Eminence, or rather eloquence, or rather economy-based medicine?

Excerpt

In spite of momentous differences in healthcare systems around the world there is a change of emphasis towards questions of quality of life, among these the problems dealing with pelvic floor defects and symptoms of prolapse, urinary and fecal incontinence and their sequelae. There are many reasons for a tremendous development of new products for conservative or surgical approaches: scientific journals and the rainbow press are filled with more or less valuable publications on this topic. Even in areas of the world where we were taught that incontinence and prolapse were a minor problem because of genetic and cultural properties (e.g. Asia or Africa) this was an apparent mistake, and there are rising numbers of epidemiologic and clinical studies describing the same incidence and therapeutic limitations we have been facing in Europe and North America. Apparently, at least in some countries, doctors deal with this problem as patients have produced pressure on them by having access to electronic media and the more or less honest reports placed there by companies, self-help associations that have become powerful on national and international bases, and forcing physicians, even GPs, to take care. The promotion of companies delivering products and healthcare providers hoping for ‘clients’ (we still prefer to treat patients!) has led to an explosion in the number of surgical products and procedures, and the revival of old and a few new conservative approaches in order to fulfill demand, or rather to help local publicity campaigns. …