The drive to boost dementia care in Britain may lead to doctors diagnosing dementia where there is no dementia, just to push the numbers up.
Jeremy Hunt, Britain's Health Secretary, has set dementia detection levels as one of the new priorities in the country's health program and has in fact endorsed new targets for diagnosis rates of the different forms of the disease. In order to show what dementia care should look like, he has also published a 'dementia map' in November that aims to help people look up diagnosis rates in certain areas of the country, for different clinical commissioning groups (CCG).
However, the implications of this aggressive move have not yet been studied and so some doctors are worried that this may compel general practitioners to overdiagnose, just to hit the target numbers. For now, there are an estimated 670,000 individuals with dementia but without a formal diagnosis. In older people, one in three have a minor cognitive impairment that shows up in tests but may actually never lead to dementia. Despite this, the health ministers are aiming to raise the number of individuals diagnosed with dementia by two-thirds by the year 2015.
Dr. Martin Brunet, a leading general practitioner from Surrey, explains that the worry is coming from the reality that dementia care is big business and this aggressive move is being made not for real dementia care but for vested interests that actually have nothing to do with actual care. This places doctors in a position that will require them to place patient need secondary to the need to reach quotas for the dementia map established.
"Medicine depends on a fundamental, unspoken agreement between patients and doctors [...] the only factor influencing the decision to diagnose should be the best interests of patients," said Brunet. He also added that, "If the validity of these strategies is not questioned, there is the danger of this spreading into other areas of medicines."
"The idea that doctors should be motivated by self interest, such as personal or corporate gain, is abhorrent and undermines the basis of the relationship (with a patient)," Brunet further expounded. "The making of a diagnosis is a key moment in a patient's journey. It can bring great benefit by opening the door to effective treatments and support as well as giving a much-needed explanation for worrying symptoms. But it can also bring great harm if incorrect."
Dementia diagnosis, when not done correctly, can bring great harm to the patient and the setting of aggressive targets are definitely directly leading to wrong diagnosis, creating harm for the patient and is a massive problem waiting to happen in Britain's health system.
Nevertheless a Department of Health spokesman assured the public that, "A timely diagnosis can make a significant difference to a person's quality of life. We would always expect doctors to act in the best interests of their patients, to assess them appropriately when they show the signs of dementia and refer them to a specialist for diagnosis."