Dr. Lisa Schwartz, Advocate for Patients, is usually Dead at 55

Dr. Lisa Schwartz, who with her husband devoted her life to warning patients about the dangers of unnecessary medical tests in addition to treatment in addition to excessive diagnoses, died on Nov. 29 in Lebanon, N.H. She was 55.

Her husband, Dr. Steven Woloshin, said the cause was cancer.

Dr. Schwartz in addition to Dr. Woloshin were the directors of the Center for Medicine in addition to Media at the Dartmouth Institute for Health Policy in addition to Clinical Practice, part of Dartmouth College’s Geisel School of Medicine. There they trained hundreds of journalists to become more skeptical about claimed scientific breakthroughs in addition to miracle cures, in addition to to better communicate the benefits in addition to risks of medical tests in addition to treatment.

They often collaborated with another Dartmouth colleague, Dr. H. Gilbert Welch, on books in addition to articles — for laymen in addition to medical professionals alike — in which aimed to demystify the credible risks of getting diseases. Their research helped the National Cancer Institute to develop the Know Your Chances website.

They lobbied the Food in addition to Drug Administration to require in which prescription medicine be labeled which has a “drug facts box,” which would certainly list the benefits in addition to harms detected in clinical trials. The agency has been considering the proposal.

“We want doctors, the public in addition to policymakers to know what they can in addition to cannot get via various medications, treatments in addition to interventions, so people can make wise decisions,” Dr. Schwartz told the college publication Dartmouth Medicine in 2012.

Last year, Dr. Schwartz in addition to Dr. Woloshin received the John P. McGovern Award via the American Medical Writers Association. The award recognized their success in illuminating “the trade-offs between too little diagnosis (missing problems in which might benefit via earlier treatment) in addition to overdiagnosis (harming people with problems in which never needed to be found).”

They saw what they called overdiagnosing as a consequence of advanced technology for detecting abnormalities in addition to of lower thresholds, set by expert panels, for defining diseases.

“More diagnoses mean more money for drug manufacturers, hospitals, physicians in addition to disease advocacy groups,” Dr. Schwartz, Dr. Woloshin in addition to Dr. Welch wrote in an essay in The brand-new York Times in 2007. “While failing to make a diagnosis can result in lawsuits, there are no corresponding penalties for overdiagnosis.”

They warned of “the medicalization of everyday life” in addition to an “epidemic of diagnoses.”

“Everyday experiences like insomnia, sadness, twitchy legs in addition to impaired sex drive today become diagnoses: sleep disorder, depression, restless leg syndrome in addition to sexual dysfunction,” the doctors wrote.

They were particularly concerned about how such diagnoses affected children.

“If children cough after exercising, they have asthma; if they have trouble reading, they are dyslexic; if they are unhappy, they are depressed; in addition to if they alternate between unhappiness in addition to liveliness, they have bipolar disorder,” the doctors wrote.

“While these diagnoses may benefit the few with severe symptoms,” they added, “one has to wonder about the effect on the many whose symptoms are mild, intermittent or transient.”

They concluded, “If more than half of us are sick, what does the idea mean to be normal?”

Not surprising, their crusade had its critics. When they complained in which a drug for restless leg syndrome was being overprescribed, the a new, GlaxoSmithKline, responded in which its advertising recommended in which patients try some other measures first. “There’s important information on our product label to inform physicians as to whether or not a product is usually appropriate,” the company said.

Lisa Miriam Schwartz was born within the Bronx on June 30, 1963, to Leonard Schwartz, an electrical engineer, in addition to Heda (Teitcher) Schwartz, a vocational rehabilitation counselor.

She graduated via Montville High School in brand-new Jersey in addition to earned a bachelor’s degree in chemistry via the State University of brand-new York at Binghamton (today Binghamton University) in 1985 in addition to a medical degree in 1989 via the brand-new York University School of Medicine.

She in addition to Dr. Woloshin met in 1990 as medical residents at Bellevue Hospital Center in Manhattan.

Working at city-run clinics on the Lower East Side in addition to in Chinatown, they got their first glimpse of the mismatch between the treatment being offered in addition to the pool of potential patients: While the clinics were equipped with high-tech diagnostic equipment, they employed no interpreters for their clients, nearly all of whom were recent immigrants who spoke little English.

The couple married in 1992 in addition to accepted a research fellowship two years later at Dartmouth, where Dr. Schwartz received a master of science degree in addition to where they became professors of medicine in addition to research partners.

In addition to her husband, Dr. Schwartz is usually survived by their daughter, Emma; their son, Eli; her mother; her brother, Mark; in addition to her sister, Susan Schwartz.

In 2011, Dr. Schwartz in addition to her husband were named directors of the Center for Medicine in addition to Media, which is usually supported by, among others, the National Institutes of Health. She, Dr. Woloshin in addition to Dr. Welch collaborated on the books “Know Your Chances” (2009) in addition to “Overdiagnosed: doing People Sick within the Pursuit of Health” (2011).

“Lisa never lost her capacity to be truly angry about corruption, misinformation in addition to lack of scientific rigor within the system,” Robert E. Drake, a fellow Geisel School professor, said in his eulogy.

Dr. Schwartz warned in which too many people were being treated on the basis of CT scans even though, she said, the scans cannot identify a progressive cancer via a nonprogressive one. In 1999, she criticized the imminent issue of a postage stamp in which said “Prostate Cancer Awareness: Annual Checkups in addition to Tests.”

“How was the idea,” she later recalled wondering, “in which the Postal Service was doing screening recommendations?”

If everyone took the recommended tests for blood cholesterol in addition to sugar, body mass index in addition to diabetes, she once calculated, three in four adults within the United States would certainly be classified as diseased.

As for her own illness, Dr. Schwartz received an accurate diagnosis in addition to coped with seven years of uncertainty as she underwent several versions of chemotherapy.

“She did everything she could,” Dr. Welch said in an email. “More important, she would certainly want patients to understand in which not bad people — doing all the right things — can nonetheless develop bad diseases.”