An exposé on Big Pharma and the American healthcare system’s zeal for excessive medical testing, from a nationally recognized expert More screening doesn’t lead to better health—but can turn healthy people into patients. 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 25 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% of 2,000 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.
A nationally recognized expert describes seven widespread assumptions that encourage excessive, ineffective, and sometimes harmful medical care—for readers of Overdiagnosed and Malcolm Gladwell 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. He doesn’t 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. More medicine does not equal more health; in reality the opposite may be true. In Less Medicine, More Health, Dr. Welch pushes against established wisdom and suggests that medical care can be too aggressive. Drawing on his twenty-five years of medical practice and research, he 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.
Every day we are bombarded by television ads, public service announcements, and media reports warning of dire risks to our health and offering solutions to help us lower those risks. But many of these messages are incomplete, misleading, or exaggerated, leaving the average person misinformed and confused. Know Your Chances is a lively, accessible, and carefully researched book that can help consumers sort through this daily barrage by teaching them how to interpret the numbers behind the messages. In clear and simple steps, the authors—all of them staff physicians at the Veterans Administration Medical Center in White River Junction, Vermont—take the mystery out of medical statistics. By learning to understand the medical statistics and knowing what questions to ask, readers will be able to see through the hype and find out what—if any—credible information remains. The book's easy-to-understand charts will help ordinary people put their health concerns into perspective.This short, reader-friendly volume will foster communication between patients and doctors and provide the basic critical-thinking skills necessary for navigating today's confusing health landscape.
Have you ever been stumped trying to understand what a judge, breeder or dog fancier is saying about a dog? Or been utterly confused when reading a Breed Standard? What is meant by “butterfly nose,” “fish hook front” or “crabbing?” Encyclopedia of K-9 Terminology to the rescue! Veteran AKC judges and breeders Ed Gilbert and his wife Pat Gilbert have pulled together every conceivable term applied to dogs to aid experts and amateurs alike to help all understand and correctly use the language of the sport.
This anthology of literary criticism is no simple collection of fragments from great critics. It is, in a way, a documentary history of literary taste, or better, a documentary history of the taste of literary critics ... It contains material that is inaccessible in many university libraries and an index which ties together the various selections and gives the book a unity which most anthologies unfortunately lack ..." [Cover].
This ground-breaking study of cross-cultural theatre in the Australasian region focuses on theatrical events and practices in avant-garde and mainstream contexts. It explores the cultural and political dimensions of Australia's engagement with Asia and sheds light on international arts marketing and trends in cross-cultural performance training.
Based on research findings and detailed, original cases, this book charts the new innovation imperative, where organizations must deliver on dual goals: an efficient return on current operations, and a burgeoning pipeline of new products. It argues that the two pursuits cannot be achieved through a bland compromise, or by switching priorities back and forth. Only a ‘dual’ organization capable of amplifying the tension can optimize efficiency while seeding innovation. Reinventing Innovation examines the nature of dual organizing, presents a series of in-depth cases to reveal its principles, and explains how to fortify organizations with ‘ambidexterity’ capabilities. Ideal for tertiary students, academics, and practitioners, Reinventing Innovation contains a rich balance of theoretical principles, case insights, and practical guidance.
At last, GPs and practice managers have a clear reference on all matters relating to practice finance. Now the need could not be greater - as primary care continues to evolve, more staff are employed and new services are offered. Sound financial management is essential if pitfalls are to be avoided. Written by specialists in the increasingly complex area of practice finance, this book provides a readily-accessible guide for non-specialists, providing answers to routine queries and illustrating typical situations with worked examples.
This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant.
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