Feel Better, Live More with Dr Rangan Chatterjee

Why Medicine Has Gone Too Far, The Problem With Getting A Diagnosis & Why Early Detection Is Not Always A Good Thing with Dr Suzanne O'Sullivan #553

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May 6, 2025

Dr. Suzanne O'Sullivan, a consultant specializing in complex epilepsy and author of 'The Age of Diagnosis', discusses the troubling trends in modern medicine. She explains how diagnostic labels can alter a person's self-view and urges a reevaluation of our understanding of health struggles as potentially normal experiences rather than diseases. The conversation also touches on the surge of autism diagnoses, the pitfalls of early detection, and the complexities of genetic testing, advocating for a more personalized and holistic approach to healthcare.

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INSIGHT

Overdiagnosis Challenge in Medicine

Medicine is shifting from underdiagnosis to potential overdiagnosis, medicalizing normal struggles.
Detecting more patients doesn't always mean better health outcomes or appropriate treatment.

INSIGHT

Medicalizing Mental Health Struggles

One in five people with mental health diagnoses raises the question: are we more unhappy or just medicalizing normal unhappiness?
Medicalizing struggles might mask social or environmental solutions that are more effective.

ANECDOTE

Genetic Diagnosis Turned Healthy Patient

A 15-year-old girl was diagnosed with a rare, progressive genetic condition that she was unaware of.
The diagnosis changed her from feeling healthy to a patient anticipating decline, raising overdiagnosis concerns.

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Could our healthcare system be making us sicker rather than healthier? In the UK, autism diagnoses have increased by a staggering 787% between 1998 and 2018, and one in five people now has some form of mental health disorder. But what if some of our health struggles aren't diseases to be cured, but normal human experiences being medicalised?

This week, I'm joined by Dr Suzanne O'Sullivan, a consultant in clinical neurophysiology and neurology at The National Hospital for Neurology and Neurosurgery, who specialises in the investigation of complex epilepsy and also has an active interest in psychogenic disorders.

Her latest book, The Age of Diagnosis: Sickness, Health, and Why Medicine Has Gone Too Far, aims to challenge long-held assumptions about medical progress and change the way we think about our health.

In this thought-provoking conversation, we explore:

Why giving someone a diagnosis is never neutral – it can fundamentally change how a person views themselves, their body and their future possibilities
How the definition of autism has dramatically expanded over the past few decades from its original concept of "extreme autistic aloneness" to now potentially including 1 in 20 children in Northern Ireland
Why screening for diseases like prostate cancer can lead to unnecessary treatment
The potential problems of genetic testing - when results are misinterpreted or used without proper context, especially with tests that aren't clinical grade
Why early detection and treatment aren't always better, particularly when it turns healthy people into patients decades before they might develop symptoms
The profound story of how Suzanne diagnosed a rare genetic condition in a 15-year-old girl, only to question whether she had actually done the right thing by medicalising someone who believed herself to be healthy

This is a nuanced, compassionate discussion that challenges many of the widely held assumptions in modern healthcare and I would urge you to listen with an open mind. Throughout our conversation, Suzanne emphasises that she's not arguing against the existence of these conditions or suggesting everyone should refuse diagnosis.

Rather, she encourages both patients and doctors to consider whether medicalising our struggles is always the right approach. I hope you enjoy listening.

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Show notes https://drchatterjee.com/553

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