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Kurt Arner's avatar

Your article hit home (I had a specific experience in exactly this area some three and a half years ago, precipitated by a hard fall on my tailbone on an icy cross-country skiing track {19 March 2020}, 1st Corona lockdown by the way), which resulted in considerable pain in my mid-spine which did not dissipate 6-8 weeks later {even after the primary tailbone pain went away}.

At the time I was 60, slightly overweight: BMI 28, physically active (skiing, cycling, mountaineering) and in otherwise robust health.

My doctor diagnosed a hairline crack on the vertebra in question; whereupon he recommended that I visit his colleague, a rheumatologist / bone density specialist, while highlighting that the entire procedure would be covered by my health insurance (nota bene not accident insurance), thus there would be zero financial risks for me. (This struck me as odd, since the clear cause of the pain was a brutally hard, high-speed fall right on my tailbone. But he was the doctor, after all, so I deferred to his recommendation and agreed to the appointment with the specialist).

My visit to the specialist’s office was marked by some very tendentious questions and a bizarre back and forth with the specialist’s assistant on signing a liability release form, should for whatever reason the diagnostic procedure not be covered by my health insurance. I never actually met the rheumatologist himself (only his assistant).

Ultimately, the specialist determined from the bone scan results, the questionnaire which I had completed and his assistant’s notes that I suffered a considerably enhanced risk of future bone fracture, so he strongly recommended that I be put on drug therapy for 3-5 years to increase my bone density. My doctor agreed. I had some questions on the interpretation of the bone density scan results and how these translated into their recommended therapy, so I set up an appointment with my doctor to discuss.

Fortunately, I asked my personal doctor some pertinent questions (e.g., the designation of the drug he and the specialist were prescribing, its mechanism for combatting my purportedly low bone density as well as any known side effects); upon which he expressed frustration with my curiosity. He said he didn’t know answers to any of these questions, so he’d have to get back to me later (but it wouldn’t be the following week). I responded that it would be fine to wait longer; after all, it was my body which would be subjected to a 3-5 year drug treatment, so I preferred to inform myself accordingly, even if that meant a delay of several weeks.

To make a long story short, I never heard back from my doctor. I changed doctors thereafter. Needless to say, I did not undergo any drug therapy.

The entire experience left me wondering who was at the center of our healthcare system: was it the patient, or was it the pharmaceutical manufacturers? Were the medical professionals benefitting financially from their recommended therapy? If so, wouldn’t this constitute a conflict of interest?

I wonder how many other individuals have been subjected to similar pressure tactics... dare I say gaslighting?

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Informed Chronicles's avatar

Thank you for this! My favorite quote came at the end, "Today, being at higher risk of developing a disease has become a disease in and of itself. An otherwise healthy person’s high blood pressure, elevated serum lipids, or low bone density become chronic conditions." This sums up our current situation in health care, and carries the potential to spark a rich conversation full of interesting perspectives.

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