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People I (Mostly) Admire

153. We’re Not Getting Sicker — We’re Overdiagnosed

People I (Mostly) Admire

Freakonomics Radio + Stitcher

Society & Culture

4.61.9K Ratings

🗓️ 15 March 2025

⏱️ 64 minutes

🧾️ Download transcript

Summary

Suzanne O'Sullivan is a neurologist who sees many patients with psychosomatic disorders. Their symptoms may be psychological in origin, but their pain is real and physical — and the way we practice medicine, she argues, is making those and other health problems worse.

Transcript

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0:00.0

Can you have too much of a good thing?

0:06.9

Medical care is a good thing, but my guest today, Susanne O'Sullivan, says that our medical

0:12.4

system is over testing, over-diagnosing, and over-treating patients.

0:17.9

That's the case she makes in her newest book, The Age of Diagnosis. How our

0:22.4

obsession with medical labels is making us sicker. Suzanne is a neurologist who focuses on the

0:27.9

treatment of epilepsy, and she's written four books about her experiences as a physician.

0:33.1

Many of my patients are in their 20s or 30s. I see people with long lists of medical labels at that age,

0:40.8

and it shocks me because I didn't see it 30 years ago.

0:43.8

And I can't believe that we've got sicker, you know, to that degree.

0:47.8

Something is going wrong, and I appreciate that some of the subjects in this book

0:52.4

will be difficult for people, but I also think that something needs to be said about these issues.

1:03.4

Welcome to people I mostly admire with Steve Levitt.

1:09.1

Suzanne not only thinks that the medical system is working on overdrive, she believes that

1:14.1

many patients are misdiagnosed. Her first book tackles the complexities of psychosomatic

1:19.9

disorders. As a neurologist, she commonly sees patients who experience paralysis, headaches,

1:25.6

dizziness, and seizures. However, she estimates that for 20% of her patients,

1:31.1

the cause of their sometimes debilitating symptoms is not neurological,

1:35.8

it's psychosomatic.

1:37.3

We start our conversation with Matthew,

1:39.8

one of the patients she describes in her first book,

1:42.0

It's All In Your Head, True Stories of Imaginary Illness.

1:50.0

So Matthew had noticed, I think he had a combination of back pain and tingling in his legs in the first instance.

...

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