Overtreated - Shannon Brownlee

Areas of the country with more MRIs, surgeons, and ICU beds have higher rates of MRI scans and surgery and more days in the ICU. Big surprise. What really is a big surprise is that they also have worse mortality statistics. They spend twice as much on healthcare in the last year or so of life, but their patients die sooner. Partly this is because receiving medical care is dangerous - the longer you're in the ICU, the more often you have surgery, the more likely someone is to make a mistake.

This is another fascinating book analyzing the American healthcare system. It claims that a third of what we spend (a third!) is unnecessary. She takes the system to task for not using evidence to guide treatment and for not doing the studies needed to generate the evidence. She talks about how the managed care fad of the 1990s damaged doctor-patient relationships and ultimately increased healthcare spending. She suggests ways to reform things (mostly by making changes to Medicare that would trickle through the non-governmental insurance system). Her arguments will change how I interact with the medical system - less visits to specialists, much more emphasis on family practice, more attempts to understand the evidence for various treatments and use older, less expensive, but equally effective options.

Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer
Sharon Brownlee
2007
Available from Amazon