don's report archive

by Donald B. Ardell, Ph. D.

Wellness in the Headlines
(Don's Report to the World)

In the world of wellness, anything associated with medical self-care (MSC) enjoys a standing equal to that of freedom, justice, equality, love, sharing and whole-wheat bread. But despite what Mae West might have said to the contrary, can there be too much of a good thing? Can MSC be overdone? Can it become a health hazard that jeopardizes a wellness lifestyle and maybe the public weal along with it? In short, is there a dark side to MSC?

You bet, and it is my duty to tell you about it!

What brings this to mind is the attention given in recent days to the proliferation of home lab tests and business ventures to sell even more stuff for adult "pretend-doctors." There are now tests on the market for home use in diagnosing such maladies as strep infection, gonorrhea, chlamydia, cervical cancer, thyroid problems, breast cancer, osteoporosis, ulcers, leukemia, diabetes, pregnancy, ovulation -- enough, already! Why would anyone want to go ballistic on testing, in the home and elsewhere? Are we becoming a nation of hypochondriacs or what?

On the other hand, maybe we need more tests, but of a different orientation. Maybe we need a few wellness self-care (WSC) lab and other tests? How about a test to determine if you are over tested? Or tests to assess body composition, exercise adequacy, fluffy floater versus slinky sinker balance, emotional IQ, stress resistance, critical thinking capacity and most vital of all, humor index?

Some of the medical test mania has been challenged in varied jurisdictions. Concerns about the home AIDS tests, for instance, are associated with the hazards of needles and the added risks when non-professionals package and send contaminated or otherwise toxic blood in the mail. However, the biggest cause for pause might be the potential emotional problems when a home user concludes (correctly or otherwise) that someone has a positive result! Holy freakout!

Other problems are associated with the accuracy of some test kits, particularly when administered by folks who are not exactly handy with tools. What impact will test mania have on medical costs? Will they lower costs? No way. Let a home tester discover a positive result from an occult blood test (blood in the stool) and what will happen next? Right -- a whole series of "professional" (expensive) workups would follow, such as an upper GI, lower GI, southwest GI, upper (probably lower, too) endoscopy, colonoscopy -- it won't be long before you have no money left for more home test kits! Also, please remember that all this serious testing could be set off, in some cases, by a false positive reading!

Let's put things in perspective here. Basically, the inherent hazard of MSC is an excessive focus on one's medical navel -- and the attendant abuses that this narcissism gone amuck invites. The hazards most likely outweigh the gains, in my view. I read a related story the other day by columnist Norma Watkins, who described how a relative would leave a medical dictionary on the bedside table for guests. By the third day, visitors felt the first symptoms of so many alarming ailments that they packed their bags and left.

If a cheap at-home test is available, does that mean you should buy it and use it? What if there are inexpensive home tests for blood pressure, cholesterol, and signs of every disease and disability known to or suspected by modern or ancient man? Contrary to the assumptions of the MSC salespersons, this should not be accepted as prima facie evidence that we should take or administer them.

As with just about anything else, the basis for the business of medical self-care is business. Promoting MSC can be highly profitable for the promoters of this do-it-yourself mini-movement. It does not make sense to fault them for trying to sell their wares. However, consumers always do well to remember that their interests and that of the vendors are not always complementary.

A few years ago we read of a $1 billion medical insurance scam in California attributed to basic insecurity on the part of the masses about their health status. The con artists "were appealing to the public's desire to know how well they are," said one Blue Cross official in explaining the ruse (USA Today, 7/10/91, p.3A).

Other factors militate against wholesale adoption of MSC at-home testing besides costs. A major concern should be the effect of medical care and screening opportunities on the very large number of people who are borderline hypochondriacs, obsessed with the lurking presence of medical disorders. Curiously, these folks would rather check than better themselves, preferring tests for illness to exercises for health.

The major problem with an orientation to a home testing obsession (or professional care orientation for that matter) is that you can and probably will get sick if you spend a lot of your time wondering, worrying and scrutinizing yourself for sickness. Hey, get a healthy life! Put your energy into getting weller and you won't want to think very much about measuring or testing for becoming worser!

In summary, too much testing at home or anywhere else could make you sick!

Maybe a few medical tests for some people on occasions are not such a bad thing. Maybe, but I think we should balance the medical stuff, if one is going to use MSC testing at all, with tests for WSC (wellness self-care).

Be well, enjoy and look on the bright side of life.

(Note: This essay will be filed in the archives in the PHYSICAL DOMAIN under the skill area of adaptations and challenges. Additional articles related to this theme may be found there.)

(Ed. Note: Views expressed in this and other columns are those of the author and not necessarily those of the SeekWellness Editorial Board.)

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