Sunday, 14 December 2008

Overtreated by Shannon Brownlee

The subtiutle of this book is "Why too much medicine is making us sicker and poorer". This book was quite shocking. I know there is a lot of what goes on in healthcare that is unnecessary yet to find a huge amount of detail and information in one place really put the issue into perspective. It is focused mainly on the USA though there are many parallels with other health systems.

Throughout the book, the author provides stories and examples to illustrate the data and statistics that without the stories would appear cold and less shocking.

As I read through the book, particularly in the early chapters I found myself going "I know him/her"! Shannon Brownlee hooks a fair amount of the debate onto the actions of some of the current health leaders in the USA (you might like to read the book to see if you are mentioned...!) There is an excellent chapter on the VA Healthcare systems, how it has improved and in many cases how it is an example of how healthcare in the USA could look and feel.

Chapters include:
  • Too much medicine: complelling arguments as to why population based healthcare would be a real improvement
  • The most dangerous place: beware the hospital and what might happen
  • Your local hospital: how uncoordinated care and overtreatment results in poor outcomes
  • Broken hearts: how the latest fad takes root, based on economics
  • The desperate cure: an argument for evidence based care if there ever was one
  • The limits of seeing: an expose on the limits to radiology tests
  • The persuaders: mmm who is influencing whom, and why?
  • Money, drugs and lies: why not to believe everything published in journals
  • The doctor isn't in: all about managed care
  • When less is more: some ideas to cope with over-capacity and overtreatment in the USA

This book is a must for every health care improver who believes their own project is making a difference... The strategic and tactical issues raised in it really provide a new perspective.

There is a website for the book, with extracts at http://www.overtreated.com/the_book.html