Equine and pediatric medicine has many parallels, notes Dr. David Ramey in an article for Horse Network, including a propensity for overdiagnosis.
Ramey draws multiple similarities between the two, including that both horses and children are reliant upon adults to make medical decisions for them. Additionally, neither small children nor horses can talk, so diagnoses must be made on observation and testing.
Ramey says that a horse may have an issue where a diagnosis is warranted, but determining an exact diagnosis can be difficult—and in some cases harmful–to the horse. An ultrasound can be a helpful tool to use if a horse is colicking and a diagnosis on whether surgery is needed is imperative. However, sometimes a precise diagnosis isn't needed. If a horse is older and sore, using every diagnostic tool to determine where it is unsound may not change the treatment or the outcome—it simply adds to the owner's expense. In Ramey's words, “'Overdiagnosis' describes a situation when an abnormality is found, but detection of that abnormality doesn't actually benefit the patient.”
Though vets have multiple diagnostic tools at their disposal, their use doesn't always behoove the horse or the owner. Using every tool available to find a diagnosis might physically harm the horse: It's imperative that the owner and vet agree that the benefit outweighs the possible risk of the test or procedure.
Psychologically, naming the issue may change the perception of what a horse can do. Some owners then become focuses on “fixing” the problem, adding in supplements and other treatments that the horse may not need. Finally, the financial strain on owners who choose to offer treatments to horses that may not garner long-term improvement can be immense.
Ramey offers some thoughts on why veterinarians may seek to over diagnose the equines in their care:
- Industry influence
- Defensiveness
- Incentives
Owners may attempt to seek out concrete diagnoses for their own peace of mind; uncertainty is not well tolerated by most people.
The benefit—to both horse and owner–of performing a test or procedure should be discussed before an owner agrees to pay for it. Many equine conditions improve on their own, so immediately throwing every test and procedure at the horse may result in the same diagnosis as waiting and not doing additional tests.
Read more at Horse Network.
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