Overtreatment in Medicine Is a Serious Problem

(Sylvia Engdahl's background information for her novel Stewards of the Flame)

At the time my article below was first posted (the fall of 2007) the belief that many standard medical tests and treatments are unnecessary or even harmful was rare enough to be called heresy, and very little was published expressing this point of view. Since then, considerable attention has been paid to the harm caused by medical overtreatment and a number of books and articles about it have appeared, as well as organized movements toward change. Moreover, it has been pointed out that a great deal of unnecessary testing and treatment is done because patients demand it, sometimes against their doctors' best judgment. Although it is common for doctors and hospitals to employ unnecessary tests, procedures, and drugs because they are conventionally, if erroneously, viewed as beneficial -- and because they are incessantly promoted by pharmaceutical companies and the rest of the medical-industrial complex -- the fundamental problem is the outlook of society as a whole. (Which is true of the fictional society portrayed in Stewards of the Flame, too, where the dystopian government run by medical authorities has the support of the voters.) Hopefully, the ever-increasing cost of medical care will wake people up if nothing else does. Society will never be able to afford medical care for all those who need it as long as so much is spent on unnecessary and sometimes-harmful care for those who do not.

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The dogmatic medical establishment in Stewards of the Flame is assumed to be monolithic, with no deviance from the official view on any health issue except on the part of the protagonists -- several of whom are doctors -- who reject it in its entirety. In our own much larger and more heterogeneous society, where supposedly freedom of opinion prevails, there is much less uniformity of opinion, right? Wrong! Yes, there is controversy about the details of effective treatment, but very little on the major issues. Doctors are free to express differing views [albeit in the face of strong pressure to conform] and a few of them do, but for the most part nobody listens, at least nobody who counts as far as determining what is likely to happen to the average patient is concerned.

There is, to be sure, wide attention given to complementary medicine (which is used along with conventional medicine) and alternative medicine (which is used in place of it). A recent survey showed that 36 percent of adult Americans use some form of one or the other. These are considered heretical by the medical establishment, which has succeeded in getting them excluded by law from the recognition and financial benefits accorded to medical practitioners by the government. However, they are not what I mean here by unorthodox medical views. I don't include them in my discussion because I personally don't think they have any healing effect apart from activating the self-healing powers of the mind in people who believe literally in the metaphorical explanations they offer for their success. That, of course, is no small achievement (see my page on the mind's influence on health) and where they include training in mental techiques such as mediation -- which is now recognized as effective in reducing stress -- they are helpful. I certainly support people's right to have access to alternative practices without government interference. But I give no credence to the physically-based ones myself.

The difficulty is that it is [or was, until recently] hard to find material critical of conventional medicine that doesn't also promote alternative medicine of one kind or another. There are many books and innumerable Web pages that challenge prevailing views of orthodox treatment, but they turn out to argue for herbal remedies, nutritional supplements, and so forth -- in many cases they are actually selling them, which is a case of the pot calling the kettle black when they complain about the pharmaceutical companies' motives for promoting prescription drugs. Few writers are willing to declare that "standard" medicine often does more harm than good without offering some alternate cure. In the case of the books, this is understandable, because ordinarily publishers don't issue such books; they don't sell well. The public wants to be told how to preserve, or regain, health. Doctors want to treat people; they couldn't go on practicing if they lost faith in treatment's effectiveness. I myself -- and I think many other individuals who avoid the health care system unless seriously ill -- believe that it is better to do nothing about a health problem than to do the wrong thing. This is definitely a minority view, and is rarely expressed.

I go to doctors only when I have a serious illness for which there is an effective treatment. This has happened several times in the past and I have received excellent care; I don't doubt the skill and dedication of those who provided it. But shortly after writing the novel I developed a condition for which there is some medication that's the lesser of evils, and other drugs and procedures that in my opinion are not, and which I therefore refused, resulting in frustrating arguments with various doctors who assumed I was either stupid or uninformed. Admittedly, I can't talk as well as I write and to them, especially when wearing a hospital gown, I looked like a typical old lady in her mid-70s who wasn't accustomed to researching scientific issues, so I tried not to take this patronizing attitude personally. It's infuriating, however, to deal with a system in which the average physician is not even aware of any position but the one adopted as "standard" -- either is afraid of being sued for not adhering to it, or hasn't had time to investigate the few published challenges by qualified medical professionals that do exist.

A lot is being published nowadays about the influence of the pharmaceutical industry -- or Big Pharma, as it's often called -- and the fact that it promotes drugs that aren't safe, let alone needed, as well as creating a perception of "diseases" that aren't really illnesses at all. Most people, and in fact most doctors, have fallen for these tactics so completely that the wonders of modern medication have not been doubted until recently, and still aren't doubted by the majority. The general public remains under the impression that the scandals that have arisen with respect to specific drugs such as Celebrex and Vioxx are rare exceptions. Alas, this is not the case, and even drugs that haven't been proven harmful have adverse effects on patients who take them unnecessarily. A few years back we learned that hormone replacement therapy -- for decades recommended routinely to older women -- was in fact detrimental to health. Mark my words, the same thing is going to happen with statin drugs sooner or later. It is unwise, to say the least, to urge the entire population to take drugs whose long-term effects haven't been tested simply to combat the alleged risk factors they're intended to reduce. Some dangerous drugs are necessary to treat conditions that are worse. A mere "risk factor" does not justify such medication. But the pharmaceutical industry makes money only on drugs taken by large numbers of people; need I say more?

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In this connection I should add something about the growing emphasis on "preventative" care. Where this means giving drugs to healthy people, the motivation behind the hype is obvious and the practice is therefore questionable. But it's questionable anyway what alleged preventative care really prevents. Its aim is to protect against long-term dangers rather than immediate ones, yet with the exception of vaccination against communicable disease, decreasing the odds of getting one illness later in life merely increases the odds of getting another. As one of the articles listed below points out,"People would expect a headline that shouts 'New Drug Prevents Heart Disease in Elderly' to herald a story about something thoroughly laudable. The headline could be equally correct and say instead 'New Drug Promises Major Increases in Dementia." Since we are all mortal, everyone not killed by injury will eventually get some kind of serious illness; there is no way of evading that. It is obviously unavoidable in the case of elderly people whose bodies are wearing out, but it also applies to anyone past middle age whose health is not robust (and for those blessed with robust health, measures taken to avoid sickness are superfluous).

"Preventative medicine" sounds good. Of course we want future illness to be prevented, so it's thought wise to accept whatever inconvenience, expense, and risk the attempt involves. But apart from the fact that most so-called preventative practices aren't based on evidence, I don't think there are any statistics showing that overall health, as distinguished from reduced incidence of specific diseases, is increased by them. Though on the average people are living longer than in the past, most of them are not healthy in old age but have one or more illnesses that have become treatable, often at the cost of lowered quality of life. A great many have do have dementia, and I sm not alone in feeling that death would be preferable. Prevention of the natural causes of death that used to prevail is not necessarily a benefit. (See my essay In Defense of Natural Death.)

I haven't included overtreatment of the dying on this page, as it's covered on a page of its own. So is overtreatment in psychiatry. And information about the mind's influence on health -- once widely considered heresy though it's now accepted by researchers, if not by most conventional doctors -- also has its own page. With these topics ruled out, along with alternative medicine and special-diet promotion, there is not a lot of heresy left, apart from criticism of the medical establishment in general. There should be more. (And in fact, since the above was written, a great deal more has appeared.)

Some links to articles about medical overtreatment.

Less Is More Medicine. Site of Dr. Jessica Otte, a Canadian family physician, containing many articles and detailed information about the new movement toward elimination of unnecessary medical care. "In medicine, more is not always better. . . . If we avoid testing and treating when it is not needed, we can focus on doing more of the things that really matter."

Risky Medicine by Jeff Wheelwright. Aeon, December 9, 2014. "Misunderstanding risk factors has led to massive overtreatment of diseases people don’t have and probably never will."

Overkill By Atul Gawande. The New Yorker, May 11, 2015. "Virtually every family in the country, the research indicates, has been subject to overtesting and overtreatment in one form or another."

When It Comes to Some Medical Treatment, Researchers Find Less Is More by Jamie Ducharme. Time, January 16, 2020. "In a fall 2019 survey of about 400 internists, 94% said they had observed an unnecessary 'cascade of care'–an ultimately frivolous chain of interventions often triggered by a fluke test or screening."

Too Much Treatment? Consumer Reports, July 2008. "Aggressive medical care can lead to more pain with no gain."

Why Do Doctors Overtreat? For Many, It's What They're Trained To Do by Mara Gordon. NPR, April 19, 2019. "It leads to patients feeling less well than they actually are, if you uncover things that are meaningless but abnormal."

Overtreatment in the United States by Martin Makary, Heather Lyu, et al. PLOS One, Septermber 6, 2017. "Most physicians surveyed (64.7%) believe that at least 15–30% of medical care is unnecessary. . . . Physicians perceive fear of malpractice, patient demands, and difficulty accessing prior medical records as the most common reasons for overtreatment."

How to Stop the Overconsumption of Health Care by Eve A. Kerr, M.D. and John Z. Ayanian. Harvard Business Review, December 11, 2014 by Aaron E. Carroll. "All too often [health care choices] are driven by habit, hunches, or misaligned economic incentives, leading to substantial overuse of unnecessary, even harmful, services."

Doing More for Patients Often Does No Good by Aaron E. Carroll. New York Times, January 12, 2015. "More is expensive. More sometimes does no good. Sometimes, more is even harmful. When our policies and care ignore these facts, we all suffer."

If Patients Only Knew How Often Treatments Could Harm Them by Austin Frakt. New York Times, March 2, 2015. "Most patients overestimate the benefits of medical treatments, and underestimate the harms."

"Overdiagnosis and overtreatment; how to deal with too much medicine," by Puneeta Gupta et al. Journal of Family Medicine and Primary Care, August 2020. "Another word for this could be 'too much medicine,' but as this can be confused with 'too much medication,' a better term might be 'too much healthcare,' which rather than benefitting the recipient, can have harmful effects." Dr. Malcolm Kendrick. Blog of a Scottish doctor who has written two excellent books about the fallacies of prevailing heath dogma, epecially the theory that statins prevent heart disease.

Most People Who Take Blood Pressure Medication Possibly Shouldn’t by Jeanne Lenzer. Slate, August 14, 2012. "A new study is turning decades of medical dogma on its head. . . .drugs used to treat mild cases of high blood pressure have not been shown to reduce heart attacks, strokes, or overall deaths. "

Why Cancer Screening Has Never Been Shown to “Save Lives”and What We Can Do about It by Vinay Prasad and Jeanne Lenzer. British Medical Journal, January 6, 2016. "Using disease specific mortality as a proxy for overall mortality deprives people of information about their chief concern: reducing their risk of dying."

Too Much Medicine. A British Medical Journal series that aims to highlight the threat to human health posed by overdiagnosis and the waste of resources on unnecessary care.

Too Much intervention Makes Patients Sicker by Aseem Malhotra, M.D. The Guardian, July 19, 2014. "A culture of over-investigation and over-treatment is now one of the greatest threats to western health."

Medical Errors: We Can’t Trust Doctors to Get It Right by Allen Frances, M.D. KevinMD.com, December 12, 2014. "In any common-sense world doctors would care about risks and harms and wouldn’t always be rushing to order stupid and dangerous tests and treatments."

Unnecessary Tests and Procedures In the Health Care System. ABIM Foundation, May 1, 2014. What physicians say about the problem, the cause, and the solutions -- results from a national survey of physicians.

The Fight against Disease Mongering: Generating Knowledge for Action by Ray Moynihan. PLOS Medicine, April 11, 2006. "Disease mongering is the selling of sickness that widens the boundaries of illness and grows the markets for those who sell and deliver treatments. . . . Drug companies are by no means the only players in this drama. Through the work of investigative journalists, we have learned how informal alliances of pharmaceutical corporations, public relations companies, doctors' groups, and patient advocates promote these ideas to the public and policymakers."

The Cost Conundrum by Atul Gawande. New Yorker, June 1, 2009. "Americans like to believe that, with most things, more is better. But research suggests that where medicine is concerned it may actually be worse."

Overtested, Overmedicated, and Overtreated by Tom Lombardo. AARP Bulletin, April 8, 2010. Interview with Rosemary Gibson, coauthor of The Treatment Trap. "The spiral of overuse . . . is an epidemic and is likely to continue.

Overdiagnosis: Bad for You, Good for Business by Lisa Chedeket. BU Today, October 26, 2011. By Lisa Chedeket. "The biggest problem is that overdiagnosis triggers overtreatment, and all of our treatments carry some harm," says [Gildert] Welch."

Too Much Cardiac Testing by Nicholas Bakalar. New York Times, March 16, 2015."Routine cardiac testing of adults without symptoms has not been shown to improve patient outcomes, and can lead to potential harms."

The Perils of Prevention by Shannon Brownlee. New York Times, March 16, 2003. "A troubling trend has taken root when it comes to doctors actively treating patients with drugs or procedures to prevent disease.... It is the general faith in the power of medical intervention to thwart not only certain discrete diseases, like hypertension, but also most chronic or potentially life-threatening conditions."

Too Much Medicine; Too Little Care by Paul Glasziou, Ray Moynihan, et al. British Medical Journal, July 2, 2013. "We are now so busy managing the proliferation of risk factors, 'incidentalomas,' and the worried well that we lack the time to care properly for those who are seriously ill."

Medical guidelines may be biased, overly aggressive By Susan Kelley. Cornell Chronicle, March 21, 2019.Treatment guidelines recommended by medical specialist organizations are more likely to call for greater use of health care services and exacerbate overdiagnosis, overtreatment and spiraling health care costs."

Sick to Death and Not Going to Take It Anymore! by Joanne Lynn, M.D. Online edition of the book. "People would expect a headline that shouts 'New Drug Prevents Heart Disease in Elderly' to herald a story about something thoroughly laudable. The headline could be equally correct and say instead 'New Drug Promises Major Increases in Dementia.' Saving the lives of children who otherwise faced polio was reasonably understood to be a very good thing. Saving the lives of elderly persons by eliminating one among a group of competing causes of death is more complicated. Eliminating one illness might well change the nature of the death and delay its timing, but the language of saving lives is misleading."

So Much Care It Hurts: Unneeded Scans, Therapy, Surgery Only Add To Patients’ Ills by Liz Szabo. Kaiser Health News, October 23, 2017. "From duplicate blood tests to unnecessary knee replacements, millions of patients are being bombarded with screenings, scans and treatments that offer little or no benefit."

Signs of Overtreatment: How to Avoid Unnecessary Care by Michael O. Schroeder. U. S. News & World Report, August 18, 2015. "More tests mean more treatment and, experts say, while care may be a boon for some who need it–and save lives–following the doctor's orders can also hurt patients, putting them at risk for everything from drug side effects to death on the operating table."

Less is More: Not “Going the Distance” and Why by Russell Harris and Linda S. Kinsinger. Journal of the National Cancer Institute, November 9, 2011. By Russell Harris and Linda S. Kinsinger. "For most of the population, going the distance [in screening for colorectal cancer] may well provide small benefits with larger costs and harms."

Overtreatment May Cause More Harm Than Good, Endocrinology Network, November 20, 2019. "In many cases . . . physicians are motivated to order unnecessary tests and treatments due to financial incentives offered by pharmaceutical companies or fee-for-service procedures."

Low Value Care. Lown Institute, 2020. "We must ensure that patients get all the care they need, and none that they do not."

Why Aren’t More Doctors like Dr. Bernard Lown? Heart Sisters, May 31, 2012. ''Here’s the profoundly important message of Dr. Lown to his colleagues: 'From my earliest days in medicine, I have struggled against the prevailing model of health care. My opposition in part was provoked by the growing prevalence of overtreatment. Resorting to excessive interventions seemed to be the illegitimate child of technology in the age of market medicine. If more than a half century ago overtreatment was at a trickle pace, it is now at flood tide.'"

Most People Want to Know Risk of Overdiagnosis, but Aren’t Told by Ray Moynihan. The Conversation, May 20, 2015. "Diagnostic thresholds for some diseases are lowered so much that people with mild symptoms, or at very low risk of illness, are labelled as “diseased” – even though many will never actually be harmed by the disease."

Gentle Medicine Could Radically Transform Medical "Practice by Jacob Stegenda. Psyche, 2020. "Most research resources in medicine belong to industry, and its profit motive contributes to that ‘obsession for pursuing fashionable trends of dubious importance'."

.by Dr. Malcolm Kendrick, June 28, 2021. "In addition to all the financial and peer-review pressure, if you dare swim against the approved mainstream views you will, very often, be ruthlessly attacked."

Learning to Say No to Dialysis by Lisa Span. New York Times, March 27, 2015. "In a Canadian survey, 61 percent of patients said they regretted starting dialysis, a decision they attributed to physicians’ and families’ wishes more than their own."

Our Absurd Fear of Fat by Paul F. Campos. New York Times, January 2, 2013. "The study . . . found that all adults categorized as overweight and most of those categorized as obese have a lower mortality risk than so-called normal-weight individuals."

The Benefits of High Cholesterol by Dr. Uffe Ravnskov. Excerpt from The Cholesterol Myths by a respected Danish researcher who has published extensively in medical journals. "High cholesterol is associated with longevity in old people. It is difficult to explain away the fact that during the period of life in which most cardiovascular disease occurs and from which most people die ... high cholesterol occurs most often in people with the lowest mortality.'"

On the Medicalization of Our Culture. Harvard Magazine, April 23, 2009. A report on a symposium held by scholars of history, law, anthropology, neuroscience, and literature.

Some books critical of today's standard medical practice.

All of these are by doctors, scientific researchers, or investigative journalists; I have excluded books by practitioners of alternative medicine and special-diet advocates, which often make valid criticisms of conventional medicine but which promote forms of health care that are in themselves questionable and therefore confuse the issue. I have also excluded most books focused on the influence of the pharmaceutical industry, of which a great many excellent ones have appeared, and books dealing mainly with financial greed or malpractice.

Overdosed America: The Broken Promise of American Medicine by John Abramson, M.D. Harper Perennial, 2005.

How We Do Harm: A Doctor Breaks Ranks About Being Sick in America by Otis Webb Brawley. St. Martin's, 2012.

Before You Take that Pill: Why the Drug Industry May Be Bad for Your Health by J. Douglas Bremner, M.D. Avery, 2008.

Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer by Shannon Brownlee. Bloomsbury, 2007.

False Hopes: Overcoming the Obstacles to a Sustainable, Affordable Medicine by Daniel Callahan. Rutgers University Press, 1999.

What Kind of Life: The Limits of Medical Progress by Daniel Callahan. Touchstone Books 1991.

The Obesity Myth: Why America's Obsession with Weight is Hazardous to Your Health by Paul Campos. Gotham Books, 2004.

Seeking Sickness: Medical Screening and the Misguided Hunt for Disease by Alan Cassels. Greystone Books, 2012.

The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders by Peter Conrad. Johns Hopkins University Press, 2007.

Generation Rx: How Prescription Drugs Are Altering American Lives, Minds, and Bodies by Greg Critser. Houghton Mifflin, 2005.

The Cholesterol Delusion by Ernest N. Curtis, M.D., Dog Ear Publishing, 2010.

Hope or Hype: The Obsession with Medical Advances and the High Cost of False Promises by Richard A. Deyo, M.D. and D. L. Patrick. AMACOM, 2005.

Drugs for Life: How Pharmaceutical Companies Define Our Health by Joseph Dumit. Duke University Press, 2012.

Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Our Illusion of Control by Barbara Ehrenreic. Twelve Books, 2018.

Tyranny of Health: Doctors and the Regulation of Lifestyle by M. Fitzpatrick. Routledge, 2001.

The Treatment Trap: How the Overuse of Medical Care Is Wrecking Your Health and What You Can Do to Prevent It by Rosemary Gibson and Janardan Singh. Ivan R. Dee, 2010.

The Denial of Aging: Perpetual Youth, Eternal Life, and Other Dangerous Fantasies by Muriel R. Gillick, M.D. Harvard University Press, 2006.

Mammography Screening: Truth, Lies and Controversy by Peter C. Gøtzsche. CRC Press, 2012.

Survival in an Overmedicated World: Look Up the Evidence Yourself by Peter Gøtzsche. People's Press, 2019.

Lipitor® Thief of Memory: Statin Drugs and the Misguided War on Cholesterol by Duane Graveline, M.D. Duane Grsveline, 2006.

The Citizen Patient: Reforming Health Care for the Sake of the Patient, Not the System by Nortin M. Hadler, M.D. University of North Carolina Press, 2013.

Last Well Person: How to Stay Well Despite the Health-care System by Nortin M. Hadler, M.D. McGill-Queen's University Press, 2004.

Rethinking Aging: Growing Old and Living Well in an Overtreated Society by Norton M. Hadler, M.D. University of North Carolina Press, 2011.

Worried Sick: A Prescription for Health in an Overtreated America. Nortin M. Hadler, M.D. University of North Carolina Press, 2008.

Pharmageddon by David Healy. University of California Press, 2012.

Limits to Medicine: Medical Nemesis, The Expropriation of Health by Ivan Illich. Marion Boyars, 1999 (1976).

Doctoring Data: How to Sort Out Medical Advice from Medical Nonsense by Malcolm Kendrick. Columbus, 2015.

The Great Cholesterol Con: The Truth About What Really Causes Heart Disease and How to Avoid It by Malcolm Kendrick, M.D. John Blake, 2007.

A Statin Nation: Damaging Millions in a Brave New Post-health World by Malcolm Kendrick, M.D. John Blake, 2019.

The Danger Within Us: America's Untested, Unregulated Medical Device Industry and One Man's Battle to Survive It by Jeanne Lenzer. Little, Brown, 2017.

What Your Doctor Won't or Can't Tell You: The Failures of American Medicine -- and How to Avoid Becoming a Statistic by Evan Levine, M.D. Berkley, 2005.

Sick To Death and Not Going to Take It Anymore!: Reforming Health Care for the Last Years of Life by Joanne Lynn, M.D. University of California Press, 2004. (Available online.)

The Price We Pay: What Broke American Health Care -- and How to Fix It by Marty Makary. Bloomsbury, 2019.

The Patient Paradox: Why Sexed-up Medicine Is Bad for Your Health by Margaret McCartney. Pinter & Martin, 2012.

The Heart Revolution: The Extraordinary Discovery That Finally Laid the Cholesterol Myth to Rest by Kilmer S. McCully, M.D. Harper Paperbacks, 2000.

What Doctors Don't Tell You: The Truth About The Dangers Of Modern Medicine by Lynne McTaggart, Avon, 1998.

Confessions of a Medical Heretic by Robert S. Mendelsohn, M.D. McGraw Hill, 1990 (1980).

Selling Sickness: How the World's Biggest Pharmaceutical Companies Are Turning Us All into Patients by Ray Moynihan and Alan Cassels. Nation Books, 2006.

Lifespan: New Perspectives on Extending Human Longevity by Thomas J. Moore. Touchstone Books, 1994.

Heart Failure: A Critical Inquiry into American Medicine and the Revolution in Heart Care by Thomas J. Moore. Touchstone Books, 1990.

Questioning Chemotherapy by Ralph W. Moss. Equinox Press, 1995.

The Cancer Industry: The Classic Exposé on the Cancer Establishment by Ralph W. Moss. Equinox Press, 1996.

Death by Medicine by Gary Null, Msrtin Feldman, et al. Practikos, 2011.

Fat Politics: The Real Story Behind America's Obesity Epidemic by J. Eric Oliver. Oxford University Press, 2006.

Disease-Mongers: How Doctors, Drug Companies, and Insurers Are Making You Feel Sick by Lynn Payer. Wiley 1994

Medicine and Culture: Varieties of Treatment in the United States, England, West Germany, and France by Lynn Payer. Penguin, 1989.

Diseasing of America: How We Allowed Recovery Zealots and the Treatment Industry to Convince Us We Are Out of Control by Stanton Peele. Lexington Books, 1995.

Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs by Melody Petersen. Farrar, Straus and Giroux, 2008.

The Cholesterol Myths: Exposing the Fallacy that Saturated Fat and Cholesterol Cause Heart Disease by Uffe Ravnskov, M.D. NewTrends Publishing, 2000.

The Secrets of Medical Decision Making: How to Avoid Becoming a Victim of the Health Care Machine by Oleg I. Resnik, M.D. Loving Healing Press, 2005.

Medical Care Can Be Dangerous to Your Health: A Guide to the Risks and Benefits by Eugene D. Robin, M.D. Harper & Row, 1986. (Hardcover edition, 1984, is titled Matters of Life and Death: Risks and Benefits of Modern Medicine.)

An American Sickness: How Healthcare Became Big Business and How You Can Take It Back by Elisabeth Rosenthal, Penguin Press, 2017.

Healing Back Pain: The Mind-Body Connection by John E. Sarno. Grand Central Publishing, 2001.

Don't Let Your Doctor Kill You: How to Beat Physician Arrogance, Corporate Greed and a Broken System by Erica Schwartz, M. D. and Melissa Peltier. Post Hill Press, 2015.

A Bitter Pill: How the Medical System Is Failing the Elderly by John Sloan. Greystone Books, 2009.

The Exercise Myth by Henry A. Solomon, M. D. Harcourt, 1984.

Medical Nihilism by Jacob Stegenda. Oxford Unnversiy Press, 2018.

The Theology of Medicine: The Political-Philosophical Foundation of Medical Ethics by Thomas Szasz. Syracuse University Press, 1988.

Pharmacracy: Medicine and Politics in America by Thomas Szasz. Praeger, 2001.

The Medicalization of Everyday Life: Selected Essays by Thomas Szasz. Syracuse University Press, 2007.

The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet by Nina Teicholz. Simon & Schuster, 2014.

Less Medicine, More Health: 7 Assumptions that Drive Too Much Medical Care by H. Gilbert Welch, M.D. Beacon Press, 2015.

Overdiagnosed: Making People Sick in the Pursuit of Health by H. Gilbert Welch, M.D. Beacon Press, 2012,

Should I Be Tested for Cancer?: Maybe Not and Here's Why by H. Gilbert Welch, M.D. University of California Press, 2004,

When Doctors Don't Listen: How to Avoid Misdiagnoses and Unnecessary Tests by Leana Wen, M.D. and Joshua Kosowsky, M.D. St. Martin's Griffin, 2014.