cover image OVERDOSED AMERICA: The Broken Promise of American Medicine

OVERDOSED AMERICA: The Broken Promise of American Medicine

John Abramson, . . HarperCollins, $24.95 (332pp) ISBN 978-0-06-056852-8

"Guilty Pleas Seen for Drug Maker"; "Merck Says It Will Post the Results of All Drug Trials": As these headlines show, the business of medicine is news. Several forthcoming books (led off by Marcia Angell's The Truth About the Drug Companies , PW Forecasts, Aug. 2) look critically at the backstory: the impact of profits on medical care in America.

OVERDOSED AMERICA: The Broken Promise of American Medicine John Abramson . HarperCollins , $24.95 (352p) ISBN 0-06-056852-6

According to Abramson, Americans are overmedicated and overmedicalized as a result of the commercialization of health care. Falling prey to marketing campaigns, we demand unnecessary and expensive drugs and procedures, believing they constitute the best possible medical care. Wrong, says Abramson: though more post–heart attack procedures are performed in the U.S. than in Canada, one-year survival rates are the same. Similarly, notes Abramson, a former family practitioner who teaches at Harvard Medical School, we spend more on high-tech neonatology than other Western countries but have a higher infant-mortality rate because of inattention to low-tech prenatal care. Abramson deconstructs the scientific sleight of hand in presenting clinical trial results that leads to the routine prescription of pricey cholesterol-lowering drugs even when their effectiveness has not been proven; he examines what he calls "supply-sensitive medical services"—the near-automatic use of medical technologies, such as cardiac catheterization, less because they are needed than because they are available. Abramson's bottom line: "More care doesn't necessarily mean better care." Arguing firmly that doctors should focus more on lifestyle changes to improve health, Abramson seems less credible when he writes off depression as "exercise-deficiency disease" and disposes of cancer in little more than a page. Still, he makes a powerful and coherent case that American medicine has gone badly astray and needs a new paradigm—one untainted by profits. Agent, Kris Dahl. (Oct.)