Are We Getting Too Much Health Care? - The New York Times

To the Editor:

Re “The Best Care May Be No Care,” by Sandeep Jauhar (Op-Ed, June 23):

As a physician, I read this Op-Ed with horror. Dr. Jauhar notes that many people have been putting off routine medical care during the coronavirus pandemic because of fear of contracting the virus. He then proclaims that most people are doing fine despite not having this routine care, citing a survey showing that most Americans think their health has not been affected. This shortsighted analysis has the potential to do harm if readers are persuaded to forgo care that they need.

Much of the routine care people receive in the outpatient setting is done before a disease manifests symptoms in order to catch it when it is more easily treatable. Furthermore, ignoring symptoms can have devastating consequences. Dr. Jauhar focuses on the cost-saving implications of skipping “unnecessary” care without explaining the nuanced but very important difference between inappropriate and appropriate care.

It is too soon to declare with confidence the impact of the coronavirus pandemic on non-Covid-related care. The results of these decisions will play out over many years and will certainly not be reflected in a survey being conducted just a few months into the pandemic.

Eric Schwaber
New Haven, Conn.

To the Editor:

While it is likely true that a small percentage of surgeries and visits are unnecessary, that percentage is not the main cause of the increase in health care spending. Instead, it is administrative costs. Let’s not blame the doctors.

If you have ever been ill, you know it is long-established, well-cultivated medical relationships that sustain and give comfort and emotional strength. That relationship needs regular attention and needs to develop over time. Medicine is not Jiffy Lube. It is about people and relationships, and both need careful nurturing.

Stephanie Taylor
Carmel, Calif.
The writer, a doctor, practices holistic medicine.

To the Editor:

Dr. Sandeep Jauhar is on to something. Americans have hugely “overmedicalized” everyday life and normal aging. Many of my contemporaries are desperately seeking medical help because (in their seventh decade) they just don’t have the same “energy” as at 30, or because they have developed a few little aches and pains. None of them have any expectation that their cars, computers or cellphones will survive in prime pristine condition until the end. So why should their shoulders, knees, hearts or brains?

I would expect to find that many, or perhaps most, of the millions of elective treatments postponed because of Covid-19 were for lifestyle rather than health reasons. Let’s start using our vaunted wisdom of age by looking more honestly at our expectations. After nearly 70 years, I can’t imagine why anyone would harbor any expectation of life with no inconveniences, difficulties or annoyances. We need to stop trying to “fix” normalcy.

David Vanderpool
Cincinnati

To the Editor:

No rushing for the train, bus, airplane, no fuming in traffic, no regulating the day by some corporate idea of work schedules, no packed elevators. No wonder most people with nagging health issues and chronic conditions are doing all right, as Dr. Sandeep Jauhar says. Maybe better than they were before the pandemic struck.

Had the medical profession unfairly been profiting from some unnecessary appointments, procedures, monitoring? Possibly. But those people whose work life stopped or took a homeward turn, in spite of major inconveniences, financial woes, and the loneliness and boredom of staying home month after month, have in the main been living a far less stressful life.

Lisa McCann
Redding Ridge, Conn.

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