The Slippery Slope of Healthcare

March 30, 2020
Former clinician Kussin (Doctor, Your Patient Will See You Now) provides an empowering compendium of health-care advice, focused on the pitfalls of overdiagnosis. Though Kussin places blame on health-care providers for pushing unnecessary care—and on patients for demanding it—he isn’t aiming for exposé or outrage, but rather to arm readers with the tools for better decision making. These include a detailed section about which screening tests are likely to yield actionable information and a list of reliable resources including Cochrane’s evidence-based research repository; websites such as MedLine Plus and UptoDate.com, which doctors respect and use; and patient decision aids provided by institutions like the Mayo Clinic. More generally, Kussin tries to convince readers that ideas along the lines of “better safe than sorry” and “get as much healthcare as you can afford” are not only wrong but potentially harmful, thanks to the dangers of hospital-caused illness. His affable, enthusiastic guide will leave readers feeling smart, informed, and better prepared for taking a nonalarmist and responsible approach to their own health.

February 15, 2020
Beware of the simple or routine blood test or X-ray; it can lead to a slippery slope of interventions. And pay close attention to updates to guidelines, such as the 2017 change in the definition of hypertension. As Kussin (Doctor, Your Patient Will See You Now, 2011) notes, 30 million of us awoke to a new diagnosis. Overdiagnosis and overtreatment can bring unintended consequences. For example, medications to reduce blood pressure can increase the risks of dizziness and falls. Largely because of high-volume, high-profit procedures like joint replacements and excessive reliance on imaging technologies (like CT scans), Americans pay almost double what people in equivalent countries pay. What can consumers do? Kussin advises that patients seek medical information from free, legitimate resources like MedPage Today and Medline Plus. We should also pay attention to which screening tests save lives, and be your own advocate. Before saying yes to what might seem like the latest miracle treatment, Kussin writes, think about mighty forces like the stature of doctors before saying yes to the latest exam or prescription. Cautionary and empowering.(Reprinted with permission of Booklist, copyright 2020, American Library Association.)