I will be bit more specific to primary care work in discussions about screening and assessing risk.
The simple meaning of screening is taking history and examining the patient for the possible diseases and try to mitigate the risk of a serious pathology. It is not uncommon to say’’ I do not know what it is but unlikely to be serious’’ to reassure patient. There is always a ''false negative'' risk as there is with any other screening tests.
Screening in case of supposedly healthy population is also a common domain of general practice as part of preventive medicine rather than problem solving aspect of medicine. Taking example of cardiovascular disease , the more people recognised earlier and intervened , the longer or better quality of lives obtained. Hence there is high ride on ‘’check-ups’’ and promote healthy lifestyle. However, I feel that in some way we shift responsibility onto patient to react on hazards and move away from the government providing psycho-social aspect of health. How often we find obesity as the single contributing factor for increased risk of HT, CVD and diabetes for example which is called modifiable in the medical field but surely not so for the patient. On the one hand, surrounded by take-away shops offering quick and cheap meals and on the other gyms with expensive membership fees, these patients are left with fear of the direct and indirect complications of obesity that is reiterated at each consultations with doctors: ‘’Your blood pressure, diabetes, arthritis and depression will improve if only you loose weight.’’ I am doubtful if articulating the degree of risk increases the motivation while the strategies in tackling the problem is lacking.
