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For many complaints and conditions, the benefits from surgery are lower, and the risks higher, than you or your surgeon think. In this book you will see how commonly performed operations can be found to be useless or even harmful when properly evaluated. That these claims come from an experienced, practicing orthopedic surgeon who performs many of these operations himself, makes the unsettling argument particularly compelling. Of course no surgeon is recommending invasive surgery in bad faith, but Ian Harris argues that the evidence for the success for many common operations, including knee arthroscopies, back fusion or cardiac stenting, become current accepted practice without full examination of the evidence.
Paperback: 240 pages
Publisher: University of New South Wales Press; 1 edition (May 1, 2016)
Language: English
ISBN-10: 1742234577
ISBN-13: 978-1742234571
Product Dimensions: 5.3 x 1 x 8.2 inches
Shipping Weight: 10.4 ounces (View shipping rates and policies)
Average Customer Review: 4.9 out of 5 stars See all reviews (13 customer reviews)
Best Sellers Rank: #518,151 in Books (See Top 100 in Books) #149 in Books > Textbooks > Medicine & Health Sciences > Medicine > Clinical > Physician & Patient #213 in Books > Medical Books > Medicine > Doctor-Patient Relations #372 in Books > Textbooks > Medicine & Health Sciences > Medicine > Clinical > Surgery > General
Ian Harris has courageously exposed the strengths and limitations of modern medicine, particularly referencing surgery. Surgery is probably the deepest layer of medical paternalism, yet here he takes a scientific approach to unpick our personal (patient) clinical (doctor) behaviour and exploitation of the placebo effect. Despite what science has revealed or can reveal, too often we plough on with our biases and misconceptions for all too-human reasons. The bad news is the good news - we are all complicit and we all have the power to change how we choose and how we deliver care. Ian shows us how, and it's a way everyone can embrace. Well done indeed.
This is the first book I've ever written a review for. It was so important that I felt compelled to do so because the information contained in it will literally transform healthcare and our ability to pay for it if we apply it. The author, an orthopedic surgeon along with with a PhD, takes a balanced look at the evidence behind common surgeries. Surprisingly, and disturbingly, he finds that good research is lacking in many of the most common areas such as surgery for lumbar spine fusion for back pain/arthritis, shoulder impingement, and knee arthroscopy for arthritis/meniscus in older people. He also does a fantastic job of explaining the placebo effect and how it works. I can't recommend this book highly enough!!
“Placebo” is a fascinating topic, which has been yielding many of its secrets to scientific probing in recent years. Professor Harris introduces the reader to this literature in an engaging and accessible fashion. In particular, he presents the science from the perspective of a highly regarded and experienced orthopedic surgeon. The result is a compelling lesson for all physicians and all patients who are committed to making informed and rational medical decisions. Nortin M Hadler MD MACP MACR FACOEM Emeritus Professor of Medicine, UNC
Surgery seems like to indispensable medical intervention. Sometimes prescriptions work, sometimes they don't. Even antibiotics are losing effectiveness as pathogens evolve. But surgery - presuming nobody screws up - is a silver bullet, right?Wrong. And this is the book of why.My only significant complaint is that I would have liked citations to studies clearly footnoted. But I also understand that this book tries to embrace a larger audience that might be intimidated by text littered with citations and footnotes.
I am an avid Dr. John Sarno belieber and this guy reminds me of him a lot. Placebo is a very strong thing and can cause people to feel better when really they are not. I was scheduled to have a knee arthroscopic procedure done later this month and I canceled it based on my belief that he is right on the money.
Arguably this might be one of the stranger reviews. I admit I have not read but two pages of this book, but I can't wait to read it fully. I am an orthopaedic surgeon of 30 years and I have always been very cautious in moving forward with elective surgery on my patients and I always wondered why. As I saw my colleagues jumping head first doing massive volumes of surgery I was cautious to a fault, at times. I think in the last ten years or so I have realized, void of formal synthesis, just what I am about to read in this book. So sight unseen I am giving this book 6 stars because I identify with the concept as a contemplative, experienced surgeon. It is a must read for everyone, especially those considering elective surgery. As for the many surgeons who need this book, I will refer to the tale of the scorpion and the frog.
This is one of the most timely books out there. With health care costs soaring, unnecessary and expensive therapies and treatments need to be tested for effectiveness. We can no longer afford to continue with practices just because they seem to work well. Not that long ago, bleeding patients to reduce their 'evil humors' was widely considered effective. Many surgeries have been show to not be worth using on a cost benefit or rick benefit analysis. Amazingly enough, as Harris points out, almost no placebo controlled studies have ever been done on surgery in general, and musculoskeletal surgery in particular.This book should be a must read for all practitioners in the health care arena and for all medical students before they begin practicing. I highly recommend it.
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