Overkill: When Modern Medicine Goes Too Far

I just finished the book, “Overkill: When Modern Medicine Goes Too Far,” by Paul A. Offit M.D.

What a great book it was! This is the best, evidence-based book on medical care written for the lay person I have read.

Let me share some of the many points (of many more) he describes in the book backed up with many randomized, controlled studies:

Fever

Fever is not a bad thing when you are sick. It helps white blood cells function better, kills bacteria and viruses, and is not dangerous (fever from an infection will not hurt brain cells).

Treating a fever can actually prolong an infection and possibly make it worse! If you have a fever, bundling up, not cooling down is what will help.

Antibiotics

Antibiotics are prescribed inappropriately 75% of the time. They are used for the wrong things or for too long (3-5 days are often enough). This overuse leads to bacterial resistance.

As I thought about this, I also thought about our collective frustration in not having a great medication to manage COVID-19. This is the world we are headed into (but for conditions from UTIs to strep throat) if we continue overprescribing antibiotics.

Supplements

The author describes the surprising issues that arise when taking many popular supplements like vitamins.

  • Vitamin D has been pushed by a strong lobby with many exaggerated claims.
  • Vitamin E was found to be associated with cancer in men.
  • Antioxidant supplements don’t work – No studies show them being effective at anything

Sunscreen

The only effective sunblock is clothing. Sunscreen should be at least SPF30 and be applied every two hours.

Cancers

Prostate cancers are something men die with, not usually of. Taking action on the basis of a PSA score is riskier than doing nothing.

Thyroid cancer is found using thyroid ultrasounds. Because of this, there has been a flood of early, frequent thyroid screenings. Still, the death rate from thyroid cancer has not changed in two decades because of the type of cancer they are incidentally finding. These screening have not saved lives, but caused pain and anguish across the country.

Breast cancer screenings don’t save lives. Studies around the world show that mortality from breast cancer remains the same whether there is screening or not.

Surgeries

Heart stents don’t work – They have no effect on mortality according to the studies. They are a waste of time, money, and are a surgical risk.

Arthroscopic knee surgery does not fix meniscal tears or arthritic knees. This is backed up with evidence. Programs of physical therapies and education (eg. posture) do better, without surgery.