Customer Reviews

Worried Sick: A Prescription for Health in an Overtreated America (H. Eugene and Lillian Youngs Lehman)

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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. Also what is considered a high blood glucose level? Those levels are set by committees, not necessarily based on scientific medicine, but many times based on influence by pharmaceutical companies.

3. Hypertension: Dr. Hadler also points out that high blood pressure is another area where science has not proven that by lowering the mild high blood pressure one can really make a difference in preventing heart disease or damage to organs. He recommends for people who have diabetes and hypertension and are elderly to be treated, if regular exercise, weight loss, and diet modifications do not help. But, to be focused on keeping the blood pressure at 120/80 and getting medication to those who are 140/90 and higher, and who have no symptoms and are feeling well, is not supported by research. One thing research has shown is that a cheap first generation diuretic works just as well as the latest and very expensive anti-hypertension drugs.

4. Ruptured disc: He points out that the concept of ruptured disc as cause of back and leg pain was proposed some 70 years ago and should have remained there. There is no evidence that a ruptured disc causes any harm. All the spinal changes due to age detected in an MRI or CT scan are normal. Some 200 randomized studies clearly show that all the treatments ranging from spinal manipulation, shots, and surgeries are of no benefit. All studies have shown that patients who refused treatment recovered as well or better than those who were treated. He recommends taking Tylenol for the pain and discomfort and getting back into one's regular routine and job.

4. Knee and shoulder pain: he also points out that knee pain is of the same case. The current diagnoses, such as a torn meniscus or torn rotator cuff, and treatments are of no value, and perhaps the solution is to take some Tylenol fro the pain and keep going until the individual recovers, whether it's back or knee pain.

5. HRT therapy for post menopausal women: here is another area which is touted as a way of preventing heart disease and osteoporosis in women. He points out that not only this has failed, but the equipment they use for testing is not accurate most of the time, and that the medications used for it don't really work. Exercise is a better alternative. Also hip replacement surgery could easily be replaced with pinning the hip,
which is less costly with a faster recovery rate.

6- Cancer screening: Like Dr. Welch, author of Do I Need to Be Tested for Cancer, he too finds no scientific basis that screening well people for cancer has any benefit. He calls it, "looking for a very small needle in a big hay stack."

There is much more in the book that you need to read for yourself, and I highly recommend that you do. I used to trust my doctor and the medical system until I began to have back pain. Due to improper diagnoses and treatments I developed pain in my neck, legs, arms, hands, and became completely disabled. That's when I realized I needed to take charge of my own health. This is where physician and health educators like Dr. Hadler provide a great service. By the way, he is also a consultant to ABC News. You can watch his commentaries and read his writing at ABC News website.

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.

My criticism of the book is that it is somewhat densely written, although Hadller's wit, sometimes expressed in sarcasm, probably evolved over time from the frustration of being a lone voice in the wilderness, makes the book more readable. However, a toned-down version could make the arguments moe accesible to the general public and perhaps give the book and its message a greater impact.

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.

Dr.Hadler book makes an excellent case for re-vamping health care in America as it currently is administered. He first,chapter by chapter,de-bunks most of the health treatments recommended by America's medical fraternity. Using statistics(and an excellent bibliography of suggested follow-up reading),Dr.Hadler points out the fallacies of the most wide-spread medical procedures and their actual lack of significant,statistical results. He makes a compelling argument that the system of surgical procedures and tests support a multi-billion dollar industry that,perhaps,doesn't put patient welfare first and foremost. He applies the same logic and statistical analysis(what there is available) to the non-regulated potients and nostrums constantly being sold through television ads and magazines. His final chapter inludes an excellent plan for a reformed,efficient and patient oriented health care system for the American public. The book is a cogent and critical analysis of health care in this country.

.. 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.

As a physician, I have been waiting for decades to read such a book. The statistics make this a rather slow and difficult read, but it will be a live saver for many who "get" the message.
James A.Garfield, M.D.

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!

It's a vicious circle: the medical technology exponential growth needs to be sold, health news (the great majority not exactly exempt) being issued all the time everywhere. At the core, our anguish concerning our frailty - and mortality: we want to live better, and longer. Our limits as human beings (who eventually become sick and die) are irrelevant.
Elaborate laboratorial exams, expensive and unproven procedures are so finding their indications (a lot of them even becoming almost "compulsory"). Scientific articles are reshaped as a official way to reflect these certainties. And who is bold enough to contradict?
Nortin Hadler is one of the rare voices who raise against those established truths.
Relying heavily on sound medical literature (the same literature who - thanks to statistics "miracles" - yields otherwise dangerous conclusions), in a language sometimes excessively technical to lay people (althoug doing his best to clarify it), Hadler, a renowned professor, open our eyes and helps us in our hard decisions about our health, even if they are against the mainstream.

This tome on the over-treated, over diagnosed, over drugged world of America is interesting. The author's premise is that we are beset with rampant Type II Medical Malpractice - the performance of unnecessary testing, diagnosing, and prescribing. He seems to perceive that we are, as a culture, drug addicts of the first order, responding to the programmed prescription of pharmaceuticals by doctors who mindlessly follow the lead of drug companies and studies financed by the same folks. In the course of this herd-like plunge off the cliff, we are engaged in a huge wealth transfer from all of us to the medical establishment. What is our reward? The lowest life expectancy of any major country!

Of course, this is the issue of the moment for our new President Obama, who seems obsessed with expanding this process.

Whether your concern is cholesterol, blood sugar, blood pressure, breast cancer, prostate cancer, dietary supplements, hormone replacement therapy, osteopenia, backaches, over or under-working, or whatever, Dr. Hadler offers a critical evaluation of the practical realities of studies, most of which are read to mean that current treatments are no better than placebos.

Dr. Hadler's view seems to be that we all live, on average, to be about 85. By that time, we will all have our fair share of diseases and will die from one or more of them. We will be best advised if we have a trusted physician who will evaluate our maladies, advise of the realities of the treatments, and then let us take a proactive role in our own self-medication. He nowhere exactly says this, but the result seems clear enough.

This is a marvelous book that should be must-reading for anyone who is concerned about any of these things - which is all of us.

For me, Dr. Hadler's excellent analysis made me revisit my own mother's breast cancer treatment in the 1950s. I think that she endured a mutilation that was probably needless, did not extend the length of her life, and surely devastated the quality of her life. I hope that you are all spared such a fate. Read about being worried sick!

Finally, Worried Sick is a book that gives voice to my observations about the healthcare industry. Recently I noticed my doctor no longer listened to me and wanted to treat me with a "battery of drugs" for one of the syndromes described here even though I expressed doubts about the treatment. Dr. Hadler discusses the validity of the studies and evidence to support the medical decisions being made for me and includes the reference to the studies. He accurately details the harm some of the annual tests can cause as well as the "worry" the patient exeperiences waiting for results. Sometimes false positive test results can lead to unnecessary medical procedures. He also describes a better way of controlling our health care costs and managing our own care. For anyone who doesn't mind reading through the details of medical studies ,this book is a provides great insight to our personal health as well as the current healthcare crisis.