Overdiagnosed: Making People Sick in the Pursuit of Health
January 24, 2011
Health is much more than not being able to find something wrong. It’s how people feel, it’s a state of mind. And it’s hard to feel good when things are constantly being found wrong with you. But we are moving towards a [notion of] health that means the absence of any abnormalities. That’s not a good definition.-- Dr. H. Gilbert Welch, Wall Street Journal Health Blog Q&A
Diagnoses of every condition, from high cholesterol and high blood pressure to osteoporosis, diabetes, and even cancer, have skyrocketed over the last few decades. Yet Americans are living longer than ever. While the medical establishment credits aggressive early disease detection as the cause of improved public heath, it is in fact the reason so many of us are told we are sick. Going against the conventional wisdom that more screening is the best preventive medicine, Dr. H. Gilbert Welch builds a compelling counterargument that what we need is fewer, not more, scans and tests.
Drawing on twenty-five years of medical practice and research on the effects of screening, Welch explains how the cutoffs for "abnormal" test results have been drastically lowered while at the same time technological advances have enabled doctors to detect more and more "abnormalities," many of which will pose no health complications. Now, with genetic and prenatal screening common practice, patients are increasingly being diagnosed not only with disease but with "pre-disease."
Examining the social, medical, and economic ramifications of a health care system that unnecessarily diagnoses and treats patients, Welch makes a reasoned call for change that would save us from countless unneeded surgeries, debilitating anxiety, and exorbitant costs.
Read Dr. H. Gilbert Welch at CNN.com discussing the negative ramifications of a blood test for cancer.
Overdiagnosed by Dr. H. Gilbert Welch, Dr. Lisa Schwartz, and Dr. Steven Woloshin, Excerpt