Dr James Gill, a GP and teaching fellow at Warwick Medical School, at the University of Warwick, comments on the list of 40 treatments that bring little or no benefit to patients, published today by the Academy of Medical Royal Colleges.
“We live in a ‘now' world. Everything is instant, from phones, to internet shopping deliveries. With this there is the belief in ‘action’, and it must be done swiftly in health care.
“That is often 100% correct. But there is a range of health issues which will either get better on their own, don't respond to treatment, or – more frighteningly – have treatments or investigations that are actually worse than the problem.
“Today's publication from the Academy of Medical Royal Colleges highlights this fact and publishes a list of treatments which, to put it simply, don't do much – if anything – and in rare cases can be causing harm.
“Advising that you don't need to use saline (salt water) to clean cuts and scrapes and that water will do the job is a perfect example.
“Anyone who has been in the sea with a cut knows it stings like nothing else. Using saline on cuts and scrapes is no different. But the action has been done – almost because we can, and because people want to show they are helping.
“Another great, but cautious, example is prostate cancer testing. For certain people, who have certain symptoms, we need to do blood tests to look for aggressive prostate cancer. But some prostate cancer is almost the medical equivalent of grey hair. It's a slow change, as part of ageing and doesn't really trouble anyone – but – we can detect it if we go looking for it. This raises an issue though, because we can't tell the difference at that stage between aggressive and mild prostate cancer, so more tests are needed.
“Further prostate cancer tests are not pleasant, and in their own right carry risk. So we could potentially be doing risky tests on people that we don't need to be tested. Hence a doubling down of the advice for prostate cancer blood tests - only testing those with worrying symptoms, not merely those who are worried and want a check-up. With those who are really worried, but again no symptoms, simple ‘watch and wait’ advice is going to help them much more than taking blood and potentially unnecessarily chopping out bits from a very sensitive area of the body.
“This is a great bit of work from the Royal Colleges. It's sensible, might save some money, but more importantly is going to help many patients, and potentially help prevent harm to others.”