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27 of 27 people found the following review helpful
5.0 out of 5 stars The Patient Paradox: Why sexed-up medicine is bad for your health
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...
Published on 16 Mar 2012 by Helen

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0 of 16 people found the following review helpful
3.0 out of 5 stars Thought provoking
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Published 21 months ago by Amazon Customer


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27 of 27 people found the following review helpful
5.0 out of 5 stars The Patient Paradox: Why sexed-up medicine is bad for your health, 16 Mar 2012
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.
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20 of 20 people found the following review helpful
5.0 out of 5 stars Medicine, screening and risk - clearly explained, 17 Mar 2012
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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.
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15 of 15 people found the following review helpful
5.0 out of 5 stars Read this if you care about your health, 4 May 2012
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.
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12 of 12 people found the following review helpful
5.0 out of 5 stars An unhealthy paradox, 22 May 2012
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'.
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9 of 9 people found the following review helpful
5.0 out of 5 stars "The Patient Paradox" provides an unbiased view., 8 April 2012
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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.
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7 of 7 people found the following review helpful
5.0 out of 5 stars A Good Look at Modern Medicine, 4 Nov 2012
By 
Donald Scott (Scotland) - See all my reviews
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This is a very readable book. I like the way the author expresses her opinion-voiced in an intelligent, rational and caring way. These are the characteristics everyone would like in their own GP? She has written this work partly to convey her concerns about the over-medicalisation of society-making patients out of normal healthy people. She covers the subjects, which often get passed over rather rapidly when making decisions about health care options. For example: What is the evidence for one form of treatment over another? Is the preferred treatment safe, effective and just what are their risks and benefits? Has the treatment been really tested, and by whom?

We are all consumers today, we need to know the things that can confuse the healthcare debate. There is the perception that by using statistics we can cover up, rather than reveal the authentic facts. What confidence can we have that Big Pharma and academics working within Media reveal all their data on research in full? Patients rely heavily on their GP's opinions on favoured options when making choices. The author suggests innate bias is not always fully recognised by either party during a consult.

Dr McCartney follows a long line of heretics who question the purpose of medical care. Currently mainstream medicine claims to be objective, scientific and absolute in its knowledge base. It disregards any suggestion that medicine and healthcare is as much an art as a science. Is it possible that medical provision is not in any way weakened by that admission, perhaps just the converse? Marcia Angell, Richard Smith, John Abramson, James Penston and H. Gilbert Welch follow the tradition of questioning mainstream thinking on health. This promotes magic bullets-the promise of fixing a problem quickly and permanently by changing a specific biochemical pathway or removing a troublesome symptom. This paradigm focuses and defines the problem as a specific isolated symptom, rather than exploring underlying psychological, nutritional or other lifestyle issues.

Much of this book concerns the media and its portrayal of illness, and its influence on people's expectations. It also considers the relevance of studies on illness conducted by groups that have inherent bias underpinning their published data. There's a saying, "If you've something big to say, then grab a statistic as it lends authority." There's also the implication that statistics are used by people who have no authentic proof. The author contends that by focusing treatment on people who are fundamentally well and then creating the illusion of potential morbidity or suggested illness, then you create a huge market for products that offer no value. Because there was no genuine illness to begin with. This is effectively a PR exercise that offers massive dividends to the providers of these products.

McCartney is skeptical about many claims-from vitamin supplements to lactobacillus in yoghurt. She cites the Cochrane review to illustrate what many believe to be a trustworthy examiner of treatment effectiveness. Cochrane Reviews are synonymous with neutral in terms of their ability to examine trials without bias. `They take account of all the evidence, not just the agreeable highlights.' (P.107). Cochrane produces a good few counterintuitive conclusions. Taking vitamins as prophylaxis (to prevent an illness occurring) for cancer, seems to be productive-perhaps due to the reduction of `free radical damage'. The same authority cannot recommend the use of vitamins after cancer has been diagnosed. Perhaps due to cancer cells using the nutrients to metabolize more rapidly, increasing the rate of mitosis. Or perhaps the extent that the environment around cancerous cells changes, influencing hormone regulation or complex immune cell adaptation. Cochrane doesn't consider the reasons why data reflects a specific conclusion, leaving others to ponder. It merely tries to ensure data reflects the real world that patients live in, rather than the laboratory or institutions that researchers inhabit.

What Cochrane doesn't do is address the obvious question of why doctors do not adopt the stance provided by their attempts at providing solid and reliable guidance? When so many doctors believe in the logic of evidence based medicine (EBM), why do they often ignore EBM guidelines in favour of less verifiable treatment methods? This is the dilemma and the paradox that the author considers in this rather excellent book. It can be recommended wholeheartedly to patients, healthcare practitioners and researchers alike, such as its broad reaching conclusions. This book deserves a broad readership and is required reading for anyone who wants to engage with their doctors, osteopaths, physiotherapists and other therapists.

For some it will prove food for though and for others a form of indigestion may be the result. Either way the experience should be memorable and will help the reader understand just how complicated good healthcare provision can be.
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11 of 11 people found the following review helpful
5.0 out of 5 stars Everyone should read this book once, if not twice!, 24 April 2012
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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.
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17 of 18 people found the following review helpful
5.0 out of 5 stars Some common sense applied to the minefield of modern medicine, 20 May 2012
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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.
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18 of 19 people found the following review helpful
5.0 out of 5 stars Essential reading for patients, doctors, journalists, and politicians, 13 Mar 2012
By 
Michael Power (England) - See all my reviews
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This review is from: The Patient Paradox: Why sexed-up medicine is bad for your health (Kindle Edition)
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.
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5 of 5 people found the following review helpful
5.0 out of 5 stars Cutting through the fog, 19 Jun 2012
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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.
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