There was an article about overtreating patients in the New York Times today. It opened with the classic case of Graves’ Disease. The article looks (briefly) at the pros and cons of getting the aggressive treatment (radioactive iodine or surgery) versus just taking a pill. Indeed, RAI and surgery do “fix” the problem, but, according to the view of the article, this may be like amputating a finger for a hangnail.
How to Steer Toward the Path of Least Treatment
The first doctor Lynn Munroe consulted about her hyperactive thyroid gland recommended radioactive iodine treatment to destroy the gland, followed by a lifelong regimen of thyroid hormone replacement pills.
The second physician she consulted said that he could operate, removing the gland without radiation, but that she would still need to take the pills.
A third doctor suggested a more cautious approach, prescribing medication to depress the gland’s activity. It worked: Ms. Munroe, 49, a publicist in West Nyack, N.Y., no longer has symptoms of hyperthyroidism, even though she has been weaned off the medication.
“And I still have my thyroid intact,” she said. “Thank God for third opinions.”
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