe
even none at all. Avoiding it is less
about knowing when to say no,
than knowing when to say, "Wait,
doc, I need more information!"
The Associated Press combed
hundreds of pages of studies and
quizzed dozens of specialists to ex-
A CT is performed on a patient in a hospital. The U.S. accounts for half of the most advanced
procedures that use radiation, and the average American's dose has grown sixfold over the last
couple of decades. (AP Photo)
amine the nation's most overused pros and cons of different options ing recommendations on overused
practices. Medical groups are start­ before choosing one.
tests, starting with low back pain.
ing to get the message. Efforts are
"This is not, I repeat not, ration­
It's trying to strike a balance, to
under way to help doctors ratchet ing," said Dr. Steven Weinberger of provide appropriate care rather than
back avoidable care and help pa­ the American College of Physicians, the most care. Rare are patients who
tients take an unbiased look at the which this summer begins publish­ recognize they've crossed that line.
Making the Switch to an Ob-Gyn
For Your Health
by
D r . R ichard N. W aldman
A dolescence— the period be­
tween puberty and adulthood— is a
challenging and sometimes confus­
ing stage of life. Many teens— and
parents— find discussions about
their changing bodies to be so em ­
barrassing or awkward that they
skip having them altogether. In­
stead, teens often look for answers
from friends or classmates who are
equally as uninformed.
Providing accurate information
and teaching young women how to
protect their reproductive health is
extrem ely im portant, especially
given the high rate of sexually trans­
mitted diseases (STDs) and preg­
nancy among teens. An ob-gyn can
be an excellent resource and a teen ’ s
partner in health.
The American College of Obste­
tricians and Gynecologists recom­
mends that an adolescent girl’s first
well-child visit to the ob-gyn occur
between the ages of 13 and 15. In
addition to addressing basic ques­
tions, concerns, and myths, this visit
is a prime opportunity to begin build­
ing a trusting doctor-patient rela­
tionship that may continue for years.
The first well-child visit focuses
on reproductive preventive care.
Ob-gyns can assess conditions that
may cause long-term complications
such as absent menstrual periods.
They can counsel teens about nor­
mal development, menstruation, and
sexuality.
Problems that may require early
intervention such as eating disor­
ders and w eight issues, blood
pressure problem s, and m ental
health issues, such as anxiety,
depression, and abuse, can also
be addressed.
Teens can learn about and be
scheduled for vaccinations includ­
ing HPV, influenza, tetanus-diph­
theria-pertussis, hepatitis B, menin­
gitis, and pneumonia.. Ob-gyns can
also advise teens about the correct
use of condoms and available birth
control options so they are well-
informed and prepared before the
onset of sex.
At the appointment, parent and
teen can be greeted together. They
will receive a thorough explanation
of the visit, and discuss issues re­
lated to doctor-patient confidenti­
ality. The rest of the visit will con­
tinue with the teen and her ob-gyn
alone to ensure privacy, but- if the
teen requests, her parent can re­
main.
The ob-gyn will perform a gen­
eral physical exam , consisting of a
visual breast exam and an external
genital exam. A pelvic exam is not
necessary unless a teen has a
m edical history of abnorm al pu­
berty, abnorm al bleeding or d is­
charge, or abdom inal or pelvic
pain. M ost sexually active teens
can be screened for STDs, such as
chlam ydia and gonorrhea, using a
urine test and most young women
do not need to have a Pap test
until age 21.
Teens may also need to visit their
pediatrician, family medicine spe­
cialist, or adolescent health special­
ist for a second well-child visit for
general preventive care.
Dr. Richard N. Waldman is presi­
dent o f the American Congress o f
Obstetricians and Gynecologists.
- DEPRESSION -
THEINVISABLE TOXIC CONTAMINANT
December 12th —from 9:00 AM to 10:30 AM at Emmanuel
Church Community Center - Pastor Franklin A. Alvey, Ph D.,
Th.D., a 30 plus year member and senior counselor of Emmanuel
Church, with a history of 51 years in marriage, will present a
forum on the subject o f Depression and its effects on the
individual and family. This will include the whys of feeling
depressed, hopeless and helpless. He will also provide some
prescriptions for ridding people of this soul destroyer. This no
charge forum will be held in Emmanuel’s Community Center at
1033 North Sumner Street. Seating is limited due to outside
media coverage.
Some subjects to be discussed will be the whys of:
•
•
•
•
•
•
•
•
•
•
Persisting sadness, anxiousness or moods o f emptiness.
Feelings of depression due to overwhelming financial strain.
Feelings o f guilt or worthlessness.
Trouble sleeping; difficulty in rising or subject to over sleeping.
Tendencies to rely heavily on sleeping medications.
Thoughts of suicide or "they ’d be better off without me."
If God really loves me why doesn’t he heal me of this problem ?
Depression brought on by abuse or rejection.
Being mentally held captive due to another s mind control.
Some proscriptions for overcoming depression.
For more information call 503.287.2223 from 9 AM through 4:30
PM Tuesday through Friday or online at www.emmanuelpdx.com