Worried Sick: A Prescription for Health in an Overtreated America

Overview

At a time when access to health care in the United States is being widely debated, Nortin Hadler argues that an even more important issue is being overlooked. Although necessary health care should be available to all who need it, he says, the current health-care debate assumes that everyone requires massive amounts of expensive care to stay healthy. Hadler urges that before we commit to paying for whatever pharmaceutical companies and the medical establishment tell us we need, American consumers need to adopt an ...

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Overview

At a time when access to health care in the United States is being widely debated, Nortin Hadler argues that an even more important issue is being overlooked. Although necessary health care should be available to all who need it, he says, the current health-care debate assumes that everyone requires massive amounts of expensive care to stay healthy. Hadler urges that before we commit to paying for whatever pharmaceutical companies and the medical establishment tell us we need, American consumers need to adopt an attitude of skepticism and arm themselves with enough information to make some of their own decisions about what care is truly necessary.

Each chapter of Worried Sick is an object lesson regarding the uses and abuses of a particular type of treatment, such as mammography, colorectal screening, statin drugs, or coronary stents. For consumers and medical professionals interested in understanding the scientific basis for Hadler's arguments, each topical chapter has an accompanying source chapter in which Hadler discusses the medical literature and studies that inform his critique.

According to Hadler, a major stumbling block to rational health-care policy in the United States is contention over the very concept of what constitutes good health. By learning to distinguish good medical advice from persuasive medical marketing, consumers can make better decisions about their personal health and use that wisdom to inform their perspectives on health-policy issues.

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Editorial Reviews

Library Journal

Hadler (medicine & microbiology/immunology, Univ. of North Carolina-Chapel Hill) amplifies and updates his 2004 book, The Last Well Person: How To Stay Well Despite the Health-Care System, here writing another clear message on his prescription pad: "Rx: less is more." Challenging conventional medical wisdom, he advises a healthy skepticism about the benefits of drugs, routine tests, and many common medical procedures-dubbing what he describes as impeccably performed but medically unnecessary treatments "Type II Medical Malpractice"-and he makes the unfashionable assertion that aches and pains are a normal part of the aging process. Topical chapters provide information on heart disease, cancer, diabetes, and other common conditions as well as discussions of how mental states and socioeconomic factors affect health; "shadow chapters" offer additional, specialized information on each topic. Though the book may not convince readers to forgo their annual prostate-specific antigen (PSA) tests or mammograms, it will educate them on being far better health-care consumers. This often densely written but provocative look at the U.S. medical system is worth the effort; recommended for larger public and academic libraries.
—Kathy Arsenault

Doody's Review Service
Reviewer: Carole A. Kenner, PhD, RN, FAAN (Council of International Neonatal Nurses)
Description: This is a guide for consumers to better understand healthcare options, navigate throughout the maze of jargon, and advocate for their own health.
Purpose: The book presents the common issues that most consumers face in healthcare today. Its purpose, though, is to assist the public in making informed healthcare decisions. These worthy objectives are met.
Audience: Although the audience is consumers, health professionals can benefit from looking at healthcare issues from a consumer perspective.
Features: Topics range from the aging population and healthcare needs through interventionists in cardiology as cash drivers in healthcare, to the disease du jour such as cholesterol, breast cancer, and dying. The topics of alternative therapies and insurance are thrown into the mix. Using a teaching approach of a healthcare professional having a conversation with a patient sets the stage. Each chapter contains scientific support for the argument presented. Then a so-called "shadow chapter" follows that presents important scientific papers for more in-depth review of the material. The only shortcoming is that little acknowledgement is given to the Institute of Medicine (IOM) core competencies that drive healthcare today.
Assessment: There is no direct competition for this book. Its unique perspective is a breath of fresh air for critically examining healthcare topics such as cardiac problems and the new specialization of interventionists. It presents options to consumers and encourages them to make informed decisions about their own health. The physician author makes clear the consumer has rights to demand good healthcare.
From the Publisher
"[Hadler's] self-confessed 'diatribe against medicalisation' is an engaging read."--Medical Journal of Australia

"This is recommended reading even if you are determined in advance to despise it. You will be better off having wrestled with his arguments and . . . probably will not find them easy to refute."--Journal of American Physicians and Surgeons

"An important book. . . . The reader will understand symptoms and their causation and will be richer for it--intellectually and in pocket."--Journal of Rheumatology

"To change unrealistic expectations about longevity or lives without pain or illness bucks vested interests, but that is what Hadler does. . . . He knows that the changes he proposes are a long shot, but when people demand that medicine stop doing unnecessary things well, reform becomes possible. Recommended."--Choice

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Product Details

  • ISBN-13: 9780807886229
  • Publisher: The University of North Carolina Press
  • Publication date: 6/2/2008
  • Format: Other
  • Pages: 392

Meet the Author

Nortin M. Hadler, M.D., M.A.C.P., M.A.C.R., F.A.C.O.E.M., is professor of medicine and microbiology/immunology at the University of North Carolina at Chapel Hill and attending rheumatologist at UNC Hospitals. He is author of several books, including Stabbed in the Back: Confronting Back Pain in an Overtreated Society and Rethinking Aging: Growing Old and Living Well in an Overtreated Society.

Nortin M. Hadler, M.D., M.A.C.P., M.A.C.R., F.A.C.O.E.M., is professor of medicine and microbiology/immunology at the University of North Carolina at Chapel Hill and attending rheumatologist at UNC Hospitals. He is author of several books, including Stabbed in the Back: Confronting Back Pain in an Overtreated Society and Rethinking Aging: Growing Old and Living Well in an Overtreated Society.

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Table of Contents

Introduction 1

1 The Methuselah Complex 9

2 The Heart of the Matter 15

3 Risky Business: Cholesterol, Blood Sugar, and Blood Pressure 33

4 You Are Not What You Eat 57

5 Gut Check 65

6 Breast Cancer Prevention: Screening the Evidence 77

7 The Beleaguered Prostate 95

8 Disease Mongering 105

9 Creakiness 111

10 It's in Your Mind 135

11 Aging Is Not a Disease 153

12 Working to Death 171

13 "Alternative" Therapies Are Not "Complementary" 191

14 Assuring Health, Insuring Disease 213

Supplementary Readings 229

Bibliography 311

About the Author 355

Index 357

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