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Overdiagnosed: Making People Sick in the Pursuit of Healthby H. Gilbert Welch
Synopses & Reviews
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
Genesis : people become patients with high blood pressure — We change the rules : how numbers get changed to give you diabetes, high cholesterol, and osteoporosis — We are able to see more : how scans give you gallstones, damaged knee cartilage, bulging discs, abdominal aortic aneurysms, and blood clots — We look harder for prostate cancer : how screening made it clear that overdiagnosis exists in cancer — We look harder for other cancers — We look harder for breast cancer — We stumble onto incidentalomas that might be cancer — We look harder for everything else : how screening gives you (and your baby) another set of problems — We confuse DNA with disease : how genetic testing will give you almost anything — Get the facts — Get the system — Get the big picture — Conclusion : pursuing health with less diagnosis.
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