Overdiagnosis in Medicine: Dr Justin Coleman
Today’s podcast features Australian GP, writer and thinker Dr Justin Coleman.
Justin is a GP currently working in Brisbane in Aboriginal Health at Inala Indigenous Health Service.
Justin is also a prolific writer – he has been producing great medical writing for about 20 years. He is the president of the Australian Medical Writer’s Association, a regular columnist at the Medical Observer and a blogger at drjustincoleman.
In the past he has been responsible for the GP Tips series which has run since 1998 and includes more than 650 ‘handy hints’ that you might find useful in your office practice – a truly wonderful resource.
Justin has more recently been writing a column at the Croakey blog entitled “The Naked Doctor” which looks at the modern medical phenomenon of overdiagnosis, over-treatment and unnecessary interventions. When I read his recent article on the “pitfalls of cutting edge medicine” it really struck a cord with me. So ever since then I have been wanting to have Justin on the podcast to share his insights.
I think we just really started to scratch the surface of this fascinating topic. I do hope he will come back soon and tell us more about some of the specific areas that we as doctors need to be better gatekeepers in the world of medical misadventure.
There are a few articles and papers discussed which are referenced below:
The BMJ series is called Too Much Medicine
The other big series of articles is called ‘Less is More’ at JAMA’s Archives of Internal Medicine
The BEACH data I mentioned is at: Bayram C, Britt H, Miller G, Valenti L 2009. Evidence-practice gap in GP pathology test ordering: a comparison of BEACH pathology data and recommended testing.
The testosterone article is from MJA 2012 “Testosterone Marketing Disease Mongering”
And one quick correction – Justin mentions the outgoing administrator of the USA Medicare boss’s comments on the huge waste in the American Health system. The chaps name is Dr Donald Berwick, and the article that Justin mentions is here in the New York Times.
Onto the Podcast DIRECT DOWNLOAD HERE Enjoy, Casey
Brilliant podcast, thanks!
As a medical educator, I spend a lot of time trying to convince just-out-hospital GP registrars that diagnostic uncertainty in general practice is not best handled by a rapid-fire machine-gun assault of indiscriminate tests. I explain that (with some notable exceptions), the best diagnostic tool we have is often follow up over time.
I’m interested to hear how other educators and supervisors help their learners become more comfortable in recognising when less is more.
Would love to hear more from Justin about widespread Vit D and testosterone testing and treatment – two of my personal bug bears.
Excellent show! It’s really interesting to hear overdiagnosis from an expert’s perspective since it’s becoming more common nowadays for doctors to diagnose excessively just to squeeze more money from their patients. Gonna share this with my doctor and see what he thinks. 🙂