- By H. Gilbert Welch

Overdiagnosed: Making People Sick in the Pursuit of Health

  • Title: Overdiagnosed: Making People Sick in the Pursuit of Health
  • Author: H. Gilbert Welch
  • ISBN: null
  • Page: 424
  • Format: Kindle Edition
  • Overdiagnosed Making People Sick in the Pursuit of Health From a nationally recognized expert an expos of the worst excesses of our zeal for medical testingGoing against the conventional wisdom reinforced by the medical establishment and Big Pharma that scr

    From a nationally recognized expert, an expos of the worst excesses of our zeal for medical testingGoing against the conventional wisdom reinforced by the medical establishment and Big Pharma that screening is the best preventative medicine, Dr Gilbert Welch builds a compelling counterargument that what we need are fewer, not , diagnoses Documenting the excesseFrom a nationally recognized expert, an expos of the worst excesses of our zeal for medical testingGoing against the conventional wisdom reinforced by the medical establishment and Big Pharma that screening is the best preventative medicine, Dr Gilbert Welch builds a compelling counterargument that what we need are fewer, not , 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 and 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 screening always improves health care.

    1 thought on “Overdiagnosed: Making People Sick in the Pursuit of Health

    1. First-World problems.If you’ve been led to believe that it’s a good idea to get an annual physical checkup even though there’s nothing wrong with you, you need to read this book. The idea that it’s beneficial that we subject ourselves to tests and screenings, which are judged based on sometimes arbitrarily-set numerical criteria, only to look for problems that do not yet exist or have not shown up yet as symptoms is a pseudo-scientific hoax that is promulgated by those who want to sell y [...]

    2. Overdiagnosed: Making People Sick in the Pursuit of Health challenges the current mindset that it's always desirable and beneficial to obsessively screen healthy people for potential illnesses. Dr. Welch describes how actively pursuing illness in healthy people can actually be harmful to the patient. Why is it bad to discover that people have diseases they don't know about and that have yet to create any symptoms? A few reasons are:1) The medical-industrial complex continually lowers the numbers [...]

    3. A very clear, well-reasoned, reader friendly, evidence-based argument for the view that preemptively hunting for health problems in asymptomatic people through routine screenings and tests, and lowering diagnostic thresholds (as has been done with high blood pressure, cholesterol, and diabetes), is not in the best interests of the vast majority of people. Many such early-intervention strategies do not lower the number of deaths from those diseases, result in false positives and overtreatment, an [...]

    4. This book is a lot better and more accurate than you would think. I happened upon it at the library. After looking at it for a week I was super bored and read it. Could not put it down! It explains how diagnostic tests have shifted (high cholesterol is now 200 and over where before it was 240 and over) after studies (paid for by drug companies-often) determined a lower threshold was needed. It also discusses how if you get enough tests you are bound to find something and that sometimes the treat [...]

    5. More than 35 years ago my father died, too young, from pancreatic cancer. I learned at a young age that there were benign tumors and malignant tumors but I've always held the belief that if I have cancer in my body I want it removed. And sooner rather than later. And I would want to know as soon as possible. Over the years I've heard that there were controversies about screening for and treating prostate and breast cancer. (These are discussed in the book and presented very well.) Who wouldn't w [...]

    6. Dr. Welch was involved in an experiment in which a group of men who had had heart attacks were split into two groups, one of which was equipped with devices to measure irregularities & the other which was given the usual regular checkups. The experiment was discontinued when the researchers found that the device-equipped group received more treatment & died in greater numbers. This got the author looking for similar medical treatment phenomena. If a form of cancer has become much more co [...]

    7. The biggest fault of this book is probably the tendency of the author to repeat himself rather a lot, both in explaining what he means and what he does not mean to say. But you can understand that because of the severe risks to his readers of misinterpretation of his message, or to himself if others looking to sue him were to misconstrue what he is saying.Welch has an important point to make - I won't bore you with a restating of what that point is, as you will have read about it already to get [...]

    8. Underwhelming. The entire book demonstrated how over-diagnosis is harmful when seeking out diseases that are asymptomatic. Welch, also dismisses the financial incentives within the market to seek diagnosis and to treat early. Lastly, he was completely silent as to how health reform provisions (if the Supreme Court doesn't shut it down) will actually curb over-diagnosis and realign incentives towards health promotion and prevention.

    9. I've always liked technical papers that have a graphic in them that summarizes the whole paper. Dr. Welch and his coauthors' sobering look at over-diagnosis can be summarized with one graph that they present in the opening chapters:We've been screening for more and more in asymptomatic patients in the last 50 years, based on the premise that it would be better to catch things early and treat them. So, have patient outcomes improved? After several million people have been affected by this onslaug [...]

    10. Everyone should read this book, but I fear that few will. Partly because it is perceived as a difficult topic. No worries there: Dr. Welch and his co-authors make this as easy and straightforward a read as possible. Even if you barely passed high school biology or math, you'll have no problems here: the science is simple, the statistics are very clearly explained.Another reason folks might not read this is that they are comfortable delegating their personal health decisions to physicians. The fa [...]

    11. 'Overdiagnosed' is, without a doubt, an important book. It convincingly shows that if we look harder for a disease, we find more "abnormalities" but we're not preventing any deaths. Instead, the more people are subjected to unneccesary medical procedures, which can be just scary, expersive and annoying but also debilitating or even lethal. The authors explains how this happens with great clarity. Let's say, as an example, that each year a hundred women find a lump in their breast. They go and se [...]

    12. I found myself feeling dubious about some of the claims. I also found myself wishing for more detail. Basically, the concept is that doing hunting expeditions for diseases isn't a good idea. He is all for what he calls diagnostic screening: if the patient goes to the doctor with a lump or something. He is very opposed to screening being done routinely and explains why in convincing detail. I'm just not completely convinced. My father in law was diagnosed with colon cancer after getting a toilet [...]

    13. If you are interested in America's health care system, you should read this book. The authors are practicing physicians and bring both real world experience and an MD level understanding of clinical trials. We are moving from treating sick people that have definite symptoms to looking at healthy people with no symptoms in the hope that "early detection" will prevent sickness. With the advent of MRIs and CT scans, we are able to see much more than ever before. The cut offs for diagnosing high blo [...]

    14. Overdiagnosed : Making People Sick in the Pursuit of Health (2012) by H Gilbert Welch describes how diagnosing people without symptoms is a serious problem with modern health systems.Over diagnosis is definitely a problem. Prostate screening and over diagnosis is accepted by many, perhaps most medical researchers as a serious problem. Screening in other areas is also seen as something that can cause real harm. Making abnormal physical characteristics diseases is definitely unwise. The incentives [...]

    15. After hearing Dr. Welch give this presentation I immediately went out and got the book. He does a convincing way of presenting data to support his premise without putting one to sleep. I feel his conclusions are well reasoned and logical and appreciate his suggestions regarding 'what now'. You can see his presentation on You Tube youtube/watch?v=C-Dnz. If this message resonates with you then I'd suggest you read The End of Illness and Our Daily Meds. Both books lend themselves to this line of th [...]

    16. This book was really interesting considering the direction American healthcare is taking, namely spending more and more money but doing nothing to actually improve quality of life. I mainly picked it up because there was a chapter about ultrasound and fetal monitoringturned out this was the shortest chapter but worth reading. The author had a degree in economics before going to med school so his perspective was unique. My main complaint is how frequently the author repeated catch phraseswe get i [...]

    17. I'd seen a few of Dr. Welch's interviews online (and enjoyed them) before reading this, and as a patient of Dr. John McDougall I was already well versed in the insidious risks of overdiagnosis - and have been an unwitting victim of it myself several times. Dr. Welch's book is an important read - because truly informed consent is so often lacking, while aggressive marketing of highly questionable "early detection" testing and other procedures is pervasive. I liked Dr. Welch's eloquent summary on [...]

    18. I have experienced overdiagnosis. It caused me emotional and mental stress (high) and financial stress (moderate) for an unnecessary surgery. The zeal for early diagnosis and treatment did not serve me well and I will think hard before going down that path again. This book was excellent to open my eyes to a different paradigm and gain more balance in how to approach my health. I really recommend it. I enjoyed the Audible version.

    19. This book presents some interesting ideas, and it certainly made me feel like a Monday-morning quarterback about some of my recent health decisions. Some of the writing feels a bit redundant, but dividing the chapters by conditions helps to keep things moving. A solid 3 1/2 stars.

    20. Really good book to help negotiate one of the many areas of difficult decisions regarding healthcare. Doesn't just give you data, but promotes different perspectives on how to analyze and interpret the data, and the difference between good and flawed data.

    21. The want to know versus the need to know. Nicely balances the concerns about over testing with the benefits of early detection. Always a two edged sword

    22. A timely look at how the medical profession is over diagnosing patients. It is time to start questioning why some tests are really necessary.

    23. Interesting views on routine testing, and worth pondering and revising. But if taken too literally, seems like dangerous advice.

    24. Sometimes I shy away from medical books as they can be dry and do nothing but spew statistics. This book is not at all like that, although there is lots of medical information and stats to back it up, it's easy to consume without being a doctor.The overall position of the book is that technological advances in screening as well as shifting opinions in how preventative medicine is viewed have lead to an epidemic of over diagnosis. That over diagnosis in turn leads to numerous highly negative impa [...]

    25. I totally agree with the author that the medical system seems to overdiagnose the patients. The benefits and the bad effects from over-diagnosed process could be put side by side to compare.With more and more sophisticated devices that we invented, we tend to be able to discover many diseases much earlier than they could actually affect our health.Welch gave us several real cases to let us see the terrible chain effect after overdiagnosed patients took following treatments, the allergic or infla [...]

    26. I'd heard a lot about the contents of this book, so I wanted to read it for more depth.It's not surprising that we find more health anomalies if we look for them. What surprised me was the moving of the bar for anomalies, which, although not mentioned in the book, seems to be coincident with the release of new and profitable drugs. hmmmm I'm not claiming a correlation or a causation, it's just an observation.

    27. While this book delivers what I believe to be a very important message, it makes its point within the first 7 or 8 chapters. After that it simply becomes repetitious. I found it well worth reading for those initial chapters, but I found myself skimming the next few chapters and not reading the rest, except to verify that they gave so little new information.

    28. Mandatory reading for anyone living in the US, much of the information discussed in the book is good to have before you need it. Clear, concise examples of how the medical system, and fees, and "normal values" are stacked in a way that is not transparent for us the actual patients (or customers).

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