Worried Sick: A Prescription for Health in an Overtreated America

Overview

Nortin Hadler's clearly reasoned argument surmounts the cacophony of the health care debate. Hadler urges everyone to ask health care providers how likely it is that proposed treatments will afford meaningful benefits and he teaches how to actively listen to the answer. Each chapter of Worried Sick is an object lesson on the uses and abuses of common offerings, from screening tests to medical and surgical interventions. By learning to distinguish good medical advice from persuasive medical marketing, consumers ...

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Worried Sick: A Prescription for Health in an Overtreated America

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Overview

Nortin Hadler's clearly reasoned argument surmounts the cacophony of the health care debate. Hadler urges everyone to ask health care providers how likely it is that proposed treatments will afford meaningful benefits and he teaches how to actively listen to the answer. Each chapter of Worried Sick is an object lesson on the uses and abuses of common offerings, from screening tests to medical and surgical interventions. By learning to distinguish good medical advice from persuasive medical marketing, consumers can make better decisions about their personal health care and use that wisdom to inform their perspectives on health-policy issues.

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Editorial Reviews

From the Publisher
"[Dr. Hadler] is a longtime debunker of much that the establishment holds dear. . . . Reviewing the data behind many of the widely endorsed medical truths of our day, he concludes that most come up too short on benefit and too high on risk to justify widespread credence. . . . Raise[s] serious questions."—The New York Times

"Having guidelines for reimbursement that went through a Hadlerian analysis is not a bad place to start reducing medical care costs without reducing the quality of patient outcomes. A much more politically attractive, and potentially quite effective, reform would make it routine for patients to be exposed to Hadler's kind of analyses whenever they are asked to consider any significant medical intervention."—Journal of the American Medical Association

"A withering critique. . . . [Hadler has] the knowledge, power, and moral obligation to reject the false coin of commerce and technological hype and to reassert the primacy of the patient."—New England Journal of Medicine

"Challenging conventional medical wisdom, [Hadler] advises a healthy skepticism about the benefits of drugs, routine tests, and many common medical procedures. . . . Educate[s] [readers] on being far better health-care consumers. . . . [A] provocative look at the U.S. medical system."—Library Journal

"This book challenges readers to alter their notions about health maintenance, discarding beliefs about the efficacy of certain medications, screening tests, and procedures. . . . This thoughtful message from an experienced medical practitioner has merit and may convince the general public to advocate more forcefully for change."—ForeWord Magazine

"It is impossible to read this monograph and remain complacent with the current medical model. . . . [Hadler] very clearly states a series of provocative tenets which deserve serious consideration."—The Pharos

"Anyone who wants help in evaluating . . . treatments will welcome the details that Hadler provides. . . . [His] challenge to the value of these treatments demands a response from the physicians, pharmaceutical companies, and others who sell these treatments' benefits and urge us to 'take advantage' of them."—Chapel Hill News

"A seminal piece of medical literature with an Avicennian touch that will be read and debated by health care professionals for years to come."—Wake County Physician

"Thought-provoking, and one of the better critical treatments of our health care approach."—DTC Perspectives

"Provides readers with the perspectives and skills necessary to advocate for themselves in the contemporary health care delivery system."—Journal of Economic Literature
"[Hadler] has the requisite irreverence and skepticism toward medical providers and the healthcare labyrinth to write a clear-sighted appraisal of the current system's failures."—The Morning News

"The question Worried Sick: A Prescription for Health in an Overtreated America aims to answer is how to get your four score and five. Surprisingly, it argues against relying on many of the accepted practices of modern American medicine. . . . Iconoclastic."—Raleigh News and Observer

"[Hadler's] arguments are logical and make one think about the status quo."—Milwaukee Academy of Medicine

"[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

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.
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Product Details

  • ISBN-13: 9780807872338
  • Publisher: The University of North Carolina Press
  • Publication date: 2/1/2012
  • Series: H. Eugene and Lillian Youngs Lehman Series
  • Edition description: 2
  • Edition number: 2
  • Pages: 392
  • Sales rank: 1,382,602
  • Product dimensions: 6.10 (w) x 9.20 (h) x 1.10 (d)

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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Sort by: Showing 1 Customer Reviews
  • Posted September 8, 2009

    more from this reviewer

    Read it!

    This tome on the over-treated, over diagnosed, over drugged world of America is interesting. The author's premise is that we are beset with rampant Type II Medical Malpractice - the performance of unnecessary testing, diagnosing, and prescribing. He seems to perceive that we are, as a culture, drug addicts of the first order, responding to the programmed prescription of pharmaceuticals by doctors who mindlessly follow the lead of drug companies and studies financed by the same folks. In the course of this herd-like plunge off the cliff, we are engaged in a huge wealth transfer from all of us to the medical establishment. What is our reward? The lowest life expectancy of any major country!

    Of course, this is the issue of the moment for our new President Obama, who seems obsessed with expanding this process.

    Whether your concern is cholesterol, blood sugar, blood pressure, breast cancer, prostate cancer, dietary supplements, hormone replacement therapy, osteopenia, backaches, over or under-working, or whatever, Dr. Hadler offers a critical evaluation of the practical realities of studies, most of which are read to mean that current treatments are no better than placebos.

    Dr. Hadler's view seems to be that we all live, on average, to be about 85. By that time, we will all have our fair share of diseases and will die from one or more of them. We will be best advised if we have a trusted physician who will evaluate our maladies, advise of the realities of the treatments, and then let us take a proactive role in our own self-medication. He nowhere exactly says this, but the result seems clear enough.

    This is a marvelous book that should be must-reading for anyone who is concerned about any of these things - which is all of us.

    For me, Dr. Hadler's excellent analysis made me revisit my own mother's breast cancer treatment in the 1950s. I think that she endured a mutilation that was probably needless, did not extend the length of her life, and surely devastated the quality of her life. I hope that you are all spared such a fate. Read about being worried sick!

    1 out of 1 people found this review helpful.

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