Health and Strength of Mind, Body and Soul
   Home      Rethinking AGING: Growing Old and Living Well in an Overtreated Society –A Review
Rethinking AGING: Growing Old and Living Well in an Overtreated Society
Book Review by Russ Horton © July 10, 2012 

Dr. Hadler analyzes and debunks faulty statistics and myths and compels all to reevaluate health care for the ‘aged’ in a completely new light. He exposes marketing chicanery and provides a useful model for personal health options.

Dr. Hadler says this clearly and emphatically as follows
“Aging, dying, and death are not diseases. Yet they are targets for the most egregious marketing, disease mongering, medicalization, and over- treatment. This book is written to forewarn and arm the reader with evidence-based insights that promote informed medical and social decision making. All who have the good fortune to be healthy enough to confront the challenges of aging need such insights. Otherwise they are no match for the cacophony of broadcast media pronouncing the scare of the week or miracle of the month; pandering magazine articles; best-selling books pushing “angles” of self-interest; and the ubiquitous marketing of pharmaceuticals and alternative potions, poultices, and chants. All are hawking “successful aging” and “long life” as if both were commodities. We awaken every day to advice as to better ways to eat, think, move, and feel as we strive to live longer and better. We are bombarded with the notion of risks lurking in our bodies and in the environment that need to be reduced at all cost. Life, we are told, is a field that is ever more heavily mined with each passing year."

While traversing the septuagenarian bridge in April, I experienced a heightened awareness of my portending decrepitude. On a recent medical visit, I expressed my concerns and was recommended to Dr. Hadler’s excellent book to serve as a wise and informed framework and reference for the years ahead.

Healthcare procedures and medications must be critically evaluated

Intelligent and good health-care decisions promote wellness and longevity. Dr. Hadley’s book serves both providers and consumers best interests about procedures and medications. Despite many miraculous and efficacious discoveries there are
medical fallacies and misconceptions. Marketing propaganda by some pharmaceutical companies can promote unnecessary expenses and may cause harm or death in some patients. The same may be said for superfluous surgical procedures. The marketplace is flooded with anxiety-laced warnings concerning your health and its maintenance.

Health-care users (almost all of us) face daunting and almost impossible tasks as various iterations include: “ask you doctor about…”, “this medication may cause this disorder or that disorder… and even death.’’ All of this drug information and plethora of warnings cascade and unfold at various breaks during the course of many one hour TV programs. Consciously or subconsciously, medical anxiety about personal health occurs amid dramatic increases in the sale of many different types of drugs. 

Most drugs are useful and promote legitimate pharmacology, but appropriate and proper use of medications requires knowledge and proper cautions. Drug details, complexity and the volume of information on new drugs and pharmaceuticals may preclude some doctors from a full and deep understanding of certain prescribed medications and OTC products. Medical doctors’ information may be limited to primary uses and common side affects/contraindications. Often, there are other reactions and precautions which should encourage weighing benefits versus risks if using a certain drug.

Proposed surgeries also should be evaluated very carefully. Patients should ask appropriate questions before any procedure and determine the expectations and probability of real improvement and a good outcome versus the current impairment. Proper questions could save needless agony as well as rigors of a Type II Medical Malpractice lawsuit.

Dr. Hadler tells us that the use of certain medications and/or screenings can be validated using legitimate, objectively presented research. A few of the
topics discussed in his book include: Diet and exercise (overview), measurement and guidelines for cholesterol lowering drugs, (Crestor®, etc.), Type 2 diabetes, (Avandia® and Actos®), hypertension/ blood pressure, Coronary Artery Bypass Graft and stents, breast and cervical cancer screening, prostate and colorectal cancer screening and Osteopenia and Osteoporosis.

The author states, “[this book] should not be interpreted as ‘doctor bashing.’… we are all advantaged by the fact that the vast majority of physicians are bright, well trained and well intended… However, the American physician in particular is faced with enormous (and perverse) constraints that compromise ethical behavior.”ii  He goes on to discuss how our litigious society and reimbursement schemes result in many unnecessary [and perhaps exacerbating] procedures.

The chart below is from Dr. Hadley’s book and clearly reveals recent and dramatic increases in the octogenarian club membership. The current ‘rule of thumb’ says if you are healthy at age 65, your chance of reaching 85 is not unexpected. This fact also connotes another aggravation toward waning Social Security funds. Post WWII population attaining age 85 was approximately 20%; today it approaches 40%.
Increasing Numbers of People Surviving to an Older Age (copyright, U of North Carolina Press) as shown in Hadler's Book on "Rethinking Aging"

Reviewer Side note: Though the author’s brief thanatology asserts neutrality toward metaphysical reference, there is a bent toward a humanistic
viewpoint, but this attitude lends no prejudice to his extensive theses.

Nortin M. Hadler, M.D., M.A.C.P., M.A.C.R., F.A.C.O.E.M. (A.B. Yale University, M.D. Harvard Medical School) trained at the Massachusetts
General Hospital, the National Institutes of Health in Bethesda, Maryland, and the Clinical Research Centre in London. He joined the faculty
of the University of North Carolina in 1973 and was promoted to professor of medicine and microbiology/immunology in 1985. He serves as
attending rheumatologist at the University of North Carolina Hospitals. Medical education has been a focus of his career at UNC and
elsewhere. He has lectured widely, garnered multiple awards, and served lengthy visiting professorships in England, France, Israel, and
Japan. He was selected as an established investigator of the American Heart Association, elected to membership in the American Society
for Clinical Investigation and the National Academy of Social Insurance, and elevated to master by both the American College of Physicians
and the American College of Rheumatologists.
Dr. Hadler, portrait from back flap, © 2011 The University of North Carolina Press, Chapel Hill
Other Books by Hadler:
Worried Sick: A Prescription for Health in an Overtreated America
Stabbed in the Back: Confronting Back Pain in an Overtreated Society
The Last Well Person: How to Stay Well Despite the Health-Care System
i Pg.1
ii Pg. 5

Nortin M. Hadler, M.D. 2011. Rethinking AGING: Growing Old and Living Well in an Overtreated Society. The University of North Carolina Press, Chapel Hill

Dr. Nortin Hadler, University of North Carolina Hospital Photo

Rethinking Aging, Book Cover c. University of North Carolina Press