Sunday, July 6, 2008

Don't Get Tested

The Last Well Person: How to Stay Well Despite the Health-Care System by Nortin Hadler

Kansas Dad found this book first and encouraged me to read it before we had to send it back through interlibrary loan. I recommend it for everyone and would be very interested to know what our friends who have medical degrees would say in response.

Dr. Hadler puts forth convincing arguments that much of the testing (and even interventions) done by doctors in America today is unnecessary because it doesn't really help people live longer or better lives. (He stresses his points do not apply if you are already sick: previous heart attack, etc.) The most important point he makes (I think) is that the testing itself causes repercussions - we feel sicker, we feel more vulnerable, we spend too much time thinking about how we feel instead of living. These repercussions negatively impact our lives to a much greater extent than any positives from the tests themselves.

I don't have the energy to adequately summarize his arguments or give good examples (a hazard of nearly the 39th week of pregnancy), but we have opted out of all the prenatal testing for many of the reasons he explains. Many prenatal tests are for conditions that only have a "cure" in abortion. Some can be dangerous to the baby, increasing the rate of miscarriage. There are also a lot of unknowns in the prenatal testing; many times they show only an increased risk without being able to definitely say whether the child actually has a condition. I know there are people who like to be prepared for something like Downs Syndrome, but I prefer to consider this child perfectly healthy and we'll deal with anything like that after the birth. I told my doctor I wanted to be tested only if it would make a difference in who we'd have present at the birth (like a special doctor for the baby) or for things like gestational diabetes that would require special monitoring during the pregnancy. It makes for a much less stressful pregnancy for me.

I was also interested in his thoughts on marketing and advertising for pharmaceuticals and medical testing. All advertising's purpose is to convince us we need something we don't need and I firmly believe medical advertising is no different. He also pointed out the relationships between doctors making recommendations for testing and prescriptions and the companies that own the equipment or medications. It seems like there should be rules against that sort of thing.


  1. That sounds like a book I'd enjoy reading. I found myself thinking these sorts of things through as I pondered Q.'s flu. She became what I would call very ill. I seriously considered taking her to see a doctor. But I found myself wondering what they could really do for her (I assumed it was a virus). And was it actually a threat to take her out? (I had a friend who took her baby to a doctor for one thing, her baby contracted a secondary infection in the unsanitary waiting room and ended up in the hospital before it was all over.) I'm not anti-doctor, but I would tend to agree that having a "medical-mindset" can actually cause more problems than it solves. Or, at least, I see the potential for that.

    I think I'll put this book on my wishlist. Thanks for the suggestion!

    Happy 39 weeks! :)

  2. I think you might like this book, too, Brandy, based on some other posts of yours I've read.

    Our pediatrician's office has usually suggested we not bring our daughter in when she was throwing up a lot. They always say as long as we can get some fluids into her (with a medicine dropper if necessary), she's probably better off at home unless there are other symptoms. I really like knowing I can call and they'll tell me to stay away if I should.


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