Should I Get Further Testing For This, Doc?: A Question That Citizens of Third World Countries Do Not Have the Luxury to Ask

Earlier this month, I had World News with Diane Sawyer in the background as I was cleaning my apartment when a particular news report captured my attention. According to the report, Americans here in the United States are being screened too often for medical tests that they really do not need. In fact, a number of those additional medical tests are doing more harm than good. How so? Because there are a number of health risks that patients are being exposed to when these medical tests are being conducted, according to Dr. Christine Cassel, the president and chief executive officer of the American Board of Internal Medicine Foundation. Therefore, in an effort to reduce this less than beneficial trend that appears to be transpiring in the healthcare world, the ABIM Foundation and Consumer Reports have teamed up to develop the “Choosing Wisely” project. In this project, nine physician groups have compiled a list of five medical tests–in a variety of fields–that are performed on patients more often than necessary. Those five tests are as follows: the cardiac stress test, chest x-rays, imaging tests that include MRIs and CT scans, colonoscopies, bone density scans, and bone mineral density tests, which are commonly known as dual-energy x-ray absorptiometry, or a DEXA scan.

This news report honestly left me not only speechless, but a little outraged. As I speak, there is an elderly woman in a remote village in Africa whose osteoporosis has left her within the confinements of her home. She has neither the strength nor the money to afford the appropriate testing and treatment for her painful bone condition. Or, there is a gentleman in his early 60’s in southeast Asia suffering from symptoms that are evocative of colon cancer. However, he has never been properly diagnosed. He is reaching the end of his fight, for the cancer has spread. But if he had had access to a colonoscopy in his early 50’s, doctors could have not only detected his precancerous growths, but removed them as well. As a result, his death rate would have been reduced by 53%. I understand that there are a number of factors (lack of infrastructure, government funds, etc.) that influence whether or not citizens of third world countries can have access to the very same tests that Americans are being inundated with here in the U.S. But like we discussed in class a few weeks back, NGOs most not limit their focus to only  life-threatening illnesses; they must also promote the idea of “quality of life” by addressing non-communicable diseases (or NCDs) as well. To the surprise of many, there has been a shift of NCDs to developing countries, where 63% of deaths in third world countries are non-communicable in nature, and 1/3 of those deaths occur before the age of 60. If NGOs do not take the time to address and treat the occurrences of NCDs, they are in violation of the human right to a healthy life.


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