But… It’s giving us GOOD chance to think more…
Some more Book Reviews Written by Gaetan Lion
Last Well Person: How to Stay Well Despite the Health-care System by Nortin M. Hadler
The medical establishment is misinforming, costly and ineffective., July 31, 2005
This is an outstanding book that decries many components of traditional and alternative medicine.
The book is not easy to read (Fog Index 16.9 corresponds to years of formal education;
Flesh-Kincaid Index 13.8 corresponds to grade level). However, it is very informative to manage your own health
in a more independent, cost-effective, and dignified way than otherwise. According to the author all our ills
that truly result mainly from the natural process of aging have been "medicalized" at no benefit to the patient.
But in turn, this medicalization has generated huge profits for the health care industries.
The author has impressive credentials to advance his views. He is a professor of Medicine at one of the top U.S. public universities, and he is a practicing rheumatologist. Additionally, he has a strong background in statistics
that he uses to interpret the objective results of random trials before spin doctors promote questionable benefit
of whatever drug tested. Also, his "opinions' are well supported by 60 pages of references to random trials
mentioned in the "Annoted Readings" section of the book.
Human beings have a mean expected life span of 85 years. Advances in medical technology has done nothing to extend this life span. With aging, a bunch of proximate diseases (cardiovascular, cancers, and others) compete with each other
to end our days. Thus, often the well publicized reduction in mortality for a certain type of cancer due to a treatment
has no implication in extending one's life span for a single day. A survivor of prostate cancer may die at the exact same time he would have died of cancer but from cardiovascular disease. The author has analyzed many related random trials
that confirmed this.
"Medicalization" is in his view an artificial social construct whereby a condition (back or knee pain)
has been turned into a disease. It results in Type II malpractice whereby patients that are well have incurred
treatments (sometimes invasive and dangerous) that were not necessary.
The benefit from breast and prostate cancer screening is highly questionable. Both mammography and the PSA tests
generate so many false positive as to render the tests useless. The ensuing investigation, treatment, and surgeries
from incurring a positive test are often painful, dangerous, and offer no proven benefits of any reduction
in mortality rate.
He feels just the same way about bypass surgery that provides no benefit and is associated with a high risk of death
as a result of the operation (2% to 8%) or depression (50%). It helps only 3% of the coronary patient
who do have extensive plaque blockage in their left-main artery. For the other 97% of patients,
bypass surgery represents an unfavorable risk/benefit trade off.
Alternative medicine is not spared either. He sees no benefit in most herbal, vitamins and mineral supplements. Chiropractic, homeopathy, and other alternatives do not seem more credible than traditional medicine.
Again, the above is supported by reference to random trials and studies.
In his view, being a well person is coping well with the acceptable and natural imperfection of health as we age.
This is a better alternative than to render ourselves patient of a medical establishment who will diagnose, test,
and operate us at great profits for themselves but significant suffering to ourselves without adding a day
to our life span, and often compromising our quality of life in the mean time.