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More Harm Than Good
What Your Doctor May Not Tell You About Common Treatments and Procedures
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C O N T E N T S
F O R E W O R D i x
I N T R O D U C T I O N
1 The Medical Prognosis—Why More Is Not Necessarily
Better 1
Taking the Data to Heart 2
The Modern Doctor’s Dilemma 5
A Deadly Intersection:: Soft Medicine and Hard
Technology 6
Understanding the Odds Can Even Them 7
The Evolution of Medical Knowledge 8
The Difference Between Trends and Individuals 10
2 Dissecting the Practice of Medicine 13
The No-Sum Game 16
The Value You’re Getting 25
Painting by Numbers 29
Flipping a Coin on a Heart Attack 30
A Stroke in the Eye 32
Under Pressure 34
Beyond Medicare 35
Is It as Bad Among Younger Populations? 36
3 Nothing Exceeds Like Excess 41
More Room at the Inn Means More Treatment 47
The Dollar Cost of Variability in the Latter Years of Life 51
Many Captains, One Ship 51
Following the Money 53
What Is to Be Done? 55
. . . And the Patient’s Preferences 58
. . . And the Doctor’s Preferences 59
4 Are You Past Your Expiration Date? 63
The Price of Living Past Your Expiration Date 64
The Body’s Expiration Date 65
Deadly Turnover 70
5 Screening Out Common Sense 75
How Doctors Make Decisions During Checkups 76
What ‘‘Sensitive’’ and ‘‘Specific’’ Mean 79
The Gold Standard in Strep 80
Good Test, Bad Test:: Same Test 82
The Popularity of Screening—Uncle Ivan and the CT
Scan 83
Terrorized by Technology 86
Screening Gone Awry 88
Pitfalls and Promises in Cancer Screening Tests 91
Length- and Lead-Time Bias 91
Testing For Prostate Cancer 96
What Makes Sense? 104
6 News from the Front:: The War on Prostate and Other
Cancers 109
How Cancers Cause Problems 112
A Closer Look at Cancer:: Incidence and Impact 113
The Rise in the Rates of Prostate Cancer 115
What About Other Cancer’s Incidence Rates and
Prognoses? 119
Some Hopeful News from the Front on the War on Cancer::
What Might Be Around the Corner 121
7 Diabetes:: Things You May Not Know 125
What Is Diabetes? 126
The Use and Abuse of Glucose 127
Two Types of Diabetes 129
Glucose:: The Small Molecule That’s a Big Deal 132
Should High Glucose Levels Be Fixed? 134
So What Makes Sense for Patients with Type II
Diabetes? 138
8 Why Some Think Threading the Artery Is Easier Than
Threading the Needle in Cardiovascular Disease 143
Putting a Price on Quality of Life 144
What Interventions Are Available to Prevent CVD? 147
9 Degenerative, Infectious, and Autoimmune Diseases 155
The First Line of Defense 157
Recent Breakthroughs in Understanding the Immune
System 158
The Autoimmune Diseases 161
Do We Really Knee-d This? 165
Making a Pain in the Neck Even Worse 169
Infection
More on Degenerative Diseases 175
10 Making the Best Medical Decisions for You 179
The ‘‘All You Should Eat’’ Special 180
Oils from the Sea and the Tree 181
All That Is Sweet Isn’t Good 184
A Hard Look at Supplements 186
An Aspirin a Day . . . 187
The Wages of Sweat 188
Additional Benefits of Exercise 191
But Doctor, Why Is My Attempt at Weight Loss Taking So
Long? 192
Watch Your Mouth, Young Man (and Woman) 193
Examining the Physical Exam 196
A Pocket Summary 198
11 How to Do More Good than Harm 203
Turning Things Around:: The Payers and Players 000
Revamping Medical Education:: Undergraduate and Post-
Graduate Studies 216
Providing Medical Care Based on Scientific Evidence 219
The Need for Universal Coverage 222
Electronic Medical Records and the Internet 224
Bringing It All Together:: A Comprehensive Unified System
of Payment (‘‘CUSP’’) 225
I N D E X
Opis
- Rok wydania
- 2008
- Numer wydania
- 1
- Oprawa
- twarda
- Wymiary (mm)
- 160 x 239
- Waga (g)
- 552