Risky Medicine

Book Review by Kam Williams

 

Risky Medicine

Our Quest to Cure Fear and Uncertainty

by Dr. Robert Aronowitz, M.D.

University of Chicago Press

Hardcover, $26.00

284 pages

ISBN: 978-0-226-04971-7

Book Review by Kam Williams

“Will ever-more sensitive tests for cancer lead to longer, better lives? Will anticipating and trying to prevent the future complications of chronic disease lead to better health? Not always... In fact, it often is hurting us.

Exploring the transformation of health care over the last several decades that has led doctors to become more attentive to treating risk than treating symptoms or curing disease, [this book] shows how many aspects of... clinical practice are now aimed at risk reduction...

This transformation has been driven in part by the pharmaceutical industry, which benefits by promoting its products to the larger percentage of the population at risk for a particular illness, rather than the smaller percentage who are actually affected by it...

Risky Medicine is a timely call for a skeptical response to medicine's obsession with risk, as well as for higher standards of evidence for risk reducing interventions and a rebalancing of health care to restore an emphasis on the actual curing and caring for people suffering from disease.”

-- Excerpted from the Bookjacket

Once upon a time, doctors took the Hippocratic Oath promising to "First, do no harm." Of course, that was before they handed over control of the health care industry to pharmaceutical and insurance companies far more focused on profits than people. And that was also prior to the rise of defensive medicine in response to the explosion of malpractice lawsuits.

The upshot is that many physicians nowadays could care less about what's best for their patients, since they get their marching orders from a combination of avaricious executives and litigation-fearing corporate attorneys. Consequently, doctors are increasingly devoting less attention to healing the sick than to figuring out ways to improve their balance sheets.

Overwhelming evidence of this development can be found in the trend towards testing and anticipatory treatment. Instead of waiting for a person to fall ill or exhibit symptoms, practitioners have become advocates of increasingly early attempts to diagnose a disease, on the theory that catching it early will improve a patient's prognosis.

But is that actually the case? That is the assumption vociferously disputed by Robert Aronowitz, M.D. in Risky Medicine. Dr. Aronowitz asserts that "overdiagnosis and overtreatment" have played a role in the "cost and quality crisis in American medicine." He says the problem is that mere risk factors and early signs of disorders are being treated as aggressively as if they were full-blown diseases, without regard to the patients' quality of life and financial best interests.

Required reading for anyone at all skeptical about how the practice of medicine evolved from simply treating symptoms and curing diseases to playing on fears and subjecting patients to a seemingly neverending battery of expensive, invasive and often unreliable tests.

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