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Overdiagnosed: Making People Sick in the Pursuit of Health

Overdiagnosed: Making People Sick in the Pursuit of Health Cover

 

Synopses & Reviews

Publisher Comments:

From a nationally recognized expert, an exposé of the worst excesses of our zeal for medical testing

 

After the criteria used to define osteoporosis were altered, seven million American women were turned into patients—literally overnight. The proliferation of fetal monitoring in the 1970s was associated with a 66 percent increase in the number of women told they needed emergency C-sections, but it did not affect how often babies needed intensive care—or the frequency of infant death. The introduction of prostate cancer screening resulted in over a million additional American men being told they have prostate cancer, and while studies disagree on the question of whether a few have been helped—there’s no disagreement that most have been treated for a disease that was never going to bother them. As a society consumed by technological advances and scientific breakthroughs, we have narrowed the definition of normal and increasingly are turning more and more people into patients. Diagnoses of a great many conditions, including high blood pressure, osteoporosis, diabetes, and even cancer, have skyrocketed over the last few decades, while the number of deaths from those diseases has been largely unaffected.

 

Drawing on twenty-five years of medical practice and research, Dr. H. Gilbert Welch and his colleagues, Dr. Lisa M. Schwartz and Dr. Steven Woloshin, have studied the effects of screenings and presumed preventative measures for disease and “pre-disease.” Welch argues that while many Americans believe that more diagnosis is always better, the medical, social, and economic ramifications of unnecessary diagnoses are in fact seriously detrimental. Unnecessary surgeries, medication side effects, debilitating anxiety, and the overwhelming price tag on health care are only a few of the potential harms of overdiagnosis.

 

Through the stories of his patients and colleagues, and drawing from popular media, Dr. Welch illustrates how overdiagnosis occurs and the pitfalls of routine tests in healthy individuals. We are introduced to patients such as Michael, who had a slight pain in his back. Despite soon feeling fine, a questionable abnormal chest X-ray led to a sophisticated scan that detected a tiny clot in his lung. Because it could not be explained, his doctors suggested that it could be a sign of cancer. Michael did not have cancer, but he now sees a psychiatrist to deal with his anxiety about cancer.

 

According to Dr. Welch, a complex web of factors has created the phenomenon of overdiagnosis: the popular media promotes fear of disease and perpetuates the myth that early, aggressive treatment is always best; in an attempt to avoid lawsuits, doctors have begun to leave no test undone, no abnormality—no matter how incidental—overlooked; and, inevitably, profits are being made from screenings, a wide array of medical procedures, and, of course, pharmaceuticals. Examining the social, medical, and economic ramifications of a health care system that unnecessarily diagnoses and treats patients, Welch makes a reasoned call for change that would save us from countless unneeded surgeries, debilitating anxiety, and exorbitant costs.

Book News Annotation:

The medical establishment in the United States claims that early detection and frequent health screenings lead to a longer more healthy life. While it is true, for a small percentage of patients, that early detection can be a life saver, says Welch (Dartmouth Institute for Health Policy and Clinical Practice), for a larger percentage it can actually be harmful. He makes a case against the current standard of excessive screenings arguing that our current health care system is an industry for profit above all else, and that the more sick people there are the more opportunities there are for profit. This capitalist approach to health care, he argues, has led to overtreatment of conditions and a general sense of paranoia which ultimately does more harm than good. Annotation ©2011 Book News, Inc., Portland, OR (booknews.com)

Synopsis:

Examining the social, medical, and economic ramifications of a health care system that unnecessarily diagnoses and treats patients, a nationally recognized expert makes a reasoned call for change that would save us from countless unneeded surgeries, debilitating anxiety, and exorbitant costs.

Synopsis:

From a nationally recognized expert, an exposé of the worst excesses of our zeal for medical testing

 

Diagnoses of every condition, from high cholesterol and high blood pressure to osteoporosis, diabetes, and even cancer, have skyrocketed over the last few decades. Yet Americans are living longer than ever. While the medical establishment credits aggressive early disease detection as the cause of improved public heath, it is in fact the reason so many of us are told we are sick. Going against the conventional wisdom that more screening is the best preventive medicine, Dr. H. Gilbert Welch builds a compelling counterargument that what we need is fewer, not more, scans and tests. 

 

Drawing on twenty-five years of medical practice and research on the effects of screening, Welch explains how the cutoffs for “abnormal” test results have been drastically lowered while at the same time technological advances have enabled doctors to detect more and more “abnormalities,” many of which will pose no health complications. Now, with genetic and prenatal screening common practice, patients are increasingly being diagnosed not only with disease but with “pre-disease.”

 

Examining the social, medical, and economic ramifications of a health care system that unnecessarily diagnoses and treats patients, Welch makes a reasoned call for change that would save us from countless unneeded surgeries, debilitating anxiety, and exorbitant costs.

About the Author

Dr. H. Gilbert Welch is a nationally recognized expert 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.

 

Table of Contents

Introduction: Our Enthusiasm for Diagnosis

Chapter 1) Genesis: People Become Patients with High Blood Pressure

Chapter 2) We Change the Rules: How Numbers Get Changed to Give You Diabetes, High Cholesterol, and Osteoporosis

Chapter 3) We Are Able to See More: How Scans Give You Gallstones, Damaged Knee Cartilage, Bulging Discs, Abdominal Aortic Aneurysms, and Blood Clots

Chapter 4) We Look Harder for Prostate Cancer: How Screening Made It Clear That Overdiagnosis Exists in Cancer

Chapter 5) We Look Harder for Other Cancers

Chapter 6) We Look Harder for Breast Cancer

Chapter 7) We Stumble onto Incidentalomas That Might Be Cancer

Chapter 8) We Look Harder for Everything Else: How Screening Gives You (and Your Baby) Another Set of Problems

Chapter 9) We Confuse DNA with Disease: How Genetic Testing Will Give You Almost Anything

Chapter 10) Get the Facts

Chapter 11) Get the System

Chapter 12) Get the Big Picture

Conclusion: Pursuing Health with Less Diagnosis

Acknowledgments

Notes

Index

What Our Readers Are Saying

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Average customer rating based on 1 comment:

dshivers, January 1, 2012 (view all comments by dshivers)
This is clearly the best book that I read in 2011. The author shows clearly how we have to move away from medical screening and rely on tests only for medical diagnosis of symptoms. He shows with multiple examples how very often screening without symptoms causes much more harm than good.
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Product Details

ISBN:
9780807022009
Publisher:
Beacon Press (MA)
Subject:
General Medical
Author:
Welch, H.
Author:
Woloshin, Steve
Author:
Schwartz, Lisa
Author:
Welch, H. Gilbert
Subject:
General
Subject:
Health Care Delivery
Subject:
Health and Medicine-Medical Specialties
Publication Date:
20110131
Binding:
HARDCOVER
Grade Level:
General/trade
Language:
English
Illustrations:
32 FIGURES
Pages:
248
Dimensions:
9.26 x 6.26 x .86 in 1.1 lb

Related Subjects

Health and Self-Help » Health and Medicine » General
Health and Self-Help » Health and Medicine » General Medicine
Health and Self-Help » Health and Medicine » Medical Specialties
Health and Self-Help » Health and Medicine » Politics of Health Care
Health and Self-Help » Health and Medicine » Professional Medical Reference
Reference » Science Reference » Technology

Overdiagnosed: Making People Sick in the Pursuit of Health
0 stars - 0 reviews
$ In Stock
Product details 248 pages Beacon Press - English 9780807022009 Reviews:
"Synopsis" by , Examining the social, medical, and economic ramifications of a health care system that unnecessarily diagnoses and treats patients, a nationally recognized expert makes a reasoned call for change that would save us from countless unneeded surgeries, debilitating anxiety, and exorbitant costs.
"Synopsis" by , From a nationally recognized expert, an exposé of the worst excesses of our zeal for medical testing

 

Diagnoses of every condition, from high cholesterol and high blood pressure to osteoporosis, diabetes, and even cancer, have skyrocketed over the last few decades. Yet Americans are living longer than ever. While the medical establishment credits aggressive early disease detection as the cause of improved public heath, it is in fact the reason so many of us are told we are sick. Going against the conventional wisdom that more screening is the best preventive medicine, Dr. H. Gilbert Welch builds a compelling counterargument that what we need is fewer, not more, scans and tests. 

 

Drawing on twenty-five years of medical practice and research on the effects of screening, Welch explains how the cutoffs for “abnormal” test results have been drastically lowered while at the same time technological advances have enabled doctors to detect more and more “abnormalities,” many of which will pose no health complications. Now, with genetic and prenatal screening common practice, patients are increasingly being diagnosed not only with disease but with “pre-disease.”

 

Examining the social, medical, and economic ramifications of a health care system that unnecessarily diagnoses and treats patients, Welch makes a reasoned call for change that would save us from countless unneeded surgeries, debilitating anxiety, and exorbitant costs.

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