Overdiagnosed: Making People Sick in the Pursuit of Healthby H. Gilbert Welch, Lisa Schwartz, Steve Woloshin
Pub. Date: 01/03/2012
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 overlooked; and profits are being made from screenings, medical procedures, and
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 overlooked; and profits are being made from screenings, medical procedures, and pharmaceuticals. Revealing the social, medical, and economic ramifications of a health-care system that overdiagnoses and overtreats patients, Dr. H. Gilbert Welch makes a reasoned call for change that would save us pain, worry, and money.
- Publication date:
- Sales rank:
- Product dimensions:
- 6.10(w) x 9.02(h) x 0.74(d)
Table of Contents
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
and post it to your social network
Most Helpful Customer Reviews
See all customer reviews >
Overdiagnosed: Making People Sick in the Pursuit of Health by Dr. H. Gilbert Welch is worthwhile reading for those interested in health and wellness. It gives easy-to-understand information on hypertension/high blood pressure, systolic reading, diastolic reading, randomized studies, what is abnormal, and what certain numbers mean. Inside you will learn about how diabetes and high cholesterol are diagnosed as well as how some patients are "overdiagnosed" for different illnesses and disease. You'll learn about "catching" an illness early before symptoms develop and why treatment is encouraged before symptoms occur. Find out what "cutoffs" and "thresholds" are. Dr. Welch explains how medical experts have "changed the rules," thus changing the number of people with certain illnesses and disease. There are definitions offered for many illnesses other than hypertension/high blood pressure, high cholesterol, and diabetes that you will read about as well, if you choose to read Dr. Welch's findings. Chapter 10 "Get the Facts" is great! - it is rather enlightening reading. This book is informative and educational.
Dr. Welch and his colleagues have produced a book that will open your eyes to the unquestioned belief in "early diagnosis" and what this actually means to your long-term health. Truth is multiple forces (Big Pharma, "true believers", doctors' fear of being sued, medical device manufacturers) have promoted "early diagnosis" as a Holy Grail, with little evidence that supports its value. We push screening blood tests, bone density scans, PSAs supposedly to find to find an abnormality "early". The result is that there is an epidemic of overdiagnosis, which means an abnormality with no symptoms. Identifying an abnormality ever earlier is of little value in terms of long-term outcome. However, it does turn you into a patient, subjects you to medications and procedures of little value. Although Dr. Welch makes these concepts clear, this isn't an especially easy read. You'll need to think and contemplate the charts and graphs. You'll be glad you did. The next time you're offered a screening test when you have no symptoms, you'll know the back story, both the minor pros and the very large cons of unquestioned belief in the value of "early diagnosis." By the way, Dr. Welch and his co-authors are not "alternative medicine" practitioners. They are well-respected, well-credentialed, experienced academic physicians.
I read Overdiagnosed this morning, and I strongly urge you to read it, too. If you've ever wondered why our country's healthcare costs are skyrocketing even though our health outcomes lag behind the rest of the industrialized world, this book has the answers. We are overtested, overdiagnosed and overtreated. But sadly and paradoxically, this intensive use of "preventive" medicine has not improved our physical health or sense of well being -- it has diminished it. Dr. Welch builds a strong case that Americans are overdiagnosed in a clear, concise and compelling way. He provides anecdotal accounts of people who were seriously harmed by the overzealous use of modern, high tech testing. And he backs these stories up with findings from landmark medical research studies. As we move from chapter to chapter and disease to disease, we see the same patterns emerge: thresholds for "illness" are lowered and suddenly tens of millions of people are diagnosed and treated for mild or nonexistent "diseases" that never would have harmed them. Dr. Welch identifies the key players who brought American medicine to this sorry state -- big pharma and medical products manufacturers hungry to increase profits, doctors who order unnecessary tests to avoid malpractice lawsuits, and overzealous patient advocacy groups who press for action in the absence of any scientific evidence of improved outcomes. Dr. Welch explains key concepts like "lag time bias" and "overtreatment bias" that enable you to see why the benefits of aggressive preventive medicine are far less than you have been led to believe. Once you understand terms like these, you will never again be swayed by misleading advertising or public health campaigns. Instead, you will be able to make decisions about your own health care in a rational, intelligent, and informed way. In short, if you read one health related book this year, it should be "Overdiagnosed." Buy one copy for yourself and another for your doctor.
As a pharmacist, I was already skeptical about our current healthcare system. After reading this book, I will change how I interact with the system. We each need to make our own individual choices as to whether or not we should pursue therapy. Our choices would be made much easier if we received better estimates of the real risks and benefits. Dr Welch looks at many common medical problems and tries to elucidate the probability of benefit versus non-monetary costs which are seldom considered.
READ THIS BOOK!!!!! Personally, I have been caught up in the endless cycle of testing for no good reason and am fed up!! I borrowed this from the library but will be purchasing a copy of my own for future reference!!