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Rethinking Aging: Growing Old and Living Well in an Overtreated Society
For those fortunate enough to reside in the developed world, death before reaching a ripe old age is a tragedy, not a fact of life. Although aging and dying are not diseases, older Americans are subject to the most egregious marketing in the name of "successful aging" and "long life," as if both are commodities. In Rethinking Aging , Nortin M. Hadler examines health-care choices offered to aging Americans and argues that too often the choices serve to profit the provider rather than benefit the recipient, leading to the medicalization of everyday ailments and blatant overtreatment. Rethinking Aging forewarns and arms readers with evidence-based insights that facilitate health-promoting decision making.
Over the past decades, Hadler has established himself as a leading voice among those who approach the menu of health-care choices with informed skepticism. Only the rigorous demonstration of efficacy is adequate reassurance of a treatment's value, he argues; if it cannot be shown that a particular treatment will benefit the patient, one should proceed with caution. In Rethinking Aging , Hadler offers a doctor's perspective on the medical literature as well as his long clinical experience to help readers assess their health-care options and make informed medical choices in the last decades of life. The challenges of aging and dying, he eloquently assures us, can be faced with sophistication, confidence, and grace.
Over the past decades, Hadler has established himself as a leading voice among those who approach the menu of health-care choices with informed skepticism. Only the rigorous demonstration of efficacy is adequate reassurance of a treatment's value, he argues; if it cannot be shown that a particular treatment will benefit the patient, one should proceed with caution. In Rethinking Aging , Hadler offers a doctor's perspective on the medical literature as well as his long clinical experience to help readers assess their health-care options and make informed medical choices in the last decades of life. The challenges of aging and dying, he eloquently assures us, can be faced with sophistication, confidence, and grace.
272 pages, Paperback
First published September 12, 2011
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Displaying 1 - 18 of 18 reviews
November 17, 2012
I was expecting a "self-help" book of the psychological/sociological persuasion. I’ve been through this type of literature several years ago during the demise of my mom and dad. More recently, I’ve read several of these books for my own peace of mind. Yes, it’s true, the older I am the long it takes to become sexually aroused...this being the greatest take-away from these self help books.
Not so with "Rethinking Aging," a coldly rational view of the current state of geriatric care. The antagonists, and there are many—pharmaceutical companies, Medicare/Medicaid, research hospitals—flood our lives with misleading information, practices and products as to their efficacy. The consequence is that Americans are spending dearly on medical care with the promise of improved quality of life and longevity. The deception is self perpetuating—if the questionable procedure works it adds to the statistical evidence demonstrating effectiveness, if the procedure fails it is due to the overriding severity of the disease. Either way, the antagonists continue to make profit and Dr. Hadler claims foul, i.e., invokes the trope, “Type 2 Medical Malpractice.”
Dr. Hadler argues for the use of rational scientific method to demonstrate the efficacy of products and procedures. His account of how this does not happen is chilling. He unravels the ganglia of statistical “evidence,” and demonstrates how it is manipulated to promote the “medicalization” of America—“reframing ordinary predicaments of life so that they are viewed as diseases.”
Personally, I reflected on all the products and procedures that were thrown in the path of my parent’s natural demise. Yes, mom and dad had enormous faith in healthcare delivery. And why not, Dr. Hadler claims, as people my parent’s age were first hand witnesses to some of the greatest medical advancements in the 20th century. But the doctor explains how things have changed, and how we are misled for profit.
I just received a note from my doctor asking me to call the office to set up my annual appointment. Well I feel fine and I haven’t called the office yet. Anyone who plans to grow older needs to read this book.
Not so with "Rethinking Aging," a coldly rational view of the current state of geriatric care. The antagonists, and there are many—pharmaceutical companies, Medicare/Medicaid, research hospitals—flood our lives with misleading information, practices and products as to their efficacy. The consequence is that Americans are spending dearly on medical care with the promise of improved quality of life and longevity. The deception is self perpetuating—if the questionable procedure works it adds to the statistical evidence demonstrating effectiveness, if the procedure fails it is due to the overriding severity of the disease. Either way, the antagonists continue to make profit and Dr. Hadler claims foul, i.e., invokes the trope, “Type 2 Medical Malpractice.”
Dr. Hadler argues for the use of rational scientific method to demonstrate the efficacy of products and procedures. His account of how this does not happen is chilling. He unravels the ganglia of statistical “evidence,” and demonstrates how it is manipulated to promote the “medicalization” of America—“reframing ordinary predicaments of life so that they are viewed as diseases.”
Personally, I reflected on all the products and procedures that were thrown in the path of my parent’s natural demise. Yes, mom and dad had enormous faith in healthcare delivery. And why not, Dr. Hadler claims, as people my parent’s age were first hand witnesses to some of the greatest medical advancements in the 20th century. But the doctor explains how things have changed, and how we are misled for profit.
I just received a note from my doctor asking me to call the office to set up my annual appointment. Well I feel fine and I haven’t called the office yet. Anyone who plans to grow older needs to read this book.
November 8, 2012
The hypothesis and conclusion of the MD author is that we have no business relying on the medical profession for sound and correct medical advice. Too many drugs, too many unnecessary visits to the doctors' office, too many surgeries, too many surgeries that do not relate to our medical complaints. We have no business going to the doctor because it "is the schedule'" to do so i.e annual physicals, routine XRays,etc. We only need to see a physician if we feel something is wrong like lumps..............
The aging is the last portion of the book, and the argument is that once you are in your 90's operations do not resolve much, and only create other problems in unrelated parts of the body.............
The target audience of this book is people in their 60's, but the examples and studies go back to people as young as their 20's. It is a wake up call of the waste and erroneous prognoses we receive from our physicians. Many times the MD's do not know the answers to our questions, but feel obligated to give us an answer, even if it turns out wrong, and even it is not in our best medical interest.
The aging is the last portion of the book, and the argument is that once you are in your 90's operations do not resolve much, and only create other problems in unrelated parts of the body.............
The target audience of this book is people in their 60's, but the examples and studies go back to people as young as their 20's. It is a wake up call of the waste and erroneous prognoses we receive from our physicians. Many times the MD's do not know the answers to our questions, but feel obligated to give us an answer, even if it turns out wrong, and even it is not in our best medical interest.
August 18, 2012
People in our country are over-medicalized. You're better off without some tests (probably prostate, mammogram etc.). Age 85 really does seem to be a human limit. Overdoing it especially then causes more harm than good. Growing old is not a disease.
I agreed with many of the author's conclusions, but found his writing style a little difficult to read.
page 59: ...eighty-five is a realistic goal in terms of longevity. Longer is wishful thinking, and to stay well much longer than eighty-five is a long shot. It is reasonable to ask whether there is anything you can do or that can be done for/to you that will offer assurance at age sixty-five that you will see your eighty-fifth birthday.
page 173: To plan to live beyond your ninth decade is unrealistic...In your ninth decade, it doesn't matter how many diseases are vying to be the reaper or which disease ultimately wins out...In your ninth decade, both the quality of living and the quality of dying are primary health concerns. Everyone who is sixty already has significant atherosclerosis. By seventy it is impressive. Most who are sixty are harboring cancer, and nearly all who are seventy are harboring cancer. Nearly all who die in their ninth decade do so WITH many potentially lethal diseases, not FROM most of those diseases. It makes no sense to cure the diseases one will die WITH in the ninth decade and little sense to cure the disease that one will die FROM in the ninth decade if another is to take its place in short order.
All of these tenets have face value; they are obvious once stated. They are the reality that tests our quest to live beyond a ripe old age of eighty-five or so. It is a reality that seldom rests easily with an octogenarian who feels well.
page 194: For me, the top priority is to identify those few elderly for whom hospitalization is likely to offer substantial benefit in the longer term and hospitalize them. All the others for whom the acute illness is but the last straw deserve a far kinder, caring, supportive fate.
I agreed with many of the author's conclusions, but found his writing style a little difficult to read.
page 59: ...eighty-five is a realistic goal in terms of longevity. Longer is wishful thinking, and to stay well much longer than eighty-five is a long shot. It is reasonable to ask whether there is anything you can do or that can be done for/to you that will offer assurance at age sixty-five that you will see your eighty-fifth birthday.
page 173: To plan to live beyond your ninth decade is unrealistic...In your ninth decade, it doesn't matter how many diseases are vying to be the reaper or which disease ultimately wins out...In your ninth decade, both the quality of living and the quality of dying are primary health concerns. Everyone who is sixty already has significant atherosclerosis. By seventy it is impressive. Most who are sixty are harboring cancer, and nearly all who are seventy are harboring cancer. Nearly all who die in their ninth decade do so WITH many potentially lethal diseases, not FROM most of those diseases. It makes no sense to cure the diseases one will die WITH in the ninth decade and little sense to cure the disease that one will die FROM in the ninth decade if another is to take its place in short order.
All of these tenets have face value; they are obvious once stated. They are the reality that tests our quest to live beyond a ripe old age of eighty-five or so. It is a reality that seldom rests easily with an octogenarian who feels well.
page 194: For me, the top priority is to identify those few elderly for whom hospitalization is likely to offer substantial benefit in the longer term and hospitalize them. All the others for whom the acute illness is but the last straw deserve a far kinder, caring, supportive fate.
February 26, 2012
Rethinking Aging Growing Old and Living Well in an Overtreated Society by Nortin M. Hadler, M.D. (broadcast 1-16-2012) Dr. Hadler uses his more than 35 years in the medical profession as an honored physician, investigator and educator to bring us an alternative view of aging in our society in the 21st century. Swimming against the current of medicalizing every step of the aging process, he works to make his readers able to make informed medical decisions “unfettered by worrisome notions of health promotion and unnecessary or harmful forms of disease management.” He does this with style, documentation and finally…poetry. For anyone planning on living to a ripe old age this book may steer you clear of a lot of the whirlpools along the way.
November 12, 2011
Taking prescription drugs and submitting to medical tests and procedures have too many side effects and unintended consequences for one not to learn about the risks as well as the benefits. Dr. Hadler falls on the skeptical end of the spectrum, and his position sounds pretty persuasive to me. Next up: Your Medical Mind.
April 15, 2012
Very interesting. Worthy of discussion among those caring for older adults. Didn't agree with all of it, but many of his points were right on. We need to focus more on quality of life.
February 20, 2016
I can't really say that I read this book. I couldn't even get started in it. Very dry, written like a boring textbook.
January 28, 2021
Another excellent book from Dr. Hadler, whose common sense concerning treatments, surgery and medicines often prescribed by general practitioners can save a lot of us from being overmedicated and even harmed. In this book he addresses aging in a calm, reasoned way and warns the elderly that many of the very procedures and medicines they believe are extending their life are actually having the opposite effect. This book is so timely because just this past year a friend was diagnosed with Type II Diabetes at a relatively young age. She was put on medicine and became ill from the meds and her sugar was all over the place. She never had any symptoms of diabetes and while I know that is not uncommon, her glucose level was only slightly above 100 and it was far too soon to treat. She suffered repercussions and, after a scare when the blood sugar dropped too low, stopped taking the meds and the condition cleared up. While there is some legitimate concern if a 20 or 30 year old person exhibits symptoms or has a high glucose level and treatment may be appropriate, expecting older people to remain within the same levels is just not logical. The older you are when things like hypertension and high glucose and cholesterol start to rise should be a consideration as to whether you need treatment. All of these issues can certainly affect the body long-term, but if you are already older, it is less likely that the conditions will lead to death or serious harm and far more likely that the treatment will do more damage and ruin the life you are enjoying NOW. Ultimately none of us will get out alive and enjoying life should be our primary goal. If something bothers you and makes life difficult, by all means treat it. If you otherwise feel well and are a "senior citizen", why rock the boat by taking something that will make you feel less well. Overtreatment should be viewed as seriously as undertreatment and lawsuits should be filed when damage has been done due to having a medication or procedure forced on you that you would rather skip. Doctors need to be reminded to "do no harm" and that can sometimes mean leveling with the patient and giving them the WHOLE truth concerning their "miracle medicines". Otherwise you may as well be treated by a witch doctor.
January 16, 2017
Too many studies, too many statistics, and too much medical jargon ruined this book for me. The topic is interesting but the book couldn't deliver for me. On the positive side if you need help falling asleep, this book will do it.
August 3, 2018
Aging from a different prospective. It is rather dry reading,, LOTS of statistics and studies are quoted but if you can get thru all of that, you will find it interesting what Dr Hadler thinks are necessary tests and what are not. and you will rethink aging.
January 8, 2021
I hesitated between 2 and 3 start. The content is interesting and could be usefull.
July 2, 2025
Medical opinion on the over-treatment of the very aged or frail. Perhaps a little dated and we can only hope general practice has improved. Very thorough references to the literature.
October 14, 2013
An excellent, clear-eyed look at aging and at the over medicalization of aging. He supported his opinions well and explained to the reader how to look at the confusing information spouted by studies and those who profit from the misunderstanding of the studies. I think this book is important to those of us in our fifth and sixth decades and I recommend it as a tool in the toolbox of aging. it is much more important to read and learn from this book than to read yet another article or book on how much money you will need in retirement. It I'd not an indictment of our healthcare system but it certainly doesn't pull any punches about needed improvements.
April 20, 2012
I would like to have rated this book higher. Dr. Hadler's thesis is that we overexamine and overtreat people. I tend to agree, and came to the book looking for facts and figure to substantiate this. However, I was unwilling to invest the effort it would have taken me to fully follow Hadler through the details of the many studies he cited and the conclusions he drew from them.
December 29, 2014
Be smart.
Don't do everything your doctor orders.
No unnecessary screening tests.
Go to the doctor only when you absolutely must.
Be smart.
Espouses my own health philosophy almost completely.
But a bit STIFF in the writing department.
Don't do everything your doctor orders.
No unnecessary screening tests.
Go to the doctor only when you absolutely must.
Be smart.
Espouses my own health philosophy almost completely.
But a bit STIFF in the writing department.
Read
October 13, 2012Very worthwhile.
November 22, 2012
This book was chosen by a book group member...not my normal 'cup of tea', but it turned out to be an interesting and thought provoking read. And best of all the group had lots to discuss.
Read
June 22, 2016201501. B. Presuntuoso. Contrario a tutto senza proporre alternative.
Displaying 1 - 18 of 18 reviews