Many people are decrying the advancement of Donald Trump to front-runner for US President. Some observers claim to be shocked by the number of voters who respond to his simple, hard-line solutions. Some claim he’s just acting, but
there’s a reason he’s chosen to play thi s role. It works.
If we wonder why we got Donald Trump, we can look to the way people accept modern medicine. The Amazon summary of a new book, Snowball in a Blizzard by Steven Hatch, says
“The key to good health might lie in the ability to recognize the hype created by so many medical reports, sense when to push a physician for more testing, or resist a physician’s enthusiasm when unnecessary tests or treatments are being offered.” In his book Overdiagnosed, Gilbert Welch questions the usefulness of diagnostic tests. Study after study shows that annual medical exams don’t affect mortality rates.
The truth is, “preventive medicine” (sometimes written as “preventative medicine,” as if the extra syllable lends authority to a nebulous concept) doesn’t exist. Scans, screening and exams rarely prevent anything. They sometimes reduce risk and allow early detection. Sometimes the risk reduction is on the order of 3% or less, which most scientists would agree isn’t clinically significant. Often early detection doesn’t affect outcomes. In his book Less Medicine, More Health, Gilbert Welch explains that cancer comes in at least three varieties: the “birds,” which grow so fast you’re doomed by the time you’re diagnosed; the “turtles,” which grow so slowly you might be dead before you can do anything; and the “rabbits,” which have an impact when caught and treated in the early stages. That’s why so many women get cancer despite annual mammograms. (more…)
This article from PBS News says it all: age discrimination starts as early as 35. Researchers sent around resumes, changing only the birth date of the applicant. Older applicants got fewer invitations.
When companies were asked why this was happening, the a”reasons given include worries that they’re not good at technology, that they don’t have computer skills. There’s worries that they’re not active, that they’re slow, that they’re not willing to embrace change. There’s worries that they’re just going to leave…” And these reasons just aren’t true.
And AARP’s recommendations, it turns out, aren’t helpful. Why are we not surprised?
According to this article, AARP told people to write, “I’m willing to embrace change.” People who followed this advice got fewer callbacks.
I’m not surprised. I once told a client to remove the phrase, “Maintain an active lifestyle” from his resume. You’re calling attention to age – and emphasizing that you define yourself by age.
So what can you do?
They suggest, “Volunteer and take classes.”
I’d beg to differ.
I’d say to position yourself away from entry level jobs; you’ll still get discrimination but not as much.
And go back to school to study entrepreneurship. Get the entrepreneurial mindset going earlier rather than later.
Responding to Abigail Zuger’s column in the New York Times. Zuger notes that today doctors spend most time prescribing for pre-illness, which means they try to predict the future.
I am amused by, “For people who feel fine… It is the patient … firmly planted in the here and now, while medical personnel spin wild tales of coming catastrophe…”
and
“In fact, our future of treating pre-illness will simply catapult us right back to a priestly past, as we offer up misty visions of the future and encourage the masses to see with us and act accordingly.”
Zuger’s image – emotional doctors versus patients demanding evidence – captures my experience perfectly. When I declined a mammogram, citing research in top journals, the doctor responded emotionally, literally throwing up her hands: “It must be better than nothing.”
Urging a bone density scan, she cited relative risk (50%) rather than absolute risk (3%). Outpatient surgical clinics require pre-op tests for despite published research consistently showing no difference in outcomes. Most doctors don’t know the Society for General Internal Medicine’s guidelines limit testing for asymptomatic adults.
Doctors eagerly embrace studies questioning the value of herbal or alternative options, but shrug off equally credible reports showing the low value of mainstream “preventive” medicine. In fact “preventive” really means “risk reduction” and often the reduction is so low as to be meaningless. Thus the line between science and magic become blurred, educated skeptics resist medical advice, and most doctors hate patients who know how to read statistics in the medical journals.
