The author of the highly acclaimed Overdiagnosed describes seven
widespread assumptions that encourage excessive, often ineffective, and
sometimes harmful medical care. You might think the biggest problem in
medical care is that it costs too much. Or that health insurance is too
expensive, too uneven, too complicated--and gives you too many forms to
fill out. But the central problem is that too much medical care has too
little value.
Dr. H. Gilbert Welch is worried about too much medical care. It's not to
deny that some people get too little medical care, rather that the
conventional concern about "too little" needs to be balanced with a
concern about "too much": too many people being made to worry about
diseases they don't have--and are at only average risk to get; too many
people being tested and exposed to the harmful effects of the testing
process; too many people being subjected to treatments they don't
need--or can't benefit from. The American public has been sold the idea
that seeking medical care is one of the most important steps to maintain
wellness. Surprisingly, medical care is not, in fact, well correlated
with good health. So more medicine does not equal more health; in
reality the opposite may be true. The general public harbors assumptions
about medical care that encourage overuse, assumptions like it's always
better to fix the problem, sooner (or newer) is always better, or it
never hurts to get more information. Less Medicine, More Health pushes
against established wisdom and suggests that medical care can be too
aggressive. Drawing on his 25 years of medical practice and research,
Dr. Welch notes that while economics and lawyers contribute to the
excesses of American medicine, the problem is essentially created when
the general public clings to these powerful assumptions about the value
of tests and treatments--a number of which are just plain wrong. By
telling fascinating (and occasionally amusing) stories backed by
reliable data, Dr. Welch challenges patients and the health-care
establishment to rethink some very fundamental practices. His
provocative prescriptions hold the potential to save money and, more
important, improve health outcomes for us all.
