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Overdiagnosed

Making People Sick in the Pursuit of Health

H. Gilbert Welch, M.D., M.P.H. Lisa Schwartz Steve Woloshin

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English
Beacon Press
01 September 2018
"A nationally recognized expert on the effects of medical testing shows us why more screening does not necessarily lead to better health but, in fact, turns healthy people into patients.

An expose on Big Pharma and the American healthcare system's zeal for excessive medical testing, from a nationally recognized expert

More screening doesn't lead to better health-but can turn healthy people into patients.

Going against the conventional wisdom reinforced by the medical establishment and Big Pharma that more screening is the best preventative medicine, Dr. Gilbert Welch builds a compelling counterargument that what we need are fewer, not more, diagnoses. Documenting the excesses of American medical practice that labels far too many of us as sick, Welch examines the social, ethical, and economic ramifications of a health-care system that unnecessarily diagnoses and treats patients, most of whom will not benefit from treatment, might be harmed by it, and would arguably be better off without screening.

Drawing on 25 years of medical practice and research on the effects of medical testing, Welch explains in a straightforward, jargon-free style how the cutoffs for treating a person with ""abnormal"" test results have been drastically lowered just when technological advances have allowed us to see more and more ""abnormalities,"" many of which will pose fewer health complications than the procedures that ostensibly cure them. Citing studies that show that 10% of 2,000 healthy people were found to have had silent strokes, and that well over half of men over age sixty have traces of prostate cancer but no impairment, Welch reveals overdiagnosis to be rampant for numerous conditions and diseases, including diabetes, high cholesterol, osteoporosis, gallstones, abdominal aortic aneuryisms, blood clots, as well as skin, prostate, breast, and lung cancers.

With genetic and prenatal screening now common, patients are being diagnosed not with disease but with ""pre-disease"" or for being at ""high risk"" of developing disease. Revealing the economic and medical forces that contribute to overdiagnosis, Welch makes a reasoned call for change that would save us from countless unneeded surgeries, excessive worry, and exorbitant costs, all while maintaining a balanced view of both the potential benefits and harms of diagnosis. Drawing on data, clinical studies, and anecdotes from his own practice, Welch builds a solid, accessible case against the belief that more screening always improves health care."
By:   , ,
Imprint:   Beacon Press
Country of Publication:   United States
Dimensions:   Height: 228mm,  Width: 152mm,  Spine: 17mm
Weight:   352g
ISBN:   9780807021996
ISBN 10:   0807021997
Pages:   248
Publication Date:  
Audience:   General/trade ,  ELT Advanced
Format:   Paperback
Publisher's Status:   Active

Dr. H. Gilbert Welch is a renowned authority on the effects of medical screening who has appeared on The Today Show, CNN, NPR, and in the New York Times and Washington Post. He and his coauthors, Dr. Lisa M. Schwartz and Dr. Steven Woloshin, nationally recognized experts in risk communication, are professors at the Dartmouth Institute for Health Policy and Clinical Practice.

Reviews for Overdiagnosed: Making People Sick in the Pursuit of Health

Very insightful and engaging. -Dennis Rosen, The Boston Globe One of the most important books about health care in the last several years. -Cato Institute One of the big strengths of this relatively small book is that if you are inclined to ponder medicine's larger questions, you get to tour them all. What is health, really?... In the finite endeavor that is life, when is it permissible to stop preventing things? And if the big questions just make you itchy, you can concentrate on the numbers instead: The authors explain most of the important statistical concepts behind evidence-based medicine in about as friendly a way as you are likely to find. -Abigail Zuger, MD, The New York Times Overdiagnosed -albeit controversial-is a provocative, intellectually stimulating work. As such, all who are involved in health care, including physicians, allied health professionals, and all current or future patients, will be well served by reading and giving serious thought to the material presented. JAMA Everyone should read this book before going to the doctor! Welcome evidence that more testing and treatment is not always better. Susan Love, MD, author of Dr. Susan Love's Breast Book This book makes a compelling case against excessive medical screening and diagnostic testing in asymptomatic people. Its important but underappreciated message is delivered in a highly readable style. I recommend it enthusiastically for everyone. Arnold S. Relman, MD, editor-in-chief emeritus, New England Journal of Medicine, and author of A Second Opinion: Rescuing America's Health Care This stunning book will help you and your loved ones avoid the hazards of too much health care. Within just a few pages, you'll be recommending it to family and friends, and, hopefully, your local physician. If every medical student read Overdiagnosed, there is little doubt that a safer, healthier world would be the result. Ray Moynihan, conjoint lecturer at the University of Newcastle, visiting editor of the British Medical Journal, and author of Selling Sickness An 'overdiagnosis' is a label no one wants: it is worrisome, it augurs 'overtreatment,' and it has no potential for personal benefit. This elegant book forewarns you. It also teaches you how and why to ask, 'Do I really need to know this?' before agreeing to any diagnostic or screening test. A close read is good for your health. Nortin M. Hadler, MD, professor of medicine and microbiology/immunology at University of North Carolina at Chapel Hill and author of Worried Sick and The Last Well Person We've all been made to believe that it is always in people's best interest to try to detect health problems as early as possible. Dr. Welch explains, with gripping examples and ample evidence, how those who have been overdiagnosed cannot benefit from treatment; they can only be harmed. I hope this book will trigger a paradigm shift in the medical establishment's thinking. -Sidney Wolfe, MD, author of Worst Pills, Best Pills and editor of WorstPills.org


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