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Overdiagnosed: Making People Sick in the Pursuit of Health

4.14  ·  Rating details ·  1,259 ratings  ·  185 reviews
From a nationally recognized expert, an exposé of the worst excesses of our zeal for medical testing

Going against the conventional wisdom reinforced by the medical establishment and Big Pharma that more screening is the best preventative medicine, Dr. Gilbert Welch builds a compelling counterargument that what we need are fewer, not more, diagnoses. Documenting the excesse
Kindle Edition, 248 pages
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Feb 28, 2012 rated it really liked it  ·  review of another edition
First-World problems.

If you’ve been led to believe that it’s a good idea to get an annual physical checkup even though there’s nothing wrong with you, you need to read this book. The idea that it’s beneficial that we subject ourselves to tests and screenings, which are judged based on sometimes arbitrarily-set numerical criteria, only to look for problems that do not yet exist or have not shown up yet as symptoms is a pseudo-scientific hoax that is promulgated by those who want to sell you tests
Mar 04, 2011 rated it liked it  ·  review of another edition
Shelves: nonfiction
Overdiagnosed: Making People Sick in the Pursuit of Health challenges the current mindset that it's always desirable and beneficial to obsessively screen healthy people for potential illnesses. Dr. Welch describes how actively pursuing illness in healthy people can actually be harmful to the patient.

Why is it bad to discover that people have diseases they don't know about and that have yet to create any symptoms? A few reasons are:

1) The medical-industrial complex continually lowers the numbers
Jun 09, 2018 rated it really liked it  ·  review of another edition
Tons of repetition for very good reasons. And some of them are excellently charted too.

This book gets specific. About certain human health conditions and the outcomes for "early find", "late find", no treatments etc.

It has specific issues to address re high blood pressure, cholesterol meds, yearly screenings for just about anything, check-ups etc. And how those patients react. Good, bad, or status quo.

And the relationship to longevity in this stats is truly amazing, IMHO.

The meds outcomes ar
Apr 24, 2011 rated it it was amazing
Recommended to A. by: no one
This book is a lot better and more accurate than you would think. I happened upon it at the library. After looking at it for a week I was super bored and read it. Could not put it down! It explains how diagnostic tests have shifted (high cholesterol is now 200 and over where before it was 240 and over) after studies (paid for by drug companies-often) determined a lower threshold was needed. It also discusses how if you get enough tests you are bound to find something and that sometimes the treat ...more
Michael Perkins
Feb 25, 2014 rated it it was amazing  ·  review of another edition
Lest there be any doubt, it was doctors who created the opioid epidemic. Big Pharma was there, ready to pounce, but it was foolish, god-like thinking that set it up....


for those who don't have the time, or the inclination, to read the entire book, here's an excellent article by the author that captures his thesis. The metrics have just been arbitrarily lowered again on blood pressure (hypertension) to sell more pills.
May 07, 2012 rated it really liked it  ·  review of another edition
Shelves: medicine, health
A very clear, well-reasoned, reader friendly, evidence-based argument for the view that preemptively hunting for health problems in asymptomatic people through routine screenings and tests, and lowering diagnostic thresholds (as has been done with high blood pressure, cholesterol, and diabetes), is not in the best interests of the vast majority of people. Many such early-intervention strategies do not lower the number of deaths from those diseases, result in false positives and overtreatment, an ...more
Jul 24, 2016 rated it really liked it
More than 35 years ago my father died, too young, from pancreatic cancer. I learned at a young age that there were benign tumors and malignant tumors but I've always held the belief that if I have cancer in my body I want it removed. And sooner rather than later. And I would want to know as soon as possible.

Over the years I've heard that there were controversies about screening for and treating prostate and breast cancer. (These are discussed in the book and presented very well.) Who wouldn't w
Aug 07, 2018 rated it really liked it  ·  review of another edition
A book that all healthcare providers and consumers should read.
Jul 03, 2020 rated it it was amazing  ·  review of another edition
Shelves: medical
Dr. Welch has written several books, most dealing with overuse of medical testing by doctors. I found this one, as well as a later book by him "Less Medicine, More Health" to be very eye-opening and informative. Dr. Welch urges patients as well as health care practitioners to rethink some procedures and tests which may do more harm than good by being too aggressive.
Sep 10, 2013 rated it really liked it  ·  review of another edition
Recommends it for: Every adult
Recommended to Joan by: ??
I found myself feeling dubious about some of the claims. I also found myself wishing for more detail. Basically, the concept is that doing hunting expeditions for diseases isn't a good idea. He is all for what he calls diagnostic screening: if the patient goes to the doctor with a lump or something. He is very opposed to screening being done routinely and explains why in convincing detail. I'm just not completely convinced. My father in law was diagnosed with colon cancer after getting a toilet ...more
Apr 03, 2011 rated it it was amazing  ·  review of another edition
If you are interested in America's health care system, you should read this book. The authors are practicing physicians and bring both real world experience and an MD level understanding of clinical trials. We are moving from treating sick people that have definite symptoms to looking at healthy people with no symptoms in the hope that "early detection" will prevent sickness. With the advent of MRIs and CT scans, we are able to see much more than ever before. The cut offs for diagnosing high blo ...more
Aug 24, 2017 rated it it was amazing  ·  review of another edition
Shelves: medicine
I've always liked technical papers that have a graphic in them that summarizes the whole paper. Dr. Welch and his coauthors' sobering look at over-diagnosis can be summarized with one graph that they present in the opening chapters:


We've been screening for more and more in asymptomatic patients in the last 50 years, based on the premise that it would be better to catch things early and treat them. So, have patient outcomes improved? After several million people have been affected by this onslaug
Jul 22, 2011 rated it really liked it  ·  review of another edition
Dr. Welch was involved in an experiment in which a group of men who had had heart attacks were split into two groups, one of which was equipped with devices to measure irregularities & the other which was given the usual regular checkups. The experiment was discontinued when the researchers found that the device-equipped group received more treatment & died in greater numbers. This got the author looking for similar medical treatment phenomena.

If a form of cancer has become much more common ove
Apr 14, 2014 rated it it was amazing  ·  review of another edition
Shelves: favorites
Everyone should read this book, but I fear that few will. Partly because it is perceived as a difficult topic. No worries there: Dr. Welch and his co-authors make this as easy and straightforward a read as possible. Even if you barely passed high school biology or math, you'll have no problems here: the science is simple, the statistics are very clearly explained.

Another reason folks might not read this is that they are comfortable delegating their personal health decisions to physicians. The fa
Asha Tenbroeke
'Overdiagnosed' is, without a doubt, an important book. It convincingly shows that if we look harder for a disease, we find more "abnormalities" but we're not preventing any deaths. Instead, the more people are subjected to unneccesary medical procedures, which can be just scary, expersive and annoying but also debilitating or even lethal.
The authors explains how this happens with great clarity. Let's say, as an example, that each year a hundred women find a lump in their breast. They go and se
A fantastic take on a wave, although done with the best of intentions most of the time, tends to do more harm than good for patients. Its harmful effects extend to healthcare systems as a whole too. His book, as well as his research, are definitely worth the time!
Jun 23, 2018 rated it really liked it  ·  review of another edition
Things to get about in the giant healthcare industry.

If you thought Big Pharma was the only sketchy player in the healthcare industry, you're in for a surprise. The author's premise is that doctors are trying "too hard" to overdiagnose - finding medical abnormalities that are not causing any symptoms of illness. This turns regular folks into patients at an alarming rate, with no clear benefit in many cases.
Thresholds for some conditions like diabetes, high blood pressure, osteoporosis, and high
The biggest fault of this book is probably the tendency of the author to repeat himself rather a lot, both in explaining what he means and what he does not mean to say. But you can understand that because of the severe risks to his readers of misinterpretation of his message, or to himself if others looking to sue him were to misconstrue what he is saying.
Welch has an important point to make - I won't bore you with a restating of what that point is, as you will have read about it already to get
Aug 01, 2011 rated it really liked it
This book was really interesting considering the direction American healthcare is taking, namely spending more and more money but doing nothing to actually improve quality of life. I mainly picked it up because there was a chapter about ultrasound and fetal monitoring...turned out this was the shortest chapter but worth reading. The author had a degree in economics before going to med school so his perspective was unique. My main complaint is how frequently the author repeated catch phrases...we ...more
Mar 05, 2012 rated it did not like it  ·  review of another edition
Underwhelming. The entire book demonstrated how over-diagnosis is harmful when seeking out diseases that are asymptomatic. Welch, also dismisses the financial incentives within the market to seek diagnosis and to treat early. Lastly, he was completely silent as to how health reform provisions (if the Supreme Court doesn't shut it down) will actually curb over-diagnosis and realign incentives towards health promotion and prevention. ...more
Hanan Kayali
Sep 26, 2017 rated it liked it  ·  review of another edition
Shelves: english
The book is good but very repetitive.
Barbara (The Bibliophage)
Over-Diagnosed: Making People Sick in the Pursuit of Health is a physician researchers’ perspective on the state of medical practice in the United States. It was published in 2011, so some of the information is dated. But the fundamental questions raised by H. Gilbert Welch, M.D. and his co-authors are vital medical ethics and practice concerns.

To simplify a complex set of topics, Welch encourages patients and even physicians to think carefully about the cost versus benefit of early detection an
Aug 21, 2020 rated it it was amazing  ·  review of another edition
Shelves: health-medicine
Screening tests for diseases including prostate cancer, breast cancer, colon cancer, osteoporosis, high cholesterol, and others are not as effective or necessary as we've been led to believe. The author posits that (not without exceptions) if we don't have symptoms, it's most likely that we don't need treatments. Unnecessary screening tests uncover possibly early cases of diseases, but the question is, how many people do they save from early death (undoubtedly some) and how many people are damag ...more
May 26, 2020 rated it really liked it  ·  review of another edition
Shelves: 2020-christina
I would recommended for all skeptical medical consumers out there, this suggestion came from a friend who has dealt with some of this firsthand. There are many reasons for medical screenings, but this book delves into why screening is not always a good thing, it leads to many false positives and over diagnoses with unnecessary medical treatments, at greater cost to the consumer. There are a lot of studies in this book on testing/screening, and I'll admit I skimmed the male (prostate) sections in ...more
Sathya Vijayakumar
Oct 18, 2020 rated it it was amazing
Highly recommend it!! My favorite sentence in the book - “ is difficult to promote health when actively looking for something to be wrong.”
All hypochondriacs should read this! Lots of good data driven facts.
Lise Kristin Knutsen
Not sure which date I started it.
Aug 03, 2018 rated it liked it  ·  review of another edition
Shelves: health
3.5 Some parts really interesting but some less so.
Bill Leach
Aug 20, 2018 rated it really liked it  ·  review of another edition
The author's position is that the medical community is over-diagnosing ailments through the process of screening. This trend is exacerbated by decreasing the limits at which a condition is considered a concern requiring further testing or intervention.

Meanwhile the indicators of abnormal conditions have been changed to become more stringent. The cut-off for diabetes has been changed from a fasting sugar level of 140 to 126, meaning an extra 1.6 million Americans (14 percent increase) have diabet
Nov 05, 2017 rated it really liked it  ·  review of another edition
I totally agree with the author that the medical system seems to overdiagnose the patients. The benefits and the bad effects from over-diagnosed process could be put side by side to compare.
With more and more sophisticated devices that we invented, we tend to be able to discover many diseases much earlier than they could actually affect our health.
Welch gave us several real cases to let us see the terrible chain effect after overdiagnosed patients took following treatments, the allergic or infla
Scott Holstad
This is a book that needed to be written long ago. The fact that it needed to be written at all "sickens" me. To say I think the American medical community, together with their associated criminal enterprises such as the pharmaceutical companies, have seemed to me to be among the most corrupt, ignorant and hypocritical is this country. If I had know 15 years ago that I would move to a new city in a new state in my late 30s with a half dozen diagnosed issues that were largely anxiety-related and ...more
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