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Rethinking Aging: Growing Old and Living Well in an Overtreated Society 1st Edition

21 customer reviews
ISBN-13: 978-0807835067
ISBN-10: 0807835064
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Rethinking Aging: Growing Old and Living Well in an Overtreated Society + The Citizen Patient: Reforming Health Care for the Sake of the Patient, Not the System (H. Eugene and Lillian Youngs Lehman)
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Editorial Reviews


A book for all readers entering the aging years, especially those who wish to avoid unnecessary and futile tests and procedures . . . . Rethinking Aging is a sobering book, calling for a careful and blunt dialogue about end-of-life and aging issues. It should evoke much discussion and debate about the proper application of medicine and surgery in the aging population.--Clifton K. Meador, MD, JAMA

[Hadler's] questioning of many conventional practices is refreshing and important. . . . In pleading for caution and clinical wisdom, he also offers a partial solution to the huge problem of how we might afford to provide good medical care for old people.--British Medical Journal

Hadler argues for holding medical interventions to a high standard.--Raleigh News & Observer

Refreshing. . . . All nurses working with older people will gain a great deal from this book, particularly with regard to prevention. This book challenges our thinking on growing old and living well, and is highly recommended.--Nursing Standard

Well organized and detailed.--Burgs Sunday book review

Hadler advocates informed decision making pertaining to all stages of aging.--Library Journal

All Americans over the age of 45 as well as health care providers and political leaders should read this book. . . . Hadler provides useful insights into successful aging within the context of this challenging system. Highly recommended.--Choice

[Hadler has] provided his readers with valuable perspective that should make it easier for them to captain the ships of their own health.--The Carrboro Citizen

With passion and enthusiasm, Hadler offers a doctor's perspective that could prove useful for many people struggling to make better choices and increase wellness as they age.--ForeWord Reviews

With this thoughtful guide, Hadler urges better options for end-of-life care than a lonely, traumatic last stop at the hospital.--Publishers Weekly


Nortin Hadler challenges much conventional wisdom about aging with insight and verve. You may not embrace all of his views, but you will agree that his approach is often original and always thought provoking.--Jerome Groopman, M.D., Recanati Professor, Harvard Medical School, Author of How Doctors Think.

|An unflinching and rational dissection of the anti-aging field from one of the most respected voices in the health care debate today. Like Atul Gawande and Jerome Groopman, Dr. Hadler's scalpel has an uncanny ability to separate facts from hype and make us reexamine every screening test and treatment we take for granted as effective.--P. Murali Doraiswamy, senior fellow, Duke Center for the Study of Aging, and coauthor, Living Well After An Alzheimer's Diagnosis


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Product Details

  • Hardcover: 272 pages
  • Publisher: The University of North Carolina Press; 1 edition (September 12, 2011)
  • Language: English
  • ISBN-10: 0807835064
  • ISBN-13: 978-0807835067
  • Product Dimensions: 9.5 x 6.5 x 0.9 inches
  • Shipping Weight: 1.2 pounds (View shipping rates and policies)
  • Average Customer Review: 4.6 out of 5 stars  See all reviews (21 customer reviews)
  • Amazon Best Sellers Rank: #153,973 in Books (See Top 100 in Books)

More About the Author


Nortin M. Hadler, MD

Dr. Hadler is a graduate of Yale College and The Harvard Medical School. He trained at the Massachusetts General Hospital, the National Institutes of Health, and the Clinical Research Centre in London. He was certified a Diplomate of the American Boards of Internal Medicine, Rheumatology, Allergy & Immunology and Geriatrics. He joined the faculty of the University of North Carolina in 1973 and was promoted to Professor of Medicine and Microbiology/Immunology in 1985. He serves as Attending Rheumatologist at the University of North Carolina Hospitals.
He has lectured widely, including many named lectureships, and is a frequent commentator for the print and broadcast media. He has garnered multiple awards and served lengthy Visiting Professorships in England, France, Israel and Japan. He was selected as an Established Investigator of the American Heart Association and has been elected to membership in the American Society for Clinical Investigation and the National Academy of Social Insurance. He has been elevated to Master of the American College of Physicians and the American College of Rheumatology and is a Fellow of the American College of Occupational and Environmental Medicine.
The molecular biology of hyaluran and the immunobiology of peptidoglycans were the focus of his early investigative career to be superseded by his fascination with what he initially termed "industrial rheumatology." For 30 years he has been a student of "the illness of work incapacity"; over 200 papers and 12 books bear witness to this interest. He has detailed the various sociopolitical constraints imposed by many nations to the challenges of applying disability and compensation insurance schemes to such predicaments as back pain and arm pain in the workplace. He has dissected the fashion in which medicine turns disputative and thereby iatrogenic in the process of disability determination, whether for back or arm pain or a more global illness narrative such as is labeled "fibromyalgia." He is widely regarded for his critical assessment of the limitations of certainty regarding medical and surgical management of the regional musculoskeletal disorders. The third edition of his monograph, Occupational Musculoskeletal Disorders, was published by Lippincott Williams & Wilkins in 2005 and provides a ready resource as to his thinking on the regional musculoskeletal disorders.
In the past decade, he turned his critical razor to much that is considered contemporary medicine at its finest. His assaults on medicalization and overtreatment appear in many editorials and commentaries and 4 recent monographs:
McGill-Queens University Press published The Last Well Person. How to stay well despite the health-care system in 2004 (paperback 2007). UNC Press published Worried Sick. A prescription for health in an overtreated America (2008, paperback 2012), Stabbed in the Back. Confronting back pain in an overtreated society (2009), and Rethinking Aging. Growing old and living well in an overtreated society (2011). A fifth book, Citizen Patient, is in press and scheduled for release early in 2013. Les Presses de l'Université Laval / Les Éditions de l'IQRC is the publisher of French translations: Le Dernier des Bien Portants (2008), Malades d'inquiétude (2010), Poignardé dans le dos (2011) - won Prix Prescrire in 2012, and Repenser le vieillissement (2012, in press).

Customer Reviews

Most Helpful Customer Reviews

94 of 95 people found the following review helpful By Joan Austin on October 11, 2011
Format: Hardcover Verified Purchase
My 89 year old mother had a stroke in April. Due to her advanced age and increasing health problems I thought after the stroke she should receive palliative care till she died. I was almost shocked to experience the exact opposite from the health care system. She was provided, with little discussion with her family, the most expensive testing and life saving treatment available. Since she was a big believer in our wonderful health care system she visited her doctors frequently prior to the stroke and followed all their advice which included taking at least 7 pharmaceutical drug and many vitamins. After her stroke she left the hospital on 10 different medications. The health care system insisted that she also needed rehab and could have the potential to live independently again. After grabbing $100,0000 in medicare dollars for acute care and rehab services there is no money left to actually care for my mother. Unfortunately she needs 24 hour care and her mind is no longer rational. This job falls to the family and is an extreme hardship emotionally as well as financially.
I am writing this to preface where I personally was when I read this book. Reading it was like seeing the sunshine after a long time in the dark. The book looks at the over treating of the natural aging processes and the reasons behind our health care system big push to treat most health matters with medication. The time with any health care professional is very limited as they are forced to see a higher patient volume and in many systems are only allowed 10 minutes or less with a patient and in which charting is also included. Very little healing can be done in this type of system other then writing a prescription.
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34 of 34 people found the following review helpful By Gaetan Lion on February 7, 2012
Format: Hardcover
This is the author's third book investigating medicine shortcomings. The first two were: The Last Well Person: How to Stay Well Despite the Health-Care System and Worried Sick: A Prescription for Health in an Overtreated America (H. Eugene and Lillian Youngs Lehman). They are all excellent. Hadler has extensive firsthand experience as a doctor, a med school professor, a clinician, and a medical investigator. Thus, he is well equipped to evaluate what works and what does not in modern medicine.

Hadler's main beef is that U.S. health care "medicalizes" normal conditions by undertaking treatments and prescribing drugs that are costly, do not work well and have side effects. He calls such malpractice a Type II error (doing something that is unecessary that may cause harm). Hadler supports his assertions by referring to numerous studies.

Medicalization becomes increasingly costly to the patient and taxpayers (and lucrative for the medical complex) as we age. A large percentage of health care dollars are spent on patients' last year of life. And, those expensive procedures are of no benefit to the elderly in terms of quality of life and lifespan. This book is interesting as it focuses primarily on the medicalization of the aging population. Meanwhile, the first two books looked at the overall medicalization phenomenon.

Hadler, more than in his other two books, uncovers the relationship between socioeconomic status and health.
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Parts of this book are not easy reads but others are, and they are oh so vital when contemplating a medical test or another scheduled doctors visit ... but when there is no obvious benefit resulting. "Properly" prescribed drugs kill a patient every 5 minutes in U.S. hospitals. Drugs impoverish systems and patients while treating the "risk factors" of normal aging that are simply numbers in a lab report.

Here is the accumulated wisdom of an exceptionally wise senior physician who dared calling into question medical interventions and tests without hard and clear patient benefit such as planned angioplasties and bypasses, bone density, prostate or cholesterol tests, ... the list is endless.

This book is vital before sitting in some waiting room. Doctor: where is the evidence that the result of [fill in the test or procedure] will make me live longer .. and by how much, and also importantly, how much healthier. Few realize cholesterol lowering drugs have shown not to make women live longer, something almost certainly also true for the aging men ... yet doctors continue to promote the fear of cholesterol with their prescription pads. It pays to know the facts. "Lowering glucose is the wrong tree" [certainly when done intensively]. "The conveyor belt to the operating room .." How to avoid the vortex [of becoming entrapped in the medical system without shown benefit]. The author is brilliant when talking bone and spine.

All this to say, this book is vital if you have any contact with the medical world and if you desire aging well. A friend scanning my copy ordered his own; he's even more impressed and is now rethinking his option regarding more invasive [prostate] testing. Empowering.
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