The Last Well Person: How to Stay Well Despite the Health-Care System

by Nortin M. Hadler

Hadler systematically builds the case that many medical interventions are hazardous to our health. Especially insidious is the misuse of longevity statistics in turning the difficulties experienced through a natural course of life, such as aging and osteoporosis, into illnesses. He argues that unfounded assertions and flagrant marketing have led to the medicalization of everyday life and he offers practical solutions on such topics as aging, obesity, adult onset diabetes, and back problems. In The Last Well Person Hadler addresses the tough questions about our health care, cutting through the medical white noise.

Genres: Nonfiction, Health, Medicine, Medical, Science

328 pages, Hardcover

First published August 31, 2004

Reviews

[Rita · Rating 5 out of 5]

I'll think twice before running off to a doctor with aches and pains and really question any recommended procedures. His writing is difficult to read for the lay person, but it can be muddled through.

[loafingcactus · Rating 5 out of 5]

Required reading, but a little on the heavy side so let's call it required reading for college graduates. Beyond the usual swats at the current state of medical "science", brings in philosophy of science with Popper and more, and sociology of health too. However, where the swats leave one feeling helpless and the sociology is usually lacking in guidance, this book advises on how to take this information into practice in order to be "the last well person.". Unfortunately, it requires knowing the medical science at least as well as the doctors, which is why this is only a solution for those able to read on a higher level. In order to stay on top of the kinds of topics he discusses (pacemakers in the elderly would be an example of something that may have exploded after this book was written) a good place to start IMHO is the longer health articles of the New York Times.

[Elizabeth · Rating 3 out of 5]

Probably too technical for a wide audience, but the information would be useful for anyone willing to plow through it. The healthcare system these days is a salse machine, and the buyer needs to understand what he is taking on.

[Joel · Rating 4 out of 5]

I've read many books on over-treatment and over-diagnosis and on the use of healthcare by well people and patients. This is one of the best. While there are books on the medical-industrial complex, this one focuses on what happens to people as they interact with the professions and medical system. Medicalization of life's normal yet recurrent troubles, the pervasive incluence of the professions and media on promoting interventions, as well as the alternative and complimentary treatments and professions are discussed from what a well person wanting to stay well can expect.

[Kari Mccrory · Rating 3 out of 5]

Lots of food for thought in this book. I agree with much of what Hadler says, but wonder if he sometimes goes a bit too far.

[Rhonda · Rating 5 out of 5]

Interesting and confirmed some doubts I have had. Reality is that mistakes happen and the profession sometimes protects its own. Did not stop me from knowing the good side.

[Nate · Rating 2 out of 5]

Dr. Hadler is a smart as they come. The points he makes are well worth knowing, for both patients and providers. The problem is that he can't convey them effectively to either audience. His prose is too dense. He needs to write in simpler sentences and use simpler words. He could be called pompous. He doesn't refer to this work as a book. He repeatedly calls it a monograph.

The most important points he makes: the role of SES in disease, the impact of job-dissatisfaction on sense of well-being and ability to cope, and the medicalization of personality and character traits (the hyperactive, the depressed, and the obese are all "diseased" in today's medical culture).

As an aside, he also makes a brilliant arguement that if a trial has to be extremely large (thousands of patients) to have adequate statistical "power", then by nature it is detecting a very small treatment effect, in fact so small (~2% absolute change) that the results could easily have occurred by randomization error. In other words, if something (a drug, a treatment) really works, you only need a small trial to detect it. Be skeptical of large trials, especially when they only show small benefit.

Finally, patients have the right to know that many of the screening tests we (physicians) order are of dubious benefit. Some may be harmful. Why do we order them anyway? One reason: its easier to order the test then spend the time necessary to explain why it may be unneccesary. All this and more is this book, just be sure you have a dictionary handy.

[Fishface · Rating 2 out of 5]

This was very satisfying when it stuck to the extremely negative, even life-threatening practices of the medical profession, pointing out over and over that docs are often willing to sacrifice the well-being of their patients in order to rack of more fees. What the book didn't do was fulfill the promise of the second half of the title: tell you how to stay well in spite of the health-care system. The author makes it seem like a job far too complicated and challenging for the layperson to understand or manage.

[Sally · Rating 4 out of 5]

The author argues persuasively that many standard treatments, in cardiology, cancer and the aged for example, are worthless or even harmful; that Americans are over treated for normal conditions that have been medicalized by the health/pharmaceutical industry and its practitioners. I didn't agree with all he had to say, but most of it made a lot of sense to me and he gives data to back up his contentions about the need/uselessness of treatments. Worth reading.

[Del · Rating 4 out of 5]

Textbooky but provocative and very, very interesting.

[Vicki · Rating 3 out of 5]

Some good medical info and how the medical community has bought into many diagnostic tests that are not really needed. I found it to be a really hard read. The author seems to be a bit too technical.