INTRODUCTION: Our enthusiasm for everything medical
ASSUMPTION #1: ALL RISKS CAN BE LOWERED
Disturbing truth: Risks can’t always be lowered—and trying creates
risks of its own
ASSUMPTION #2: IT’S ALWAYS BETTER TO FIX THE PROBLEM
Disturbing truth: Trying to eliminate a problemcan be more
dangerous than managing one
ASSUMPTION #3: SOONER IS ALWAYS BETTER
Disturbing truth: Early diagnosis can needlessly turn people into
patients
ASSUMPTION #4: IT NEVER HURTS TO GET MORE INFORMATION
Disturbing truth: Data overload can scare patients and distract
your doctor from what’s important
ASSUMPTION #5: ACTION IS ALWAYS BETTER THAN INACTION
Disturbing truth: Action is not reliably the “right” choice
ASSUMPTION #6: NEWER IS ALWAYS BETTER
Disturbing truth: New interventions are typically not well tested
and oft en wind up being judged
ineffective (even harmful)
ASSUMPTION #7: IT’S ALL ABOUT AVOIDING DEATH
Disturbing truth: A fixation on preventing death diminishes
life
CONCLUSION: Seeking medical care is not the most important thing
you can do for your health
Acknowledgments
Notes
Index
Dr. H. Gilbert Welch is an academic physician, 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. Dr. Welch is the author of three previous books, including the highly acclaimed Overdiagnosed. He lives in Thetford, Vermont.
“Avoiding medical jargon, Welch speaks directly to the layperson
and focuses on certain assumptions that have increased consumption
in a market-driven society; some of which have become so ingrained
by popular media that refuting them seems downright
scandalous… Welch’s words, though wise beyond money, border on
sacrilege in a country of generally healthy people who have
developed an expensive health-care habit and who are expected to
support a lucrative health-care industry. Welch’s conversational
style makes his prescription for better health an easy pill to
swallow.”
—Booklist, starred review
“A bright, lively discussion of the excesses of medical care to
which patients often unwittingly go due to certain false
assumptions… Welch demonstrates the flaws in these
assumptions. His stories involve the risks, uncertainties and harms
of cancer screenings, treatments for heart disease, drugs, medical
devices and surgical procedures. He makes an especially strong case
for the risks of mass screenings for cancer—the fear, the false
alarms, the overdiagnoses and the resulting overtreatments. Vivid
images make what could be discouragingly technical quite
understandable… Welch's engaging style and touches of humor
make this an easy read, and the facts he presents make a convincing
case.”
—Kirkus Reviews
“Read this book. It is smart, witty, wonderfully written, and above
all wise. We've overmedicalized life and yet we need medicine
throughout our lives. No one explains better when we do, when we
don't, and why.”
—Atul Gawande, author of Complications and Being Mortal
“Wise, witty, fascinating and alarmingly persuasive—this is a
book everyone should read, especially my doctor.”
—Bill Bryson, author of A Short History of Nearly Everything
“With the style of a trustworthy country doctor, Welch, an academic
heavyweight, urges us to reject the allure of reducing all health
risks by using the latest technology to gather all the data and to
fix the problems sooner rather than later. Showing the dangers of
our ill-informed enthusiasm for medicine, he brilliantly builds the
case for respecting its power and limitations: to seek it when ill
and all but avoid it when healthy.”
—Victor M. Montori, MD, Professor of Medicine, Mayo Clinic
“Gil Welch's latest book shows us exactly how too much medical care
can be harmful and even deadly. This is a needed corrective
to the American attitude that the more screening and testing, the
healthier we will be.”
—Marcia Angell, author of The Truth About Drug Companies
“Its title, ‘Less Medicine, More Health,’ sums up his
trenchant, point-by-point critique of test-based health care and
quality control.”
—New York Times
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