Nortin M. Hadler
Forfatter af Worried Sick: A Prescription for Health in an Overtreated America
Om forfatteren
Nortin M. Hadler has lectured widely in North America and abroad and testified before the U.S. Congress and U.S. Social Security Board
Værker af Nortin M. Hadler
The Citizen Patient: Reforming Health Care for the Sake of the Patient, Not the System (2013) 8 eksemplarer
Poignardé dans le dos : Affronter le mal de dos dans une société surmédicalisée (2011) 3 eksemplarer
Patient et citoyen : réformer le système de santé dans l'intérêt du patient et non du système (2014) 3 eksemplarer
Repenser le vieillissement : vieillir et bien vivre dans une société surmédicalisée (2013) 2 eksemplarer
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Statistikker
- Værker
- 13
- Medlemmer
- 191
- Popularitet
- #114,255
- Vurdering
- 3.8
- Anmeldelser
- 5
- ISBN
- 39
- Sprog
- 1
I read this several days ago, and had put so many book darts in the book that I was too intimidated at the thought of collecting the notes from them all, until now, to face writing the review.
And,
I have no idea why some reviewers say this is challenging or dry or a slog. I found it very easy to read & to understand. Good science, clearly & directly written.
So, the other reviewers did most of the work for me, as it turns out. Basically, yes, the premise is that we should treat only those conditions that are proven treatable, and that, if left untreated, would be very likely to kill us before age 85 or our personal determined lifespan, whichever comes first.
So, for an example probably common to many of us, don't take statins for cholesterol if you're a decade or so from death anyway. They'll just make your last years more miserable, and, besides, cholesterol levels are a marker only, high cholesterol is not in & of itself a disease.
He also points out that normalizing glucose levels of those with Type II diabetes is not proven to be effective in helping them avoid complications of diabetes or death. And he therefore refuses to prescribe to his patients any oral hypoglycemics.
He is absolutely incensed that angioplasties and stents are still performed, after numerous studies have shown *no* benefits to patients.
One thing he discusses at length applies to anyone reading any sort of scientific or even economic report, really, any statistics. Absolute risk is very different from relative risk. Be sure you understand ratio measures, odds ratios, etc., so that you don't get suckered by a campaign that says '50% reduction.' If the numbers are 6/10,000 and 3/10,000, it's a 50% reduction, sure. But the odds are, really, that you're one of the other 9,994 and so you don't need that expensive medicine or that risky surgery.
He's never had his cholesterol checked. Here's why:
To restate the mantra, one never wants to submit to screening unless the test is accurate, the disease is important, and we can do something about it."
The mantra applies to testing of Bone Mineral Density - "Screening by BMD for the risk of fragility fractures fails on all scores. It is basically an expensive way to ask ask a thin white or Asian woman her age." The story of the patient overtreated for her fragility fracture is both appalling and heartbreaking.
And just one more example (many more in the book; read it yourself!), of treating natural consequences of aging as if they are curable diseases:
"Do not assume that because these joint hurt, they are damaged.
Do not assume that whatever osteoarthritis is present is the cause of the joint pain.
Do not assume that the joint pain is the cause of the compromise in mobility or quality of life."
Can't get much clearer than that, can you?
And now I'm off to read one of his other books, Worried Sick.
"… (mere)