Disease-Mongers: How Doctors, Drug Companies, and Insurers Are Making You Feel Sick - Hardcover

Are your health care providers duping you? Payer ( How to Avoid a Hysterectomy ), formerly chief medical correspondent for the International Herald Tribune and health editor for the New York Times , seems to think so, arguing that far too many doctors, as well as drug companies and insurers, are bilking the public, frightening people with unnecessary tests and concentrating far too much on benign conditions--e.g., fibrocystic breast disease, mitral valve prolapse and insomnia. Even though young women fall victim to breast cancer, for example, she opposes regular mammogram screenings for women under age 50 because the test often does not find cancer in the women. She cites studies showing that women who underwent regular screenings did not fare much better against breast cancer than those who were not screened. And she's concerned that since mammograms detect noncancerous abnormalities that must be checked out, they cause anguish and unnecessary surgical expense215 . When it comes to insurance, she advises that if a person has a pre-existing condition that he or she does not want to acknowledge, the person should make sure there is no way an insurance company can find out about it (either through medical or pharmacy records or from a central medical data bank). To be sure, there are devious drug companies and incompetent and crooked physicians who will wreak havoc with one's health. And yes, doctors often administer far too many tests in order to prevent a malpractice challenge. But does that mean the public should abandon medicine--or common sense?
Copyright 1992 Reed Business Information, Inc.

Payer's book seems to be addressed to the "worried well" or hypochondriacs and offers scant comfort to anyone living with any medical condition for which ignoring or minimizing symptoms and simply being tougher may not be the best idea. This book has many important ideas and insights into the way we conceptualize disease but is severely limited by the author's anecdotal style (though the text is heavily referenced) and her focus on individuals, making only passing acknowledgment of the social, economic, and ethical contexts expressed more coherently and sensitively in Arthur Barsky's Worried Sick: Our Troubled Quest for Wellness (Little, Brown, 1988) or Daniel Callahan's What Kind of Life: The Limits of Medical Progress ( LJ 1/90). An optional purchase.
- Mary Chitty, Biotrends Research, Natick, Mass.
Copyright 1992 Reed Business Information, Inc.