Written by Dr. H. Gilbert Welch
Reviewed by: Michael Fiorini, New York University
Less Medicine More Health: 7 Assumptions That Drive Too Much Medical Care comes at a time in medical history of great skepticism and distrust of previously lauded medical practices. In spite of this, I feel this book is a far cry from other less founded movements such as the anti-vaccination movement. Well-sourced and coming from an author with extensive expertise on the effects of medical testing, the book incorporates empirical data, historical examples, personal anecdotes, and a compelling narrative to discuss the downsides of contemporary over-treatment. Challenging the ingrained assumptions of the medical field, clinical practitioners, and western society at large, Dr. Welch takes a controversial but important stance on what he characterizes as excessive preventive measures in medicine that do more harm than good for patients. In doing so, he exposes our underlying and, ultimately, misguided attempts at controlling public health on a macro and micro scale, reframing for readers practices that they might not have thought of in a negative light previously. Though he criticizes myriad medical assumptions and rampant negative reflexive practices, he also offers guidance towards improvement and shows an ever-present consciousness of medical intention and how it has changed.
Breaking its narrative into the titular seven assumptions driving too much contemporary medical care, Less Medicine More Health considers them individually and in relation to one another as part of an overarching discourse. Each medical assumption is given its own chapter along with an adjoining “disturbing truth” that refutes it. The “truth” sets the tone and guides the discussion with an aim to illuminate the issue at hand. In order, the book discusses the idea that all risks can be lowered, that it’s always better to fix the problem, that sooner is always better in treatment, that it never hurts to get more information, that action is always better than inaction, that newer treatments are always better than older ones, and finally that treatment is about avoiding death. Each part serves to discuss the potential harm inflicted by what can sometimes be unnecessary treatment; professional readership might find what is discussed useful to incorporate into their clinical practice. The material in this book is also potentially helpful as a means of reconsidering certain approaches and attitudes taken with some clients. The book is written so that it can be read by non-professional readers as well, but there is nonetheless a fundamental research and historical foundation for the subject matter that promotes academic and professional study.
Because it challenges many longstanding beliefs and practices undertaken in the medical and clinical community, Less Medicine More Health is an important entry into the contemporary discourse on the role care should take. As a warning against hypochondriacal preventative measures and potentially damaging reflexive examinations, the book presents its argument effectively and accessibly. It is also not at all dry to read, and the personal elements added to certain portions serve to remind readers that the topic is one that all readers can relate to, either in practice or in firsthand experience. The salience of overmedication as an emerging issue makes the argument presented here extremely compelling. Even if readers do not agree entirely with what is proposed here, the body of knowledge brought forth and the position the author takes on what he considers overmedication are intellectually and professionally significant for the current state of clinical affairs.
Dr. H. Gilbert Welch is a practicing physician and academic, working as a professor at Dartmouth Medical School. He is a nationally recognized expert on the effects of medical testing and his work has been published in the Los Angeles Times, New York Times, Washington Post, and Wall Street Journal, as well as several major medical journals. He has appeared on network television, CNN, NPR, and is the author of two other books, Should I Be Tested For Cancer? and Overdiagnosed.
Welch, H. (2015). Less Medicine More Health: 7 Assumptions That Drive Too Much Medical Care. Boston, MA: Beacon Press.
Hardcover. 218 pages.
Includes index and references.