Customer Reviews

The Patient Paradox: Why Sexed Up Medicine is Bad for Your Health

5 star:		(18)
4 star:		(2)
3 star:		(1)
2 star:		(0)
1 star:		(1)

 

 

This is an excellent book. Using clear language, straightforward diagrams and plenty of examples, McCartney (who is also a practising GP) takes the mystery out of medical screening, reviews and statistics. Her analysis reveals some surprising and negative results, including overdiagnosis, further testing and anxiety, and increased costs. The arguments are persuasive and challenging, but ultimately positive: "Addressing inequalities is where the biggest gains in health are to me made, not our current model of taking well people and screening them into diagnoses they don't need and won't benefit from"

Accessible and easy to read, with a narrative grounded in personal experience backed up with well referenced, evidence based research, this fascinating book would appeal to anyone with an interest in healthcare, be it professional or personal.

This is a clearly written book, accessible to all giving an insight in to our current obsession with medical screening.

It gives the most readily understandable explanation that I have come across of relative versus actual risk of contracting serious medical conditions. It lays bare how statistics are manipulated and over-hyped to give a good story rather than to allow individuals to assess risks versus benefits and make a considered judgement, with their GP, of what might be the best course of action for them.

Margaret McCartney deserves a wide audience and I hope this book stirs the "worrried well" in to taking a more balanced approach to life.

Margaret McCartney is a GP who writes passionately and eloquently about the problems created for her and her patients when health stories are sexed-up by journalists and politicians.

Probability, prognosis, and risk are difficult even for statisticians, but Dr McCartney explains in crystal clear language how these are misunderstood and misapplied. The consequences are serious: wasteful expenditure on unnecessary investigations and treatments, often with serious psychological and physical effects.

"The patient paradox" should be read by everyone - at least twice.

There is a very strong history of breast cancer in my family. Nevertheless, when I'm offered regular screening mammograms in a couple of years time, I will probably refuse them. It's also unlikely that I will go for any more smear tests, despite the recent 'Jade Goody effect'.

Controversial?

Margaret McCartney's book separates the facts from the headlines, explains the encroaching position of government and pharmaceutical companies on our welfare, and explains how thousands of healthy people are being turned into patients. She looks at the influence of charity and celebrity, and emphasises the increasingly difficult position that our GPs are placed in today.
This is a fascinating, well-researched and easy to read book that should make you question how the NHS works, how it ought to work, and how you want it to work for you.

This is the book to read if you want to know what the hidden agenda is when you visit the doctor's surgery, and whether the screenings you are offered from NHS and private companies are really risk-free, beneficial or even necessary.

It is no surprise that the pharmaceutical industry has an unhealthy and powerful influence on clinical practice, but Margaret McCartney will shock you by revealing study results and parliamentary inquiry conclusions on just how controlling this heartless industry is.

The `inverse care law', the phenomenon of the most ill people having the least access to care, was first described by a Welsh GP nearly 40 years ago. Rather than adjusting the balance in favour of caring for the most needy, our healthcare system has perpetuated this law by focussing even more intensely upon the `worried well' who are made vulnerable by clever advertising then parted from their cash in return for screenings they don't need.

Margaret McCartney offers a lively and impassioned explanation of the hidden facts about screening for the illnesses we are told we should be most concerned about. She reveals facts about tests whose accuracy and value we take for granted, and how screenings are introduced by vote-seeking politicians rather than clinicians on the basis of hard evidence.

This is an important book...you'd have to be living in a bubble to not be exposed to the public 'fight' against cancer, cholesterol and other threats to wellbeing. The Patient Paradox encourages a closer look at the weapons used in this 'fight' and redefines terms like 'wellbeing' and 'risk'.

I suffer from NHS fatigue. I feel that rather than concentrating on the issue that I have attended the GP surgery for I seem to be bombarded with reminders for cervical screening and blood pressure monitoring. (my blood pressure is and has always been good). No doubt before long I will be pursued for breast examination, cholesterol testing, bowel cancer screening etc etc....... Well now that I have read this book I will feel confident and reassured to turn down these invitations. This book distinguishes between pre-symptom screening and for example going to the surgery if you discover a lump or have some other niggling symptom for a few weeks or more. The anxiety of all these tests is guaranteed to raise the blood pressure of even the most fit and healthy. My family and I, not to mention numerous friends have had nothing good, and arguably more harm come of this barrage of screening. For example, my fit and healthy 84 year old grandmother has recently had bowel surgery for a 'cancer' which she didn't know was there, had no symptoms for and now suffers the anxiety of constant hospital visits, the pain of surgery and the diabolical treatment of a hospital ward which still makes her upset every time she talks about it. As she said, she has had a good life and would more than likely have otherwise passed away without ever knowing that she had a problem. On the other hand, my mum had two years of horrendous near constant bleeding which the doctor claimed was the menopause and tried to push her out of the door with HRT. It turned out that despite never missing a smear test in her life she had advanced cervical caner and had to endure chemo and radio therapy. We have knowledge of three other women who have also had cervical cancer and their worrying symptoms ignored. All of which attended screenings when invited. In contrast we can think of no-one who has had their life made better, by screening. Back to my poor old Nan, she has cholesterol levels which the GP says are excellent for a woman of her age, yet they keep giving her fasting blood tests for cholesterol which make her feel unwell and leave her panicking and cutting things out of her diet that he enjoys for fear of the results. Conclusion. Screening does more harm than good. For some tests the actual number of lives saved is proportionately tiny. The book carefully explains the difference between relative and absolute risk which in my opinion is the golden nugget that has more or less completely relieved my screening anxiety and confirmed something that I always suspected to be true.

Ever known a healthy person who's become a 'patient' overnight? That's what can happen if we subscribe to the so-called "catch it early" mentality of mass screening which is costing the NHS a fortune: money which could be better spent helping those who really are sick. This book will give you the confidence to say no to those often arrogant screening 'invitations' which play down (or don't even mention) the negative aspects of such procedures, e.g. false positives, over-treatment.

What Margaret McCartney has to say is important. She gives a clear evidence based explanation of the little reported dis-benefits of medical screening, of the dangers of the mass prescription of drugs such as statins and the way in which the drug companies use charities to front their PR campaigns. She also explains how politicians fall into the trap of pushing simplistic solutions to complex and often counter-intuitive medical issues.

She has a clear grasp of medical statistics and the ability to explain the statistical evidence to her readers. In particular, she clearly explains the confusion arising from the difference between relative and absolute statistics.

However, her greatest strength is that her only bias is that of a Glasgow GP. There are many bloggers and writers commenting in this field but all too often their persuasive analysis misuses the evidence and is followed by a pitch for their own fish oil supplement, subscriber only newsletter or rejuvenating health course.

We are bombarded, as patients and consumers, by a never-ending storm of flim-flam, nonsense and misrepresentation.

This book helps equip you with the skills you need to cut through the nonsense and identify hard evidence from quackery.

This book has been carefully researched and is accurate and well-written.

These aren't maverick views; every doctor I know shares most of them. So why are patients not more aware of this - have doctors been deliberately hiding them?

The answer is firmly 'no'. Unfortunately doctors simply do not have time for a fully informed discussion with all of their patients, but this isn't their fault - it is because these examples of over-screening, investigation and treatment are so widespread now, that doctors have little choice but to comply with them, for reasons explained in this book. They are often exasperated themselves!

My advice would be: read and enjoy this book and if you're concerned about things like screening invitations, don't spend endless hours researching on the internet. Ask your GP what they think and more often than not, you will find that their opinions are similar to those of Dr McCartney's.