Less Medicine, More Health

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This week, I had the great pleasure of listening to a talk by Dr. H. Gilbert Welch. Dr. Welch is a general internist and professor of Medicine at the Dartmouth Institute for Health Policy and Clinical Research in the Geisel School of Medicine.

Dr. Welch was in Edmonton to give the 2016 Picard Lecture at the Faculty of Law at the University of Alberta. His talk was based on his book “Less Medicine, More Health”. Dr. Welch’s talk was informative and very entertaining. The talk was so good that I thought that I should share some of the highlights.  In his talk he discussed the 7 Assumptions in Medicine that are wrong and drive too much medical care and less health. These assumptions are common in health care are responsible for adding unnecessary costs to the health care system.


Assumption 1: All Risks Can Be Lowered

  • Disturbing Truth: Risks can’t all be lowered and trying creates risks of its own.


Assumption 2: It’s Always Better to Fix The Problem

  • Disturbing Truth: Trying to eliminate a problem can be more dangerous than managing one.


Assumption 3: Sooner Is Always Better

  • Disturbing Truth: Early diagnosis can needlessly turn people into patients.


Assumption 4: It Never Hurts To Get More Information

  • Disturbing Truth: Data overload can scare patients and distract your doctor from what important.


Assumption 5: Action Is Always Better Than Inaction

  • Disturbing Truth: Action is not reliably the “right” choice.

Assumption 6: Newer Is Always Better

  • Disturbing Truth: New interventions are typically not well tested and often wind up being judged ineffective (even harmful)


Assumption 7: It’s All About Avoiding Death

  • Disturbing Truth: A fixation on preventing death diminishes life


For those that missed this great talk,  you can actually listen to Dr. Welch present his ideas in a short video (7 min).

I certainly want to acknowledge that yes I am a family physician and admittedly I am at risk of falling into these assumptions. But as many of you know who have come to see me in my office I often spend more time discussing health promotion ideas and discouraging tests that lack evidence. I am in absolute agreement with Dr. Welch’s conclusion

“Seeking medical care is not the most important thing that you can do for your health.”

If you are interested in reading more on this topic, I would encourage you to find a copy of his book at either the library, online or your local book store.  His previous book call ‘Overdiagnosed: Making People Sick in the Pursuit of Health’ is also recommended. You may find the Choosing Wisely website interesting. http://www.choosingwisely

-Post by Doug Klein, Content from Dr. H Gilbert Welch, Photo Credit from book cover ‘Less Medicine, More Health’ by Beacon Press

  • That sounds like a great book, thanks for sharing the main pointers.
    Another book about “Too much medicine” is The Patient Paradox by Margaret McCartney a GP from the UK. It also makes you think about the risks of doing too much in medicine.
    Thanks for the blog!

  • I am glad i got to read THIS. I have been examining out a few of your articles and its pretty stuff to read. I will surely bookmark your blog.

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