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Less Medicine, More Health: 7 Assumptions That Drive Too Much Medical Care Paperback – March 1, 2016

by Gilbert Welch (Author)
4.6 4.6 out of 5 stars 456 ratings
See all formats and editions
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A nationally recognized expert describes seven widespread assumptions that encourage excessive, ineffective, and sometimes harmful medical care—for readers of Overdiagnosed and Malcolm Gladwell

You might think the biggest problem in medical care is that it costs too much. Or that health insurance is too expensive, too uneven, too complicated—and gives you too many forms to fill out. But the central problem is that too much medical care has too little value.

Dr. H. Gilbert Welch is worried about too much medical care. He doesn’t deny that some people get too little medical care—rather that the conventional concern about “too little” needs to be balanced with a concern about “too much”: too many people being made to worry about diseases they don’t have and are at only average risk to get; too many people being tested and exposed to the harmful effects of the testing process; too many people being subjected to treatments they don’t need or can’t benefit from. The American public has been sold the idea that seeking medical care is one of the most important steps to maintain wellness. Surprisingly, medical care is not, in fact, well correlated with good health. More medicine does not equal more health; in reality the opposite may be true.

In Less Medicine, More Health, Dr. Welch pushes against established wisdom and suggests that medical care can be too aggressive. Drawing on his twenty-five years of medical practice and research, he notes that while economics and lawyers contribute to the excesses of American medicine, the problem is essentially created when the general public clings to these powerful assumptions about the value of tests and treatments—a number of which are just plain wrong.

By telling fascinating (and occasionally amusing) stories backed by reliable data, Dr. Welch challenges patients and the health-care establishment to rethink some very fundamental practices. His provocative prescriptions hold the potential to save money and, more important, improve health outcomes for us all.
Previous page
  1. Print length
    240 pages
  2. Language
    English
  3. Publisher
    Beacon Press
  4. Publication date
    March 1, 2016
  5. Dimensions
    6 x 0.67 x 9 inches
  6. ISBN-10
    0807077585
  7. ISBN-13
    978-0807077580
  8. See all details
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Editorial Reviews

Review

“Avoiding medical jargon, Welch speaks directly to the layperson and focuses on certain assumptions that have increased consumption in a market-driven society; some of which have become so ingrained by popular media that refuting them seems downright scandalous… Welch’s words, though wise beyond money, border on sacrilege in a country of generally healthy people who have developed an expensive health-care habit and who are expected to support a lucrative health-care industry. Welch’s conversational style makes his prescription for better health an easy pill to swallow.” 
—Booklist, starred review

“A bright, lively discussion of the excesses of medical care to which patients often unwittingly go due to certain false assumptions… Welch demonstrates the flaws in these assumptions. His stories involve the risks, uncertainties and harms of cancer screenings, treatments for heart disease, drugs, medical devices and surgical procedures. He makes an especially strong case for the risks of mass screenings for cancer—the fear, the false alarms, the overdiagnoses and the resulting overtreatments. Vivid images make what could be discouragingly technical quite understandable… Welch's engaging style and touches of humor make this an easy read, and the facts he presents make a convincing case.”
—Kirkus Reviews

“Read this book. It is smart, witty, wonderfully written, and above all wise. We've overmedicalized life and yet we need medicine throughout our lives. No one explains better when we do, when we don't, and why.”
—Atul Gawande, author of Complications and Being Mortal

“Wise, witty, fascinating and alarmingly persuasive—this is a book everyone should read, especially my doctor.”
—Bill Bryson, author of A Short History of Nearly Everything

“With the style of a trustworthy country doctor, Welch, an academic heavyweight, urges us to reject the allure of reducing all health risks by using the latest technology to gather all the data and to fix the problems sooner rather than later. Showing the dangers of our ill-informed enthusiasm for medicine, he brilliantly builds the case for respecting its power and limitations: to seek it when ill and all but avoid it when healthy.”
—Victor M. Montori, MD, Professor of Medicine, Mayo Clinic

“Gil Welch's latest book shows us exactly how too much medical care can be harmful and even deadly.  This is a needed corrective to the American attitude that the more screening and testing, the healthier we will be.”
—Marcia Angell, author of The Truth About Drug Companies

“Its title, ‘Less Medicine, More Health,’ sums up his trenchant, point-by-point critique of test-based health care and quality control.”
—New York Times

About the Author

Dr. H. Gilbert Welch is an academic physician, a professor at Dartmouth Medical School, and a nationally recognized expert on the effects of medical testing. He has been published in the Los Angeles Times, New York Times, Washington Post, and Wall Street Journal, and has appeared on Today. Dr. Welch is the author of three previous books, including the highly acclaimed Overdiagnosed. He lives in Thetford, Vermont.

Product details

  • Publisher ‏ : ‎ Beacon Press; Reprint edition (March 1, 2016)
  • Language ‏ : ‎ English
  • Paperback ‏ : ‎ 240 pages
  • ISBN-10 ‏ : ‎ 0807077585
  • ISBN-13 ‏ : ‎ 978-0807077580
  • Item Weight ‏ : ‎ 2.31 pounds
  • Dimensions ‏ : ‎ 6 x 0.67 x 9 inches
  • Customer Reviews:
    4.6 4.6 out of 5 stars 456 ratings

About the author

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H. Gilbert Welch

H. Gilbert Welch

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Dr. H. Gilbert Welch is an internist at Brigham and Women's Hospital - Center for Surgery and Public Health (go figure), and a nationally recognized expert on the effects of medical testing. He has been published by the Los Angeles Times, New York Times, Washington Post, and Wall Street Journal, as well as major medical journals, and he has appeared on network television, CNN, and NPR. Dr. Welch is the author of three books, Less Medicine, More Health; Should I Be Tested for Cancer?; and the highly acclaimed Overdiagnosed.

Customer reviews

4.6 out of 5 stars
4.6 out of 5
456 global ratings
Welch nails it.
5 Stars
Welch nails it.
Everyone who wants to protect themselves from too much doctoring should read this.
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Top reviews from the United States

Not born yesterday
5.0 out of 5 stars A wise doctor's prescripton for a happy, healthy, unmedicalized life
Reviewed in the United States on November 8, 2016
Verified Purchase
If I were president, the very first thing I would do is appoint Dr. Welch as US Surgeon General so he could slay the test pushing, pill popping, money grubbing healthcare monster. Today we are ordered to take tests we don't need for diseases we don't have and subjected to treatments that won't benefit us while we watch our wallets bled dry.

Unfortunately, I can't appoint Dr. Welch as Surgeon General, but I can recommend Less Medicine, More Health, a book that will teach you how to take control of your own healthcare so you can achieve the best health with a minimum of medical intrusion. Reading this book is like sitting down with a well respected, caring and wise physician, which is exactly what Dr. Welch is -- a professor of medicine and public health at Dartmouth Medical School, a doctor who was actually trained by the previous Surgeon General, Dr. C. Everett Koop.

I read Dr. Welch's previous book Overdiagnosis, and I have to say that while I loved the first book (and gave it a glowing review on amazon), the second book is even better because it doesn't just tell which medical tests to avoid, it tells you how to approach each interaction with doctors and the healthcare system, regardless of whether you are perfectly healthy, acutely ill, chronically ill, or dying. Moreover, it does it in an easy to read and enjoyable, conversational style.

I'm in my mid 60s and have given a lot of thought to how I want to live out the rest of my days. I'm happy to say it's exactly how Dr. Welch wants to live out the rest of his days. Like Dr. Welch, I want to stay as healthy as possible for as long as possible, but without medicalizing my life. That means I eat right, exercise, get vaccinations and treat only those conditions I actually have. I don't subject myself to anxiety provoking screenings to find new problems unless I have actual symptoms. I value my present happiness and ability to lead a pleasant, unmedicalized life far more than I do the small probability of extending my life by extraordinary means just so I can live long enough to develop another horrible illness. I want to enjoy a healthy, happy life today, but I absolutely refuse to making avoiding death my primary goal.

Thank you, Dr. Welch, for writing this important book and for spreading the message that we can safeguard our health by living right and seeking medical care only when necessary. We can take control and avoid being victims of the wasteful, harmful, greedy healthcare monster.
59 people found this helpful
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Anuja Sharma
5.0 out of 5 stars must read
Reviewed in the United States on November 2, 2023
Verified Purchase
I really enjoyed the personal account of Dr. Welch and his philosophy on health and well-being. It’s refreshing and insightful. As a doctor, I feel I should have read it a lot earlier.
One person found this helpful
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Gerigirl
4.0 out of 5 stars Loved the dialogue and the tone set by the doctor
Reviewed in the United States on February 3, 2016
Verified Purchase
Loved the dialogue and the tone set by the doctor. This is a necessary read for anyone and everyone who thinks that they have to be on hyper alert and screened for any and every medical concern. My worry/hypervigilence meter is now turned way down - to a level of normal awareness. For example: the meter just brings my attention to things, like choose a banana over a snickers bar; driving a little too fast, take my foot off the gas and sit back and relax while driving. My attention is now focused where it should be - on my life outside my body. Oh, and my workout intensity - up several notches and it feels great! Even my sleep is better. My average resting heart rate? at age 55 - it is 53!!!
6 people found this helpful
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Isaac G. New Jersey
5.0 out of 5 stars An Excellent Book. I Read the Whole Thing While Recovering from Covid-19...
Reviewed in the United States on October 8, 2020
Verified Purchase
There is an Ancient Jewish Expression that says “A little bit of light has the power to push away much of the darkness”.
Let’s just say that the attitudes expressed in this book (I’ve also read “Overdiagnosed”), is worth its weight as 100 Medical Textbooks. I’ve been telling friends for years that “you can become more knowledgeable about your specific condition than your doctor”, and this book backs this up with many facts and properly designed randomized trials.
Your doctor is doing his job when he recommends a diagnostic test or procedure, and after that it is time for us to step up to the plate and do Our job, of researching, contemplating, and making Personal Value Assessments, and sometimes saying “no, thank you”. This is how we all behave in all of our other consumer interactions, and Medical Care cannot be treated differently.
Make no mistake about it, this book is a threat to a Multi Trillion Dollar industry, and the contents should be read, and reread until the contents become part of our Subconscious thought process. I especially liked the part where a thorough analysis of “Duration of Life” as opposed to Quality of Life comes into distinct question.
I now consider myself a true student of Dr. Welch, and will carry this information into all of my interactions with the Medical System.
4 people found this helpful
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Top reviews from other countries

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Ruy Madsen
5.0 out of 5 stars O melhor autor da Slow Medicine
Reviewed in Brazil on August 28, 2018
Verified Purchase
Muito bom! Gilbert Welch mantém o mesmo padrão de Overdiagnosed.
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Stephen T
5.0 out of 5 stars Be informed by a real doctor . . .
Reviewed in the United Kingdom on March 22, 2018
Verified Purchase
Every patient and every doctor should read this book. The author comes across as someone I'd like to have a beer with. Someone who'd give medical advice based on patients' best interests and not increasing profits for him, his colleagues or pharma. If you don't want to be a product on the medical conveyor belt where your best interests might not be a priority, this is well worth reading. The assumption that screening is automatically good or that routine visits to doctors are wise are two ideas I no longer believe.
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Amazon Customer
5.0 out of 5 stars Just what the doctor didn't order !
Reviewed in Canada on November 24, 2015
Verified Purchase
Full disclosure: I'm a doctor. An old one, still in practice though. I teach mindfulness in a medical setting. This is mindful medicine at its best.
This is THE book everyone should read and apply, patients and doctors alike since we are all mortal beings. I love the way Welch articulates and explains complex concepts in a simple (and understandable by everyone) but not simplistic manner.
Have realistic expectations about what medicine can do for you and be AWARE of the dangers : too much medicine might make you sicker sooner than you need !
Read it and bring it to your doctor... He needs it too, probably more than you. You'll have made a BIG difference in everyone's life.
THANK YOU SOOOO MUCH DR WELCH for this great book. Don't walk, RUN to get it, and share it. Wise and compulsory reading.
4 people found this helpful
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Rodrigo Olmos
5.0 out of 5 stars O livro que todo médico deveria ler
Reviewed in Brazil on January 17, 2016
Verified Purchase
O livro é excelente, claro e objetivo. Mostra o quanto a medicina invadiu nosso cotidiano. Todo médico e, todo paciente potencial, deveria le-lo!
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Dale Nicoll
5.0 out of 5 stars Excellent overview and a book that should be read by ...
Reviewed in Canada on July 21, 2015
Verified Purchase
Excellent overview and a book that should be read by every health care consumer. I am an older physician and have recommended Welch's books (all of them) to many patients. This provides a more objective approach to the risks and benefits of modern medicine.
One person found this helpful
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