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Book Report: Overwhelming Overtreatment

by Andy

Shannon Brownlee's new widely acclaimed book, Overtreated, is an insightful look into the negative effects of America's obsession with the marvels of modern medicine and the underlying institutional problems that allow for its misappropriation. The obsession is so engrained, she argues, that a good deal of treatment is unnecessary and ultimately dangerous. Furthermore, she describes via detailed cases where these expensive treatments upon thorough scientific inquiry as not proven effective. Overtreated clearly illustrates how economic incentives govern the workings of a fragmented system that is in need of repair.

The book uses the shock-and-awe strategy of extreme anecdotes that are typical of this genre to illustrate why this 'overtreatment' is occurring. In the process, Brownlee does an excellent job of illustrating supply-induced demand of medical care. She also broaches the delicate underlying cultural challenges that need to be overcome in order to reform the system. She is critical of the on-demand care that the current system provides and for which the medical community is ultimately compensated. She also recognizes how profits drive various components of the system not just out of avarice, but out of necessity of survival - such as non-profit hospitals using the profits from lucrative procedures to subsidize care to the uninsured and money-losing operations such as urban ERs.

The book points to evidence-based care, which she sees as the lynchpin of success of the Veterans Health Administration (VHA), and which she holds as a case study that she opines for the medical community as a whole to embrace. While Brownlee definitely offers insights into some incremental change that could improve healthcare, her argument ultimately commands that the medical system and the way Americans view medicine be entirely revamped. It is both a validation of the power of the country's economic engine in relation to healthcare and a critique of its negative effects.