The New Healthcare Paradigm - “Less Is More”

Health news recently has been awash in reassuring, “don’t worry” stories. Here are a few of them.  We could probably find several more. 

• ·       If you have atrial fibrillation, there’s no need for ultra-strict control of heart rate to below 80 beats a minute at rest – a more lenient 110 beats a minute will do just as well, according to an article in the New England Journal of Medicine. 
• ·       Colonoscopies aren’t as effective (or at least, as cost-effective) as fecal occult blood tests in screening for colon cancer – according to several experts – and are much more unpleasant. See also this report.  (Don’t be misled by the fact that our President had a “virtual colonoscopy” instead of either of these.)
• ·       You don’t have to push the antihypertensive regime in diabetics.  Lowering systolic blood pressure levels below 140 mm Hg does not prevent adverse cardiovascular events, according to a study in the New England Journal of Medicine.
• ·       Diabetics don't have to be too strict about their blood sugar control - it can backfire.      
•         Don’t worry about having a PSA blood test for prostate cancer every year – discuss with your doctor whether it’s necessary. If you need help, see this article in the Archives of Internal Medicine.
• ·       It’s not so bad to be a little overweight – in fact, it may be more healthy for older people.  See my “Moving the Goalposts” item from some weeks ago.

These trends could have two good results.  They might cause people to worry less, and they might reduce health costs by a measurable amount, which is pretty important, right now.