Overdiagnosed: Making People Sick in the Pursuit of Health

Overdiagnosed: Making People Sick in the Pursuit of Health

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Overview

Overdiagnosed: Making People Sick in the Pursuit of Health by H. Gilbert Welch, Lisa M. Schwartz, Steven Woloshin

From a nationally recognized expert, an exposé of the worst excesses of our zeal for medical testing

Going against the conventional wisdom reinforced by the medical establishment and Big Pharma that more screening is the best preventative medicine, Dr. Gilbert Welch builds a compelling counterargument that what we need are fewer, not more, diagnoses. Documenting the excesses of American medical practice that labels far too many of us as sick, Welch examines the social, ethical, and economic ramifications of a health-care system that unnecessarily diagnoses and treats patients, most of whom will not benefit from treatment, might be harmed by it, and would arguably be better off without screening.

Drawing on twenty-five years of medical practice and research on the effects of medical testing, Welch explains in a straightforward, jargon-free style how the cutoffs for treating a person with "abnormal" test results have been drastically lowered just when technological advances have allowed us to see more and more "abnormalities," many of which will pose fewer health complications than the procedures that ostensibly cure them. Citing studies that show that 10 percent of two thousand healthy people were found to have had silent strokes, and that well over half of men over age sixty have traces of prostate cancer but no impairment, Welch reveals overdiagnosis to be rampant for numerous conditions and diseases, including diabetes, high cholesterol, osteoporosis, gallstones, abdominal aortic aneuryisms, blood clots, as well as skin, prostate, breast, and lung cancers.

With genetic and prenatal screening now common, patients are being diagnosed not with disease but with "pre-disease" or for being at "high risk" of developing disease. Revealing the economic and medical forces that contribute to overdiagnosis, Welch makes a reasoned call for change that would save us from countless unneeded surgeries, excessive worry, and exorbitant costs, all while maintaining a balanced view of both the potential benefits and harms of diagnosis. Drawing on data, clinical studies, and anecdotes from his own practice, Welch builds a solid, accessible case against the belief that more screening always improves health care.

Product Details

ISBN-13: 9780807022016
Publisher: Beacon Press
Publication date: 01/18/2011
Sold by: Penguin Random House Publisher Services
Format: NOOK Book
Pages: 248
Sales rank: 616,064
File size: 3 MB

About the Author

Dr. H. Gilbert Welch is a professor at Dartmouth Medical School and a nationally recognized expert on the effects of medical testing. He has been published in the Los Angeles Times, New York Times, Washington Post, and Wall Street Journal, and has appeared on Today. In 2009, he received the Under Secretary's Award for Outstanding Achievement in Health Services Research.

Drs. Lisa Schwartz and Steven Woloshin are associate professors at Dartmouth.

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Overdiagnosed 4.1 out of 5 based on 0 ratings. 11 reviews.
EGHunter01 More than 1 year ago
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.
Horsewoman More than 1 year ago
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.
nancyrobertson More than 1 year ago
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.
pillcounterBH More than 1 year ago
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.
Anonymous More than 1 year ago
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!!
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