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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.
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
About the Author 355
Posted September 8, 2009
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!
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