An acclaimed medical expert and patient advocate offers an eye-opening look at many common and widely used medical interventions that have been shown to be far more harmful than helpful. Yet, surprisingly, despite clear evidence to the contrary, most doctors continue to recommend them.Modern medicine has significantly advanced in the last few decades as more informed practices, thorough research, and incredible breakthroughs have made it possible to successfully treat and even eradicate many serious ailments. Illnesses that once were a death sentence, such as HIV and certain forms of cancer, can now be managed, allowing those affected to live longer, healthier lives. Because of these advances, we now live 30 years longer than we did 100 years ago.
But while we have learned much in the preceding decades that has changed our outlook and practices, we still rely on medical interventions that are vastly out of date and can adversely affect our health. We all know that finishing the course of antibiotics prevents the recurrence of illness, that sunscreens block harmful UV rays that cause skin cancer, and that all cancer-screening programs save lives. But do scientific studies really back this up?
In this game-changing book, Dr. Paul A. Offit debunks fifteen common medical interventions that have long been considered gospel despite mounting evidence of their adverse effects, from vitamins, sunscreen, fever-reducing medicines, and eyedrops for pink eye to more serious procedures like heart stents and knee surgery. Analyzing how these practices came to be, the biology of what makes them so ineffective and harmful, and the medical culture that continues to promote them, Overkill informs patients to help them advocate for their health. By educating ourselves, we can ask better questions about some of the drugs and surgeries that are all too readily available—and all too heavily promoted.
Paul A. Offit, MD is the Chief of the Division of Infectious Diseases and the Director of the Vaccine Education Center at the Children’s Hospital of Philadelphia. Dr. Offit is also the Maurice R. Hilleman Professor of Vaccinology, and a Professor of Pediatrics at the University of Pennsylvania School of Medicine. He is a recipient of many awards including the J. Edmund Bradley Prize for Excellence in Pediatrics bestowed by the University of Maryland Medical School, the Young Investigator Award in Vaccine Development from the Infectious Disease Society of America, and a Research Career Development Award from the National Institutes of Health.
Dr. Paul A. Offit has published more than 130 papers in medical and scientific journals in the areas of rotavirus-specific immune responses and vaccine safety. He is also the co-inventor of the rotavirus vaccine, RotaTeq, recently recommended for universal use in infants by the CDC; for this achievement Dr. Offit received the Gold Medal from the Children’s Hospital of Philadelphia and the Jonas Salk Medal from the Association for Professionals in Infection Control and Epidemiology.
Dr Paul Offit was also a member of the Advisory Committee on Immunization Practices to the Centers for Disease Control and Prevention and is the author of multiple books.
8th July 2021, proper review. I was told that I shouldn't send all my reviews around twice, but I don't I write 'reviews' as I read it and then a final one (sometimes). I could do it on updates, but if I do that, I lose what I've written as the bookshelf export doesn't show that. So there you go.
1. Fevers are good for you. It's the immune system causing it because it works better at higher temperatures. If you can put up with aches and pains and feeling miserable you will shorten the illness by about 3 days.
2. Finishing the antibiotic course seems to be a lot to do if you are in hospital (very short courses, insurance companies want you out of hospital) or at home (very long courses, drug companies who pay your doctor want you to have long ones).
3. Antibiotic resistance is from long courses, but not how you would think. All bacteria in and on your body communicates. All of them can become resistant.
4. Japanese eyeball licking and antibiotic eye drops. They don't work. You get better just as fast without them for conjunctivitis. Use other soothing ones that don't cost so much and don't need a doctor's visit and prescription. There was a long discussion about Japanese eyeball licking from which a lot of Japanese kids who had conjuctivitis and various medications, days off school, etc were tested. Japanese eyeball licking is probably fictional!
5. Vitamin D supplements are akin to the MMR vaccination and Dr Andrew Wakefield. The person who said we needed more, a professor, was doing research entirely funded by a lot of vitamin companies. He also advised tanning beds. He was part owner of a tanning bed company. Dr. Michael Holick is no longer doing research. Vitamin D is not a true vitamin, it is a hormone, as the body can make it, unlike all other vitamins. Very few healthy people need vitamin D supplements because food is already fortified with it and the sun does the rest.
There are people who don't eat those foods and don't let their skin be exposed to daylight, think of women in burkhas and of their daughters some as young as 9 with their bones still developing. Vitamin D was introduced as an additive because of little children in Victorian London onwards who worked in factories throughout daylight hours, never got the right food but got rickets and soft bones. So it's in bread, margarine and a few other items. I wonder if these women and girls eat these foods> If not maybe the range of foods with added vitamin D needs rethinking.
Somewhat ironically, the book I've been reading alongside Overkill: When Modern Medicine Goes Too Far is Stephen King's Misery. In case you're not familiar with it, it's about a famous author who is in a terrible car accident. He wakes up a couple weeks later, addicted to Novril and tended by a psychotic woman, who he learns is his "number one fan". We might think Paul is lucky that this woman was a nurse. Wrong! A goat herder would have taken better care of Paul than retired nurse Annie Wilkes.
Now to Overkill....
Overkill is not a novel and it's not about crazy nurses purposely getting their patients addicted to drugs, keeping them locked up in their homes, and sawing off their thumbs because they're pissed. What it is about is medical practices that are outdated, which research shows are not effective or even harmful, that doctors continue to perform. Maybe that doesn't sound as exciting to read as a novel about a psychotic nurse torturing some poor soul, but believe me, it is!
In Overkill: When Modern Medicine Goes Too Far, author and physician Paul A. Offit explores several common practices, screening tests, and supplements and shows why we need to reconsider them. Included are such things as:
• Cancer screenings for thyroid, prostrate, and breasts
• Vitamin supplements
•Aspirin to prevent heart attack and stroke
•Knee replacements
•Finishing the entire course of antibiotics, even after you feel better
•The insertion of heart stents
•Treating fever with antipyretics
Mr. Offit explains why these and other practices are outdated. He backs up his claims with numerous studies that I found fascinating to read. As he says, we should not just take his word; we need to look at what scientific studies show. And wow! What the studies show will probably surprise you!
The author examines the way these practices came into being and why they at first seemed successful, even though later tests proved the opposite.
He also explores the various reasons many doctors are hesitant to change. From merely not having time to keep up with the new research, to wanting to placate patients by giving in to their demands (ahem.... please stop listening to pharmaceutical ads and thinking you know better than your doctor what medication you need. Chances are, you don't); to fearing a lawsuit if they don't do every possible test or procedure, even when they know it probably won't be beneficial; to wanting paid... and you don't make money by doing nothing.
One thing is clear, we as patients need to demand more from our doctors when it comes to education and information, and less when it comes to medication.
Overkill is a must-read for anyone wanting to make informed decisions about their health. In order to be an advocate for ourselves, we first need to be educated. While some readers might be daunted by the mention of plentiful studies included in the book, it is nothing to feel intimidated by. Mr. Offit writes clearly, in a way easy to understand for the average person. You need not be a medical practitioner to understand the studies, nor do you need to have a background in medicine to make sense of the results. If you want to become a better advocate for your own health, you don't want to miss this book!
I hate it when my long-held beliefs are blown up by sound scientific studies! Offit takes on fifteen common medical beliefs that are held by the general population and medical professionals and are not supported by double blind experimentation. Lowering a fever does not help the body fight an infection. Antibiotic eye drops rarely cure pinkeye. Antioxidants and vitamin E can actually contribute to cancer. Giving testosterone to older men does not improve their sex lives but doubles their risk of a heart attack. And sunscreen does not prevent skin cancer—something my pale ‘Scottish’ complexion definitely did not want to know!
Offit cites studies, and more studies, to support these conclusions. So---I am going to have to rethink my beliefs. Who knew that RICE (Rest, Ice, Compression, Elevation) isn’t good for a sprained ankle? And that taking extra vitamin C does nothing to counter a cold? [Sorry Dr. Pauling—it seems you were wrong.] Highly recommend.
For too long, Americans have been taking their medical advice from the likes of Jenny McCarthy and Gwyneth Paltrow, says Dr. Paul Offit. Overkill is his (hopefully not futile) attempt to get the scientific truth out there. The book’s chapters dispel longheld beliefs/myths either propagated by doctors or supported by them. Each topic is filled with randomized clinical studies that show unambiguously, simply and directly that common knowledge is flat-out wrong.
1. One very basic falsehood is that fever is bad and must be addressed with meds to reduce it. Fever is the body’s immune response, its way of delivering help. Increased heat means blood carries aid to the damaged area faster. The heat allows the body’s defenses to operate more quickly and intensively. It is a sign the body is dealing with the problem. Chilling a fever, lowering body temperature and defying the help with anti-pyretics defeats the system and means a slower recovery (and sometimes death). An infinite number of studies shows this is true. Brain-frying from too high a fever is a myth; the body knows how high it can go in the battle to restore health. If you have a fever, bundling up, not cooling down is what will help.
2. Antibiotics are misprescribed 75% of the time, Offit says. Doctors prescribe them for conditions such as viruses, for which they have no use at all. Patients demand them, and will give a doctor a poor rating if s/he doesn’t quickly prescribe them. Offit shows that taking antibiotics all the way through is not only pointless, but damaging. This is the very opposite of popular thinking that everyone must take the full course in order to completely defeat the bacteria causing an illness. He says as soon as the bacteria begin to abate (ie. the patient begins to feel a little better), it means the body has taken charge and will eliminate the intruders itself. Usually 3-5 days’ worth of antibiotics suffices. Two and three week courses achieve nothing other than strengthening the bacteria that survive.
3. Vitamin D is a scam. Study after study proves beyond question it has no effect. Yet the marketing and promotion by certain doctors say the opposite – that vitamin D has been shown to improve bone strength or any number of other claims. Not one is true. Everyone wants vitamin D to be effective for treatment, so the studies continue. But it has never once come through. Same for beta carotene. Incredibly, it evens says on my own blood test report how valuable and important very high levels of vitamin D are, according to the loudest mouth on the subject, who is also behind the continual raising of the minimum level required. He has engineered it so that everyone automatically has a vitamin D deficiency. That is not medicine. It is marketing for big profit. And it works.
4. Antioxidant supplements don’t work. They don’t do the job people buy them for. No studies show them being effective at anything. People spend billions on antioxidant supplements for absolutely nothing, except overdosing on them can cause cancer and heart ailments, and people love to up their own dosages. Massive doses of vitamin C have also shown to be completely useless in preventing or shortening colds. The whole culture of self-dosing with vitamin C came from one very famous doctor, who continually denied the results of gold-standard clinical studies and refused to admit he was wrong. It costs Americans billions.
5. Testosterone doesn’t work. It does not provide any of the promised changes in well-being. No studies show it effective for any of the promises made. Testosterone declines naturally as men age. An extreme decline may be hypogonadism, but testosterone supplements do not cure that, either. It does not increase bone density, lighten depression or cure erectile dysfunction. Like any steroid, overuse can (easily) lead to aggression, hostility and violence. And it increases the risk of heart attack and stroke, with no upside.
6. Aspirin is not the miracle drug everyone thinks it is. It is not safe or harmless, and also not effective for things like high blood pressure and hypertension. It causes bleeding in a lot of people. Offit shows the most amazing thing about aspirin is that it keeps reinventing itself. Just when the medical establishment has given up on its current main attraction as being invalid, it comes up with another. Baby aspirin does not prevent first strokes or heart attacks. But it does have an effect preventing a second stroke or heart attack, and also helps prevent colon cancer.
7. Food allergies can be prevented by feeding those foods to infants. Preventing infants from encountering them sets up a confrontation with the immune system later, when it locks up.
8. The only effective sunblock is clothing. Sunscreens are effective up to a point, but none screens out 100%. Proof of UV ray damage is volunteered daily by people using tanning beds, a national suicide cult, it seems. Like a mice experiment, tanning bed users have shown us the difference between UVA and UVB rays (UVC rays don’t make it to the ground), and how the different cancers manifest. There are three types of skin cancer: squamous (surface), basal (deeper) and melanoma, which can occur anywhere and even affect people who get little sun. Sunscreens actually increase the risk of melanoma, so they are not a panacea. Worse, sunscreen creams make people believe they can take more sun without risk. This is totally false. Sunscreen should be at least SPF30 and be applied every two hours.
9. Reflux meds do not help babies. Babies spit up and cry. They do it not because they are defective but because they are young. Lying on their backs after eating allows acidic stomach fluids up the esophagus in their underdeveloped systems. And reflux meds can be fatal to babies. The problem usually ends by the first year anyway.
10. Prostate cancers are something men die with, not usually of. The standard test, PSA, is riddled with false positives and false negatives. Doctors know this, but prescribe it continuously anyway. Taking action on the basis of a PSA score is riskier than doing nothing. The “cures” are usually worse than doing nothing. 50 of 80 who choose prostatectomy or radiation will suffer complications. 15 will develop erectile dysfunction, 15 incontinence, and five will die even if the prostate is completely removed. Per 100, one life will be saved. For 99 it will be a waste of time. Mostly, it’s a moneymaker for the healthcare system. Offit quotes the discoverer of PSA in a New York Times op-ed: “I never dreamed my discovery four decades ago would lead to such a profit-driven public health disaster.”
11. Thyroid cancers can now be detected with ultrasound machines, and as a result, the number of thyroid cancers detected has soared. Unfortunately, the cancers detected are papillary and not really cancers. Still, victims have to go through biopsies, surgery, chemotherapy or radiation and must replace the thyroid’s secretions by meds, which are very tricky to get right, and often result in numerous other undesirable conditions. And for all this, the death rate from thyroid cancer has not changed in two decades, Offit says. The flood of early, frequent screenings has not saved lives, but caused pain and anguish across the country.
12. Breast cancer screenings don’t save lives. Studies around the world show that mortality from breast cancer remains the same whether there is screening or not. For one thing, breast cancers have been studied so finely we are able to discriminate among variations, and have a deep arsenal of effective treatments for them. For another, the anguish of undergoing biopsies, surgery, chemotherapy or radiation therapy – for a false positive, is unacceptably high. As with prostate cancers, many diagnosed with breast cancer will die with it and not of it.
13. Heart stents are very popular. Patients demand them, and doctors accede to their wishes. They don’t work. They have no effect on mortality according to the studies. They are a waste of time, money, and are a surgical risk.
14. Arthroscopic knee surgery does not fix meniscal tears or arthritic knees. The studies prove it. Programs of physical therapies and education (eg. posture) do better, without surgery.
15. Mercury dental fillings are not poisonous, except to the oceans, where old fillings end up. The quality of the mercury does not lend itself to disease, or everyone would have died of it. All kinds of people claim to have been instantly relieved of a menu of symptoms with the removal of their filings. Offit says this is despite the fact that by removing the fillings, the patient absorbs a tremendous amount more mercury than if they were left alone. The ADA’s Council of Ethics, Bylaws and Judicial Affairs says “Removal of amalgam restoration solely for the purpose of removing toxic substances from the body when such treatment is performed at the recommendation of the dentist, presents a question of fraud or quackery.”
16. Ankle sprains are extraordinarily common, and everyone “knows” to treat them with RICE: rest, ice, compression and elevation. Except that’s 0 for 4. None of those things work. Their exact opposites are what is needed. Even the doctor who came up with RICE admits he was wrong. But that hasn’t stopped anyone. What victims should do is let the warmth of inflammation do its work, and rather than rest, wiggle their toes as if writing with a pencil.
17. Teething does not cause fever. It turns out that infants lose their immunity from birth bacteria at just about the time teeth come in. So those who come down with fevers are the victims of coincidence, not caused by teething.
Overkill is refreshingly candid, clear and simple. It clears the air, adding a small doses of certainty where the fog of common knowledge usually reigns.
What we all could use is a good old dose of of what my mum would refer to as common sense. Many people seem to be missing the common sense 'gene' these days. The only thing that was really new to me in this book was the advice about not icing sprains. However, once explained, it makes a whole lot of sense. Overall, I wished for a more engaging tone and I found I skimmed to get to the 'good' bits.
As I read, my mind wandered and I thought about the approach of my British family during my formative years which was to wait and see. Then, in contrast, the more pro-active approach of American friends who rushed to the doctor's office for antibiotics at the first sniffle. Then, for some reason, I thought of the Monty Python sketch where the Black Knight's arm is cut off and he continues to wield his sword saying, "Tis but a scratch."
Overkill: When Modern Medicine Goes Too Far by Paul A. Offit is a refreshing look at modern medicine. Health problems are not always medical problems. In our modern world, we expect that pills, procedures and surgeries will solve everything that ails us. We then are submitted to unnecessary and most times expensive solutions that will not bring us back to good health. Dr. Offit dispenses good advice in a manner that informs as well as educates us. He discusses a dozen examples of this “overkill” and, at times, one cannot help but agree with the doctor. This very interesting book will make the reader think. Highly recommended.
My feelings about "Overkill" are mixed and lean towards disappointment.
First, the negatives. If you've read some of Dr. Offit's other books then you've mostly read this one. And this one is less engaging. Whereas in the past he's exhibited a fluid storytelling ability here it feels canned. Too many times he cites study after study with gray, monotonous, rote predictability. It felt very mailed in. There's some new material, and it's good, but be ready for the same old material about supplements and Linus Pauling, and the cancer metaphor (or is it an analogy?) of the barn door and the bird, the rabbit and the turtle. It's simply wrong to repeat so much in multiple books. I don't want to think of Dr. Offit the same way I see David Pogue - someone I really admire and enjoy that went to the well too often with books they've authored. "Overkill" overlaps a good deal with "Overdiagnosed" by Dr. H. Gilbert Welch (Welch is even cited in "Overkill") but Welch's book is far better all around.
Next, the good stuff. Public mistrust of science can be problematic and when done by charismatic crackpots with a following it's downright dangerous. Offit is himself a man of science and he challenges conventional medical wisdom for the public good. He conveys lots of helpful information by way of scientific studies and offers lots of insights to help the reader approach their medical decisions objectively. He's a man of real science and that's worth a lot.
If this book is on your to-read list, skip it and read Welch's book instead. But you should read Dr. Offit's books too. Just stick with the better ones such as "Do You Believe in Magic?" and "Autism's False Prophets."
I borrowed a big pile of his books from the library a few months ago and read all of them but this one. I almost just returned it without reading it, because I thought I’d already seen most of these topics covered elsewhere. So glad I actually read it! Even though I had come across several of these elsewhere, as usual he has a much better, clearer, accessible way of explaining them than most. It’s really hard to believe so many of these beliefs have persisted so stubbornly. I feel especially irritated at the ones around vitamin C and supplements. But it’s also very disappointing how many doctors are willing to perform either unnecessary or not worthwhile surgery either for profit or fear of bad feedback or being sued. Our medical system is just so messed up.
But one thing I thought this was going to be and it wasn’t is a look at how the US healthcare system can be very quick to prescribe medications for conditions that may not necessarily merit them or where risk far outweighs benefit, the tendency to prescribe something just so a patient feels they got their time’s worth, etc. That’s what I originally thought he meant by overkill. I think I have a good outline-type of idea of why that is, but if anyone knows of a book looking deeper into this, or comparing US methodology with health systems of other countries, please tell me! (I’m interested because of how the same condition of mine was handled in Europe vs the US, where Europe shrugged it off and undertreated and in the US it was over-aggressively treated to the outcome of horrible side effects. There must be a middle ground.)
Anyway, as usual he’s the best, read this. Being an informed advocate for your own health and having understandable scientific evidence explanations to back up the reasoning is the best.
This is one of the best books I've ever read. I consider it a must-read for everyone, both for the specific popular delusions it corrects, and for the larger lessons on the perils of making up one's mind ahead of, or in spite of, the evidence. The sad story of Linus Pauling stands out - he was a two-time Nobel Laureate who promoted the false (it turns out) notion that vitamin C in large doses cures or prevents the common cold. How many of us got suckered by that one? No individual's reputation, no matter how prestigious, outweighs the double-blind controlled study with replication.
Perhaps my only quibble was where Offit engaged in a wee bit of overkill of his own, by invoking a subtle naturalistic fallacy when blasting testosterone replacement therapy for aging men. Yes, aging is a natural process; and yes, trying to interfere with aging is "unnatural." But so is all of medicine! There are no doctors in a state of nature. If unnatural is bad, then we must dispense with all doctors and treatments and let nature take its course unmolested, whether that means cancer, malaria, or anything else regarded as a "disease." Offit asserts that aging itself is not a disease and therefore does not warrant treatment. But this is silly, as the definition of "disease" is arbitrary and always relative to some expected state of health. As medicine improves, our expectations increase. Aging is just another natural process like malaria. The only valid argument against treating aging as a disease is that we don't know how to do that yet. (Although, arguably, many diseases closely associate with aging, and there are plenty of attempts to treat them.) Should a general treament for aging appear, which would restore an old person to a state of youthful health and appearance, it would be medicine's greatest gift of all time. For now, it's sufficient to present the data for testosterone therapy being ineffective or harmful on balance. That is, the only thing wrong with a treatment for aging is that it doesn't work.
This is the 6th book I’ve read by Dr. Paul Offit and loved all of them. Dr. Offit is very concerned that sometimes medical practices don’t follow the data and this is the point of the book. In these areas, Offit discusses the background of the practice and the studies that show that these practices are not data-driven. While the book could have lapsed into a jargon-ridden dissertation, it did not thanks to Dr. Offit’s writing skills. This book is clearly written for the lay reader but will still be of great interest to readers with more medical knowledge. My only criticism of the book is that it seemed too short. I don’t know if this is because I couldn’t put the book down or because Offit’s writing just carries the reader away. In either event, I strongly recommend this book for anyone interested in medicine. Disclosure: I received a complimentary copy of this book via Edelweiss for review purposes.
Great read to start the year, not long before returning to work as a resident family doctor.
I think the book would benefit the general population, as it tries to shatter some well established medical myths. From antipyretics, to supplements, mercury amalgams, stenting, knee arthroscopy, and teething fever, the author tackles the change in the understanding and practice of medicine based on ongoing medical research.
The sad truth pervading the book is that regardless of the weight of scientific evidence, the narrative of the highly influential persons is more likely to be accepted by the general public.
My opinion is that evidence based medicine will be harder and harder to practice in a world where truth is subjected to individual opinions and preferences, and where social media influencers have a say in everything, including medicine.
I consider myself pretty well informed and scientifically literate, and yet I still learned a lot from Overkill. I’ve read most of Dr. Offit’s books at this point and this is one of my favorites for its content, delivery, and importance. Honesty, the fact that he continues to publish books, speak publicly, and hasn’t completely given up hope on educating humanity is incredible.
What a great book this one is. Very quick read. The only real criticism I have is I wish it were longer.
He went through many different topics around medicine. Most chapters start out by describing the condition, then talking about the history of the condition with how we started to learn about it, and then to walk through the history and studies of the changes in thought on the condition. Often then ending with why it's been difficult for patients and sometimes doctors to change the way they think about and prescribe.
This book does not mention Covid at all. But stepping through the 30 or so different topics covered, one thing becomes very clear. What we know about any given condition often changes radically as we do more double-blind quality studies. Seeing how difficult it sometimes is to get the medical establishment to change its mind over years, is it any wonder that needing to change our views on masks so quickly, turned out to be such a disaster.
Throughout the book, he also frequently talks about why it is so hard to change our minds on things. Most of what he said is very well known to anyone in the US. It's all about the perverse incentives that are in place. A few highlights of things we need to fix: 1) Doctors get paid more for doing something rather than nothing. 2) Advertising dollars are a disaster for our health. Did you know the US and New Zealand are the only countries that allow medical advertising directly to consumers? Why don't we have advertising dollars for NIH to inform us on topics that have big spending on the other side of them? 3) Ratings for doctors are big business, and sadly, the thing that can most quickly hurt a doctor's rating is pushing back on a patient that wants something that could be harmful. Antibiotics being the worst culprit.
I'd definitely recommend this book to everyone, I've already recommended to many. I learned a lot and had a hard time putting it down. Would love to see the next book from him focused on things we should be doing since this book was so much about things we generally should not be doing. If you know of a good book that tells us what we should be doing based on the evidence, I'd love to hear it.
No doubt an interesting book for those made unaware of the contents, this covers a wide gamut of medical misconceptions and beats them down quite soundly. While some may find it is very much an agent of repetition, it still has a lot of value, especially for anyone caught in past thinking. However, it does tend to droning on a bit throughout, and is very dry. Well worth reading for the information, but maybe bring a coffee with you.
This is a change from Offit's other books in that here he looks at the medical establishment, not outside quacks and profiteers, and that made it all the more disturbing. Especially as I read about treatments prescribed to my own family members which I know I will not be able to convince them are worthless and could even be harmful.
As someone who makes a conscious attempt to stay informed of the latest scientific consensus (particularly when it comes to the field of medicine, given the vast amount of misinformation that abounds), I have to say that I was greatly surprised by Dr. Paul Offit’s debunking of several medical misconceptions, including at least one that I fell for myself.
In Overkill: When Modern Medicine Goes Too Far, Paul Offit (a respected pediatrician and co-inventor of a rotavirus vaccine) examines a number of common medical interventions that have been proven to be more harmful than helpful. There’s no need to take his word for it, each chapter cites the scientific evidence for each of his conclusions.
I’ll just repeat a few of the book’s chapter titles to give you a sense of the information provided: - Treating Fever Can Prolong or Worsen Illness - Finishing the Antibiotic Course Is Often Unnecessary - Supplemental Antioxidants Increase the Risk of Cancer and Heart Disease - Vitamin D Supplements Aren’t a Cure-all - Baby Aspirin Doesn’t Prevent First Strokes or First Heart Attacks - Prostate Cancer Screening Programs Do More Harm Than Good - Heart Stents Don’t Prolong Lives - Don’t Ice Sprains - Vitamin C Doesn’t Treat or Prevent Colds
What is most shocking is that many medical professionals still dispense this discredited “wisdom” despite scientific evidence to the contrary. In fact, I was told by my doctor that my Vitamin D levels were low and had been taking supplements for the past several years (all based on a false premise and the dubious intentions of a single doctor in an influential position).
Insightful. It’s hard wanting to do the best thing as a physician when you’re fighting insufficient knowledge, big pharma, and patient satisfaction. The similar chapter breakdowns made it easy to read and left me satisfied after each chapter. So many things to know, not enough time to learn them and fix the system that’s perpetuating false hopes and beliefs.
A very informative book debunking many of the preconcieved ideas we have about our health. Here are a list of most of the ideas covered: Allowing a fever to progress without medication will reduce the length of sickness. Vitamin C has no correlation to staving off a cold. Vitamin supplements offer no benefit, people should get vitamins from foods. Excess supplementation cause greater health risks. Mammograms and thyroid screenings for cancer are mostly unnecessary and don't lead to more lives saved. There is a very high rate of false cancer diagnosis for mammograms. Stents don't prevent heart attacks. The benefits of Vitamin D supplementation are overblown. Arthroscopic knee surgery is less productive than physical therapy. There are no adverse effects of having mercury fillings. Fevers in babies are not caused by teething. The RICE (rest, ice, compression, elevation) method of dealing with sprains and injuries involving inflammation actually slows the healing process.
The author uses exhaustive studies to support his claims that the science is settled in these areas. Doctors may not be up to date in these areas, or, they fear that saying something to the contrary will lead to patient dissatisfaction. So, these ideas persist.
I and other family members have been impacted by at least half of the contested ideas. My entire life, I had colds and sinus infections. I tried supplementation with Vitamin C, which had no effect. Then I supplemented with Vitamin D. My colds and sinus infections went away. Now, 10 years later, I haven't had to use any cold medication or mucinex. On the very rare occasion I get sick, it lasts days not weeks. So I feel more research should be done there.
Finally, I was left confused regarding the use of stents. If someone's artery is blocked 95%, is the author suggesting not to have the procedure? How else can they open up the impacted area. Since I've been diagnosed with heart disease and had a brother die of a heart attack at age 53 this is a major worry.
I love a good debunking! Alternative stuff provides easier targets, and this book takes on some of that, but it's more aimed at misinformation that comes from the medical professions, abetted (or initiated) by the pharmaceutical industry.
Many drugs, surgeries, screenings, and other practices that are widely regarded as good and necessary are, in fact, not helpful and often harmful. Some of them are still supported by medical organizations' guidelines. Others are no longer recommended but still widely used. The author provides data from early studies that established those practices, and later, more definitive studies and reviews that disprove them. He goes into the physical mechanisms involved and the methodology of the studies, and it all is convincing.
The chapters are short and easy to read - a lot of information without an excess of words. The chapter titles show the author's points, such as "Treating Fever Can Prolong or Worsen Illness," "Finishing the Antibiotic Course Is Often Unnecessary," and "Baby Aspirin Doesn't Prevent First Strokes or First Heart Attacks." "Vitamin D Supplements Aren't a Cure-all" was a favorite of mine (it's so trendy!), as were "Thyroid Cancer Screening Programs Don't Save Lives" and "Heart Stents Don't Prolong Lives." The heart stent chapter was the first time I've understood the likely reason for this conclusion.
Not the best book for a hypochondriac. I learned a lot and maybe a little too much. It covered some very relevant topics from the over diagnosed nature of cancer, that Vitamin C doesn't really help before a cold, no one is really deficient of Vitamin D (oh and sunscreen doesn't really work), and you don't have to take a your antibiotics the full term prescribed.
An avalanche of knowledge and I'm going to take it all with a grain of salt. The point that really drove it home though was the reason we are given treatment plans that aren't necessary and over prescribed medication. There has been research proving that doctors that prescribe more and diagnose getting better reviews, less lawsuits, and more clients. They are rarely sued for over diagnosing, but are constantly sued if by chance they miss anything. They have also realized that everyone thinks they know exactly what is wrong with them and what they need and how much and if the doctor doesn't listen then they again get punished with complaints, bad reviews, and lawsuits.
So basically, we are controlling the medical industry as consumers and getting in their way to the point that they are just telling us what they think we want to hear.
I loved how this author presented information on medical practices that are common, yet proven to be of no real efficacy by multiple studies. I kept bringing stuff from this book up in my conversations with others as I read. With books like this, I like it when the author is able to present scientific evidence (i.e. citing multiple studies and their conclusions) without bogging down in technicalities. This gave me just enough info to understand and be persuaded without losing me in the details of numerous studies.
My notes and highlights will probably speak more to what impressed me with this than anything else I might write.
"People shouldn’t be expected to be their own doctors, but they should be informed about their health so that at the very least, they can ask good questions. If your doctor prescribes vitamin D or recommends a heart stent or a thyroid screen or a prolonged course of antibiotics, you would do well to know the facts. Then and only then can you be the best advocate for your health and your children’s health. Otherwise, you will continue to fall prey to the inertia, financial influences, and dogma that continue to allow for outmoded, unnecessary, and potentially dangerous therapies."
Book 17/50 for 2020: Another excellent, quick to read exposé of the pitfalls of modern medicine. Not to say it isn't great, it's just that sometimes we struggle to accept what the evidence actually says. Do away with the vitamin C loading, reconsider that mammogram, and realize it's avoiding the sun rather than the use of sunscreen that will decrease your risk of skin cancer. The only fault I found was in the section on reflux interventions for infants. Where's the evidence that a wedge under the mattress, rice cereal in the bottle or laying the baby on their tummy works because all three practices are not recommended for other reasons like SIDS or choking. I am concerned that a parent who struggles with their fussy infant may take an alternative one sentence suggestion to help and won't know that tummy time is only okay when baby is awake or that a baby position device is not recommended. In my opinion, if the interventions are found to be effective by the research then endorse and educate on how to do it properly/safely.
I have liked his previous books as well as this one. He summarized many published studies and synthesized the results into useful and unbiased information. His topics are common medical misconceptions for treatment of heart disease, knee pain, ankle strain, conjunctivitis and fever; screening for breast, prostate and thyroid cancers; supplements including vitamin D, aspirin, antioxidants and testosterone; and other over prescribed medications, procedures and bogus interventions. His explanations are simplistic but appropriate for the audience. Patients need to be their own advocates when they seek medical attention. Providers lament “Dr Google”, but they too often offer inaccurate remedies because they are not current on research, they are influenced by financial incentives, and rely on outdated dogma so patients must consult resources on their own. This book is an excellent resource.
“Patients aren't patients anymore; they're clients. Customer satisfaction has become the coin of the realm.”
4.5/5 - eye-opening and heavily condensed medical misconception debunker. Concerns about skewing data in author’s favour, will be checking out key papers associated with cited research. Great read if only to plant seeds of suspicion, discusses the dangers of non-falsifiable beliefs and the importance of thinking for yourself. Touches on antibiotic resistance, invasive screening tests for various cancers, and the pharmaceutical industry’s ties with healthcare creating heavy commercialisation of well-being. Would be interested to read about this from an ethical perspective- recommendations welcome pls!!
So interesting. The author debunks various therapies and medical "facts" with a thorough presentation of studies. I knew about the lack of evidence for vitamin C preventing the common cold but who knew that RICE was not good therapy for injuries. Also that reducing fever can prolong illness because you are blunting your body's immune response. But I'm still uncomfortable about the results for mammograms even though I had read about that before.
Overall, a very informative book and important in one's arsenal of being a smart health care consumer.
I felt like some of the things that Offit discussed seemed a bit out there, but since I am aware of the major racial inequities in health care, the baked-in fatphobia, and how big pharma controls so much I could see the possibilities for the things Offit was claiming to be true.
I am curious to know how he chose which myths to debunk. Also, he said a variety of fatphobic things, which was extremely disappointing. I had hoped for more from someone claiming to debunk healthcare myths. I would have really appreciated him debunking the myths surrounding weight.
What a fantastic book! Everyone who cares about their health and well-being should read this book. He does a tremendous job citing the scientific literature to demonstrate that many medical procedures should no linger be conducted. He also provides evidence that people shouldn’t be taking vitamins and that sometimes they cause more harm rather than just doing nothing. Ultimately it is up to each individual to be vigilant about their health and have conversations with their doctors.
With ample end notes (50 pages worth) to support challenges he may expect to be forthcoming, this hit-list of medical myths and misguided therapies comes from a highly reputable source - the director of Vaccine Education at the Children’s Hospital in Philadelphia and a professor of vaccinology and paediatrics. Robin Osborne, GPSpeak
interesting, quirky. Basically seeks to debunks some prevailing notions within medical care (as as you don’t necessarily have to finish a complete antibiotic treatment, or you don’t necessarily have to treat a fever because a fever could help break a condition quicker without intervention). I am not sure what I thought of this book but I will say I had a hard time putting it down.
In the past, many people succumbed to diseases that are otherwise kept under control in this day and age thanks to modern medicine. However, unbeknownst to many people, many medical practices that have persevered to this day have proven to be useless or worse, harmful. Yet, people still do them and even doctors advocate them. Why? Doctor Paul Offit seeks to explain this and debunk old medical practices that cause more help than harm.
When you have fever, take antipyretics (paracetamol, aspirin, ibuprofen). Take vitamin D supplements, because we all lack this essential vitamin. Always finish your antibiotic courses. Vitamin C prevents colds. Sound familiar? It's because these are advice that we follow, and our family doctors also tell us to do so. But what if these advice are outdated? In fact, what if they're more harmful than you think? If so, why do they still persist? Personally, I've seen how contentious some advice are in the medical community, so even I can't tell which advice is sound or not. Paul Offit wants to debunk some medical myths once and for all, some of which I didn't even know about.
I always love contrarian books. Books with content that runs counter to conventional wisdom. Not because I want something different from established facts, but more like I am open second opinions and "what if" theories. Dr. Offit's book is one of them, and it's enlightening to read how some conventional wisdom is perhaps as wise as you think. Taking paracetamol when you're having a fever is perhaps not the best thing to do, because the medicine impedes the immune system from fighting against the disease that infected your body. In the age of antibiotic-resistant bacteria, maybe you shouldn't complete your full antibiotic course which would make bacteria more resistant to it. Such eye-opening claims!
The medical literature continues to evolve with time, and people (especially doctors) should become more prudent with prescribing remedies. Yet, as expected of human beings, we are imperfect and we continue with practices that have been debunked even for a long time. Whether it's because of financial incentives, cognitive dissonance, or even evading litigation threats, we will always be careful about what treatment works and what would be detrimental to our health. Dr. Offit implores that we do, and I thank him for confirming some of the things that even I wasn't sure about. You should pick up this book, and put down those excessive vitamin C and D pills.