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Worried Sick: A Prescription for Health in an Overtreated America (H. Eugene and Lillian Youngs Lehman Series) Hardcover – June 2, 2008

28 customer reviews
ISBN-13: 978-0807831878 ISBN-10: 0807831875 Edition: 1st

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Editorial Reviews


"In Worried Sick, author Nortin M. Hadler, M.D., presents a carefully reasoned case to help health-care providers assess the value and benefit of potential therapies to better treat their patients."--Los Altos Town Crier

"It is impossible to read this monograph and remain complacent with the current medical model. . . . [Hadler] very clearly states a series of provocative tenets which deserve serious consideration."--The Pharos

"[Dr. Hadler] is a longtime debunker of much that the establishment holds dear. . . . Reviewing the data behind many of the widely endorsed medical truths of our day, he concludes that most come up too short on benefit and too high on risk to justify wid

"Challenging conventional medical wisdom, [Hadler] advises a healthy skepticism about the benefits of drugs, routine tests, and many common medical procedures. . . . Educate[s] [readers] on being far better health-care consumers. . . . [A] provocative look at the U.S. medical system."--Library Journal

"To change unrealistic expectations about longevity or lives without pain or illness bucks vested interests, but that is what Hadler does. . . . He knows that the changes he proposes are a long shot, but when people demand that medicine stop doing unneces

"This book challenges readers to alter their notions about health maintenance, discarding beliefs about the efficacy of certain medications, screening tests, and procedures. . . . This thoughtful message from an experienced medical practitioner has merit

"Having guidelines for reimbursement that went through a Hadlerian analysis is not a bad place to start reducing medical care costs without reducing the quality of patient outcomes. A much more politically attractive, and potentially quite effective, reform would make it routine for patients to be exposed to Hadler's kind of analyses whenever they are asked to consider any significant medical intervention."--Journal of the American Medical Association

"A withering critique. . . . [Hadler has] the knowledge, power, and moral obligation to reject the false coin of commerce and technological hype and to reassert the primacy of the patient."--New England Journal of Medicine

"An important book. . . . The reader will understand symptoms and their causation and will be richer for it--intellectually and in pocket."--Journal of Rheumatology

"This is recommended reading even if you are determined in advance to despise it. You will be better off having wrestled with his arguments and . . . probably will not find them easy to refute."--Journal of American Physicians and Surgeons

"[Hadler's] self-confessed 'diatribe against medicalisation' is an engaging read."--Medical Journal of Australia

"[Hadler's] arguments are logical and make one think about the status quo."--Milwaukee Academy of Medicine

"The question Worried Sick: A Prescription for Health in an Overtreated America aims to answer is how to get your four score and five. Surprisingly, it argues against relying on many of the accepted practices of modern American medicine. . . . Icon

"[Hadler] has the requisite irreverence and skepticism toward medical providers and the healthcare labyrinth to write a clear-sighted appraisal of the current system's failures."--The Morning News

"Provides readers with the perspectives and skills necessary to advocate for themselves in the contemporary health care delivery system."--Journal of Economic Literature

"Thought-provoking, and one of the better critical treatments of our health care approach."--DTC Perspectives

"A seminal piece of medical literature with an Avicennian touch that will be read and debated by health care professionals for years to come."--Wake County Physician

"Anyone who wants help in evaluating . . . treatments will welcome the details that Hadler provides. . . . [His] challenge to the value of these treatments demands a response from the physicians, pharmaceutical companies, and others who sell these treatme


If, by some wild stretch of the imagination, the U.S. Congress convened and empowered a national convention to transform the American health-care system (i.e. industry), Nortin Hadler's Worried Sick would have to serve as the template and the moral bible. His subtitle says it all, 'A Prescription for Health in an Overtreated America.'
Case by case, drug by drug, test by test, and procedure by procedure, Hadler exposes the excesses, the unjustified costliness, and the ineffectiveness of the present medical scene. With an encyclopedic review of the published medical literature, Hadler shows us that the public is medicalized to an extreme and to no gain in the overall health of the nation.
Hadler presents a proposal for a health-care insurance system that will increase the health of the nation, provide only effective care, and reduce costs. All self-funded employers must read, absorb, and install Hadler's well-founded ideas. As Hadler points out, it is probably too late for any federal plan to do anything but further increase costs and extend ineffectiveness.--Clifton K. Meador, M.D., author of A Little Book of Doctors' Rules, Med School, and Symptoms of Unknown Origin

|Worried Sick is for anyone who wants to make wise decisions about how to care for themselves and their loved ones. Dr. Hadler lucidly reveals the expensive tests that determine little and the quick fixes that boost nothing but cost to point the way toward a health system that we can't afford not to have.--Scott Simon, National Public Radio, author of Pretty Birds and Windy City

|A serious diagnosis of what ails modern American medicine which will surprise and educate even the most savvy reader. Hadler exposes the fallacies that drive unnecessary and often harmful treatments and offers a hard-hitting series of remedies that could benefit us all.--Jerome Groopman, M.D., Harvard Medical School, author of How Doctors Think

|Hadler documents that many Americans receive health care that is useless and often harmful because their physicians do not follow scientific standards of effectiveness. He makes a strong case that these standards should be the basis of payment and should guide patients in selecting physicians and consenting to treatment.--Daniel M. Fox, Milbank Memorial Fund

--This text refers to the Paperback edition.

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Product Details

  • Series: H. Eugene and Lillian Youngs Lehman Series
  • Hardcover: 392 pages
  • Publisher: The University of North Carolina Press; 1 edition (June 2, 2008)
  • Language: English
  • ISBN-10: 0807831875
  • ISBN-13: 978-0807831878
  • Product Dimensions: 9.5 x 6.8 x 1.2 inches
  • Shipping Weight: 1.5 pounds
  • Average Customer Review: 3.9 out of 5 stars  See all reviews (28 customer reviews)
  • Amazon Best Sellers Rank: #200,260 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

89 of 92 people found the following review helpful By Fred Amir on April 30, 2008
Format: Hardcover Verified Purchase
If you want to save yourself from being labeled with a disease you don't have and take medications you don't need, then you must read this book.

Worried Sick is a follow up to Dr. Hadler's The Last Well Person. It has updated research information and written for the public at large. In this book, Dr. Hadler examines many of the common diagnoses and treatments and questions their validity and scientific basis. He shows clearly that many of them are not founded based on science, and that treatments are of questionable value, and possibly harmful.

Here is a brief overview but you really need to read the book for the whole story.

1- Heart bypass surgery and angioplasty: Dr. Hadler explains how bypass surgery has not been shown to be of any use. In fact, some patients whose chests were simply opened and closed had similar improvements in their level of pain after the surgery. However, those who had the surgery experiencing dementia (40%) and difficulty returning back to their regular jobs. Although, the efficacy of this treatment has never been proven, it and angioplasty continues to account for 500,000 procedures a year in the US.

2- Type 2 diabetes: He mentions that increase blood glucose level is an expected part of aging, and the effort to regulate blood sugar with medication has shown no effect in terms of preventing damage to the eyes or kidneys or preventing heart disease or stroke. In fact, ten years of intensive therapy offered no real advantage to 1000 middle aged hyperglycemic (high blood glucose level) people. So, why would anyone want
to be on therapy and suffer the side effects of medications that have no real benefits? He says changes in diet, weight loss, and exercise have are a much better approach.
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28 of 29 people found the following review helpful By bronx book nerd VINE VOICE on September 26, 2008
Format: Hardcover
In Worried Sick, Dr. Nortin Hadler contends that many procedures like bypass surgery, stents, angioplasty, colonoscopy, mammography, prostate cancer and cholesterol screening, among others, ultimately do very little for the patient and a lot for the medical and pharmaceutical industry. He claims that the biggest predictor of health is socioeconomic status (SES), and not necessarily any of the indicators flushed out by screenings and diagnosis. He proposes a health insurance scheme based on proven effectiveness of procedures and pharmaceuticals, with medical care incorporating SES questions into the history and diagnosis. His contention is that we have "medicalized" conditions that have always been the bumps and bruises of life, with this medicalization resulting eventually in health insurance coverage and expansion of definitions that captures more people in these conditions and thereby expands the pool of patients.

Hadler has been making these points for some time in other works, and I think it's an important voice in the debate over health costs and medical insurance. Ultimately, Hadler claims that we should be debating not just about the efficiency of delivering health, for some the panacea for reducing its costs, but fundamentally the effectiveness of the care offered and provided. If, as Hadler claims, so many of the procedures, pharmaceuticals and gadgets foisted on the American public do little, nothing or may actually be harmful, why argue about how to better provide them, and instead, debate on whether they should be automatically included in the menu of options for which patients recruited and which insurance plans eventually pay.
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14 of 14 people found the following review helpful By Alison Ulrich on October 17, 2008
Format: Hardcover
An eye-opener for so many caught on the treadmill of tests, diagnoses, questionable treatment. There's a lot of commonsense dispensed in this book that makes me realize anew how much more frightening is morbidity than mortality.
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14 of 15 people found the following review helpful By Curious Cat on October 31, 2008
Format: Hardcover
.. though not the classic his "The Last Well Person" is. This book restates and updates much of the information in "Last Well Person" as well as adding new information, but there is an undertone of frustration in it which I didn't find in the first one. I think banging his head against the brick wall of the American system of health care for the last 10-15 years has understandably caused Dr. Hadler some pain, and it sometimes shows. Also, the verbiage is occasionally unnecessarily dense, showing his years of arguing these points with health-care insiders rather than laymen.

This is nonetheless a very interesting book with well-supported positions and a wealth of information on what you need to know in evaluating "recommendations" by health professionals. The last section is Dr. Hadler's proposal for creating a sustainable health care system on the bones of the old system, rather than starting from scratch, and I found that very intriguing. I wish it had been fleshed out more, but it certainly creates a very good starting point for discussions.

In sum, I recommend this book for anyone interested in how we can make informed choices for our own health care and for the health care system in this country.
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10 of 10 people found the following review helpful By AvidReader on January 18, 2009
Format: Hardcover
While not the easiest book to read, Dr. Hadler's book is well worth the effort for all of you MD's, PA's, and NP's in the United States. It might well change your outlook on medicine significantly, ease some of the anxieties over the way you practice, and perhaps even ease personal/family medical anxieties. Bravo for Dr. Hadler, who has excellent medical credentials, for taking on the status quo in US medicine today. He convincingly explains why the US medical system is far from the best system, but far and away the costliest system. It's not just the fragmented system of greedy insurance companies -- it's the waste in doing a lot of medical treatments that are worthless or near worthless, and can, at worst, result in harm to patients. What happened to Primum non Nocere (first, do no harm) in medicine today? Thank you, Dr. Hadler. Read this book, medical providers!
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