What do you think The Guardian’s recent op-ed by Aseem Malhotra, Why Modern Medicine is a Major Threat to Public Health?
Its premise can be summarized in the following quote: “…rather than address the root cause of these conditions through lifestyle changes, we prioritise drugs that give – at best – only a marginal chance of long-term benefit for individuals, most of whom will derive no health outcome improvement.” Or perhaps quote: “You can’t drug people into being healthier.”
Essentially, Malhotra believes that instead of prescribing medications (or in her view, over prescribing medication), we should be focusing on lifestyle changes that would achieve the same outcome with fewer side effects and associated costs.
I don’t think anyone would disagree that reversing hypertension or diabetes through diet and exercise is better than simply managing these diseases with medication.
But I also wonder how realistic it is to assume that everyone can make these lifestyle changes at the drop of a hat, or that a push to prescribe less medication would invariably result in a healthier baseline for the population.
For example, after gaining nearly 60 pounds on prednisone, I’ve been working on losing the weight. I only have about 20-25 more pounds to go. But losing weight is immensely difficult — and this is coming from someone whose weight gain wasn’t a result of her habits, who already generally ate healthily and liked to exercise.
Medications for chronic diseases certainly extend and save lives. But do they, like this article suggests, contribute to an over-reliance on medication without treating the root cause?
(Or are the root causes deeper than behaviors and lifestyles? Since research does support the idea that health and health behaviors are heavily influenced by your circumstances, not your willpower)
So — what do you think? Do you think modern medicine is killing public health? Or do you think this discussion (or my interpretation!) requires more nuance?