Less Medicine, More Health: 7 Assumptions That Drive Too Much Medical Care

Less Medicine, More Health: 7 Assumptions That Drive Too Much Medical Care

H. Gilbert Welch / Dec 07, 2019

Less Medicine More Health Assumptions That Drive Too Much Medical Care The author of the highly acclaimed Overdiagnosed describes seven widespread assumptions that encourage excessive often ineffective and sometimes harmful medical care You might think the biggest prob

  • Title: Less Medicine, More Health: 7 Assumptions That Drive Too Much Medical Care
  • Author: H. Gilbert Welch
  • ISBN: 9780807071649
  • Page: 381
  • Format: Hardcover
  • The author of the highly acclaimed Overdiagnosed describes seven widespread assumptions that encourage excessive, often ineffective, and sometimes harmful medical care 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 centThe author of the highly acclaimed Overdiagnosed describes seven widespread assumptions that encourage excessive, often ineffective, and sometimes harmful medical care 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 It s not to 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 So medicine does not equal health in reality the opposite may be true The general public harbors assumptions about medical care that encourage overuse, assumptions like it s always better to fix the problem, sooner or newer is always better, or it never hurts to get information Less Medicine, More Health pushes against established wisdom and suggests that medical care can be too aggressive Drawing on his twenty five years of medical practice and research, Dr Welch 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, important, improve health outcomes for us all.

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      Published :2019-09-24T19:55:28+00:00

    About "H. Gilbert Welch"

      • H. Gilbert Welch

        H. Gilbert Welch Is a well-known author, some of his books are a fascination for readers like in the Less Medicine, More Health: 7 Assumptions That Drive Too Much Medical Care book, this is one of the most wanted H. Gilbert Welch author readers around the world.


    1. As an emergency physician my job mostly involves reassuring people that they DON'T have a serious illness when they're worried that they DO. Many simply aren't satisfied unless I've ordered a lot of "tests." This is not simply my opinion--many studies bear this out as true. Doing less is very difficult when all the incentives point to doing more. I believe over-testing, over-diagnosis, and over-treatment are the real causes behind America's abysmal track record. We spend nearly twice as much per [...]

    2. I once had a wonderful physician who used to tell me, "I'll give you my medical-legal opinion and then I'll tell you what I think." She taught me to always ask doctors to think a bit more about their recommendations. If the test is positive, what would we do differently? What are the possible secondary consequences? What happens if we do nothing?Dr. Welch, a primary care physician, has given us a thoughtful but radical critique of common medical practices, based on epidemiological statistics. In [...]

    3. About a year ago, I found the book "Overdiagnosed: Making People Sick in Pursuit of Health". Upon hearing the audiobook I felt I had finally found an author who shared my opinion on the screening and diagnoses made in health care.This new book by Welch seems to be directed to the general population. It is less detailed and technical, and the tone is lighter. However, I would recommend it also to all who provide health care.The author discusses many of the myths that patients and carers have in r [...]

    4. As a retired lab tech grunt who toiled away trying to do justice to the tons of specimens submitted for long lists of tests that are ordered by Physicians, I can assure you that more testing is definitely not leading to better care. Welch is a wise physician and I hope his critical view of testing clears the benches of many of those stupid, trivial test requests that we get in the lab. Cut out the cover-your-butt off-the-wall test requests and all of us will benefit-particularly the patient who [...]

    5. I loved this book. I have been a practicing Optometrist for 41 years and I learned a lot. Dr. Welch wrote this book for the general public but I would recommend it be read by everyone in health care. I am from the little town in western Pennsylvania -Donora - that had the killer smog in 1948 that he references in the book so this resonated a little more with me.Primarum non nocere-"first do no harm" is the mantra of all in health care. But as Dr. Welch painfully points out," the only Doctor that [...]

    6. I thoroughly enjoyed reading this very sensible discussion about interacting with the healthcare system in such a way that you avoid having your life become unnecessarily medicalized. An once of "prevention," in the form of screenings and tests for the asymptomatic, all too often leads to worse health outcomes rather than better ones. I recommend it.

    7. This review was written for LibraryThing Early Reviewers. 4.5 stars.Lately I have been taking the time to read a few books on health/nutrition every year so that I am better informed about decisions I make for my well being. This book was a worthy first choice for 2015.The author basically makes the case for less medical intervention for non-acute medical care and end of life situations. I've always thought that nature more or less knows best, and people need to get out of the way of nature when [...]

    8. The first time I've ever had the statistics used when describing medical probabilities. The power to ignore anything under a 100% increase is a huge gift.

    9. I just finished Less medicine, more health: 7 Assumptions that Drive Too Much Medical Care , and heartily recommend it! The seven assumptions are All Risks can be Lowered, It's always better to Fix the problem, Sooner is Always Better, It never hurts to get more Information, Action is always better than inaction, Newer is Always Better, and It's all about Avoiding Death. Notice those "always" and "never"s? Dr. Welch does recognize that every situation is different and sometimes our new technolog [...]

    10. o much medical care has too little value.I am not a doctor nor do I work in the healthcare industry. I'm just an ordinary U.S. citizen who happened to wonder about many of the assumptions Welch addresses in Less Medicine, More Health, which is why I requested a copy.Welch's writing style was conversational and easy to understand. While there were significant amounts of data and stats discussed as well as medical terminology, at no point did I feel like he was talking over my head. He also succee [...]

    11. I grabbed this book at the ALA Midwinter Meeting because it seemed right up my alley. And I was correct! About a year ago I read “How We Do Harm,” written by Otis Brawley--the Chief Medical Officer of the American Cancer Society. He was the first perspective I’d read on the potential harms of screening for different types of cancers, and it blew me away. While this book isn’t entirely about screening for cancer, it certainly addresses it, and I feel like everyone should read this importa [...]

    12. This book caught my eye because the title sums up my own philosophy in a nutshell. With eloquence and humour Dr.Welch states the case for his belief that too many people are being made to worry about diseases they don't have and are at only average risk to get, too many people are being tested and exposed to the harmful effects of the testing process, and too many people are being sub jected to treatments they don't need or cannot benefit from.Below I list the seven assumptions Dr. Welch covers [...]

    13. from the libraryLESS MEDICINE, MORE HEALTH7 Assumptions That Drive Too Much Medical CareAuthor: Dr. H. Gilbert WelchCONTENTSINTRODUCTION: Our enthusiasm for everything medical ixASSUMPTION #1: ALL RISKS CAN BE LOWERED 1Disturbing truth: Risks can’t always be lowered—and trying creates risks of its ownASSUMPTION #2: IT’S ALWAYS BETTER TO FIX THE PROBLEM 28Disturbing truth: Trying to eliminate a problem can be more dangerous than managing oneASSUMPTION #3: SOONER IS ALWAYS BETTER 51Disturbin [...]

    14. I'm glad I read this at this time! I may be needing to make a decision about cochlear implants in the near future and I think this book will help me with the decision. I'm also reminded how I got hounded and nagged into allowing my wisdom teeth to be removed and I really wish I hadn't done so. I was sick for two months after that surgery and there was no good reason to remove them. Welch says only get them removed if there is pain and there wasn't any pain. GRRRRR. It got me into trouble at work [...]

    15. Wow! This is a great book for any of us at any age. It is so easy to fall into old assumptions that are not valid. Dr. Welch is a physician on the faculty of Dartmouth Medical School. He counters some ideas that most of us have such as the sooner you are treated, the better. This is not to say that you should ignore physical or emotional problems but you do not always have to rush to get some things "healed." Best of all like a good academic professor, Dr. Welch provides the source of all he ass [...]

    16. Interesting book written by Dr. H. Gilbert Welch, a nationally recognized expert on the effects of medical testing, who is an academic physician at Dartmouth Medical School. His premise is that doctors should only do things that stand up to the rigors of quantitative review for example he feels that many tests given patients are likely to cause unnecessary procedures to be performed, that research as proven are unnecessary and possibly more harmful. He debunks 7 common assumptions about practice [...]

    17. The author gives real-life stories of how medicine has gone awry by being driven by the payer driven healthcare system we have in place today. Jonathan Bush points out the eagerness of the dollar over the health of the patient. Robert Morgan in his book about Daniel Boone gives us the realization that we need to return to understanding and accepting the gift of a beautiful death. This book gave some insightful strategies from a physician's point of view as to how our payment system has drifted s [...]

    18. Since I agree with all the ideas in this book, and have for many years, of course I thought it was terrific. I particularly appreciated the correct presentation of statistics (yes, correct statistical methodology is one of my soapboxes). Most doctors are sadly ignorant of statistics and use metrics in ways that can be harmful. So, getting down off the soapbox, other good things are: the book is written in a pleasant, conversational style, it's an easy, fast read, and if you're fussy there is a c [...]

    19. Practical and convincing information for the layperson about complicated medical issues. Welch, a GP, addresses such question as: (1) Under what conditions is health screening valuable? (2) When is a "risk factor" worth paying attention to? (3) When is medical treatment likely to be helpful and when is it likely to be harmful? Etc.I checked this book out of the library to read it, but am thinking I should buy it, to have on hand as a sanity check and confidence builder when up against medical au [...]

    20. Extremely important book that I wish everyone would read. Welch -- a Dartmouth medical school professor, internist at the VA Medical Center in White River Junction, VT, and a medical researcher -- looks at the beliefs physicians and patients have that lead them to make poor decisions concerning medical care and provides evidence to show why we are mistaken. He makes convincing arguments that risks can't always be lowered and trying to do so creates risks of its own; trying to eliminate a proble [...]

    21. I agree with the idea and enjoyed his humour. I felt it belaboured the point a bit. But, no chemotherapy or mammograms for me!

    22. I'm really glad I read this. There is a lot of useful information in it for anyone who is wondering why their doctor is insisting on certain tests when there are no symptoms.

    23. I recommend this book. Even if you don't agree with it all, I think it'll help you worry less about the deluge of medical advice and new findings that the media overwhelms us with constantly. I've been skeptical about the idea that screening mammograms may be overdone, because my own breast cancer was an invasive 3.5 cm stage 2 tumor when it was found on a screening mammogram. It wasn't palpable even to my doctor a few weeks before that because it was so close to the chest wall in very dense bre [...]

    24. This book reinforced some basic beliefs of mine - the the more medical care you receive, the worse your health becomes, provided you take care of yourself with proper diet and exercise. In these days of rationing healthcare, self-rationing of medical services is beyond wise. Here are my favorite quotes/summations of the material in the book:"Medical care can be extremely valuable. But that does not imply it is routinely valuable. Because of the dramatic impact medical care can have on human heal [...]

    25. The older I get, the more I question the 'wisdom' of Western medicine, particularly the almost unavoidable 'preventative care' that Americans have shoved down their throats at every opportunity. My husband's employer's recent decision to institute a 'wellness' program that utilizes a carrot and stick approach - participate in these activities we have decided are good for your health (health questionnaires, screenings, annual physicals, exercise programs, etc.) and you'll be rewarded; otherwise, [...]

    26. Alright, so here's my take on this book. It's well written and easy read. The target reader is most likely a non-medical professional. The author makes valid points about overuse to screenings in medicine and treating abnormalities rather than disease. We think more data about our health is a good think but it's not. We have seen a surge in technologies that promises to give us real time information about our physiology and people are flocking to buy such gadgets but more data is not necessarily [...]

    27. Great educational book for both patient's and doctors. He hits a lot of good topics that are common misconceptions in healthcare. It is written very clearly with many examples. He also likes to make jokes every now and then, so it is light-hearted and can be entertaining. I really liked how he points out that healthcare shouldn't be about living as long as you can, but having the best life that you can. Also that he mentions the best thing you can do for your health is the basics of eating good [...]

    28. We all need to read this book or others that question our current approach to health care. If one can't evaluate the benefits and risks of screenings and treatments, one is susceptible to the over caution of some physicians, the chance that a normal condition will be treated as illness, and the costs of screenings, treatments and drugs that may do more harm then good. Making the right choice is hard, but information can only help us in the decision making process. This book is one introduction t [...]

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