Going to the doctor: Not fun, but necessary
Dr. Steven Markowitz, MD, DrPH — Thu, Dec 30, 2021 @ 13:12 PM
Going to the doctor is no one’s idea of fun, especially these days.
People on the young side feel like they do not need to see the doctor, while older people feel like they do nothing but see the doctor.
Furthermore, people on all sides are on edge because the pandemic surges and recedes over and over again, but never seems to disappear. It will though.
You would hardly know that we are in the golden days of medicine. Consider these facts:
Heart disease deaths have dropped 60 percent over the past four decades, despite the fact that it is still the leading cause of death in the U.S. In 1980, when your parents or grandparents were your age, the annual heart disease death rate in the U.S. was 410 per 100,000 people per year, or one of every 250 people per year.
Now, the heart disease death rate is 162 per 100,000 in the U.S., or one of every 615 people per year. This is a 60 percent decrease in the heart disease death rate.
How about stroke? Back in 1980, strokes killed 92 people per 100,000 every year in the U.S. Now, it causes 36 deaths per 100,000 people each year. This is also a 60 percent drop in deaths from strokes, over the past four decades.
Cancer has declined over the past four decades by about 25 percent. Cancer caused 167 deaths per 100,000 people in the U.S. in 1980, and caused 129 deaths per 100,000 people in 2019.
The fact is, the pandemic has blinded us to the good news about our health.
Why has our health improved so much?
Medical care has greatly improved
Heart doctors are aggressively using many new medications to treat elevated blood pressure and blood lipid levels, preventing heart attacks and heart failure.
They have new medications and stents to intervene when heart attacks and strokes occur, and thereby limiting tissue damage. They have brilliant new imaging (x-ray) techniques – sophisticated stress tests and others – to identify heart disease early when it can be treated.
Surgeons have pursued minimally invasive surgery, meaning they can perform complicated surgery such as removing cancers and taming blood clots through small scopes inserted through small incisions in the skin.
Recovery time has greatly lessened, so people can go home the same day or after short hospital stays, limiting time away from home and quickening recovery.
New medicines for cancer are improving survival for certain cancers, especially melanoma, blood cancers, lymphomas and lung cancer. Immunotherapy, in which drugs work with the body’s immune system to kill cancer cells, has been effective on some cancers and promises to help with more types of cancer.
Understanding the genetic makeup of cancers has improved greatly and allowed more treatments that are better tailored to individuals with cancer.
Prevention is key
We now have very effective methods to screen and detect early stages of the top three cancers in the U.S.: lung, breast and colon cancer. Together, they account for four out of every 10 cancer deaths.
A simple 30-second CT scan of the chest (“low dose chest CT scan”) once per year can allow doctors to find and remove small lung cancers and greatly reduce chances of death from lung cancer. Mammography and colonoscopy do the same for female breast cancer and colon cancer.
They work as deaths from these top three cancers have declined 25 to 40 percent over the past 30 years.
Immunizations have also improved. Young people can get the HPV (human papilloma virus) vaccine and reduce the chances of young women developing cervical cancer by over 90 percent. Shingles in older people can not only be bothersome, but also lead to chronic pain. This can be avoided by getting the widely available shingles vaccine.
Health care providers are changing
You may have noticed that you may see a nurse practitioner or physician’s assistant instead of a doctor, or before you see the doctor at a medical visit. This is a healthy development.
Nurse practitioners and physician’s assistants are frequently trained in talking to and educating patients, and often have more time than doctors to discuss your health problems and answer your questions.
They may be less rushed and can enable a more relaxed visit where you remember to ask all your questions. It is also possible they make healthcare more accessible and/or affordable, but that remains to be seen.
Our medical system did not predict the COVID-19 pandemic, or prevent so many people from falling ill and dying. However, treatment of COVID-19 has significantly improved, and the vaccines have saved millions of lives worldwide.
Setting COVID-19 aside, we are living in a golden age of medical care, especially compared to previous generations who lived just a few decades ago. This is good news and something to think about during this season of gratitude.