by Dr. H.Gilbert Welch
Dr. Welch lists seven assumptions: 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; It’s all about avoiding death.
Then he masterly lampoons them all.
Yes, this is mostly about health and medical results; however all the things we shouldn’t be doing cost a lot of money. Dr. Welch is generally against screening tests—mammograms and prostate exams particularly. Most growths found are not worth finding. He names cancer types: turtles, which grow so slowly, they’ll never cause you a problem unless you’re diagnosed with one—then the patient will endure worthless medical procedures and suffer emotionally.
The next cancer is a rabbit—if they find it, yes, that would be good, but they’re a small part of the problem and can be diagnosed from symptoms. Then there are birds, ones that spread so fast that it doesn’t make any difference, because they’re really lethal—these are frequently found in young women who don’t even get mammograms.
Because of the way the body works, we all have turtles and the body coexists, as long as no doctors find it. Whatever you do, consider potential benefits and potential harms. Basically, if you have no symptoms, let the sleeping dog lie.
This is an easy, quick read with plenty of humor. Let’s be clear: medical procedures, even if all goes well, are horrible and degrading. The New York Times had an op-ed on colonoscopies—which are recommended not doing after age 75 or so. The prep is nasty, and the elderly can faint just from the prep. The New York Times has a comment section and one person wrote, “What’s the big deal about fainting if you can cure cancer?” The big deal is that people don’t faint on cue—they might be driving, fall down stairs, or just fall and cause a concussion. Those are real, known risks that are often fatal. Besides, there are alternatives, such as stool tests—gross, but not life-threatening.
I highly recommend this book, as it informs the reader on the issue of the high cost of health care.
