In a National Post review of his new book called “Risk: The Science and Politics of Fear”, Dan Gardner calls our era “The Age of ‘Disease-Mongering” and although I think he means well, in my opinion he misses the complexity of modern medical realities and patient expectations.

Our scare with SARS pointed out the importance of rigid infection control and the morbidity and deaths associated with recent outbreaks of C. difficile showed the importance of proper hand hygiene and sanitizing techniques. It is quite clear to me that in the world today serious germs and diseases exist that have the potential to impact us on an individual level and collectively.

Mr. Gardner discusses the “hype” surrounding the risk of germs and the role of Big Pharma. He writes that it is not in the economic interests of a corporation selling pills to unhealthy people for people to perceive themselves to be healthy and that what matters is whether someone believes there is something wrong that can be cured with a pill. This apparently is called “disease mongering” by critics.

This perception would certainly fly in the face of all the attempts to prevent such entities as heart attack and strokes and cancers because a patient may have no warning or cues that they have serious health problems. They may perceive themselves as healthy when they are undergoing a disease process that if left untreated will have serious repercussions for them individually and for government which carries the cost of providing their lifelong care. We see preventative screening for breast cancer even when patients feel well. We have new programs to screen for colon cancer and a vaccination that will help decrease the numbers of women who must suffer or die with cervical cancer.

The patients’ right to perceive themselves as ‘well’ should not be denied, but the health care community has the responsibility to educate patients and give them the information to make educated decisions about their health. Some decisions will involve whether or not to take a medication or to be tested for familial disease or genetic risk factor for new medical disorders or dysfunctions.

For some people, this may be disease-mongering. For others it is simply a way of controlling disease processes that were previously uncontrollable.

I doubt very much that this is “shifting the line between healthy and diseased”--as the saying goes: “to each his own”.