The New Health Dialogue

Rosemary Gibson and Janardan Prasad Singh have collaborated on a new book, The Treatment Trap: How the Overuse of Medical Care Is Wrecking Your Health and What You Can Do to Prevent It.

Gibson, whom I know slightly, worked for many years at the Robert Wood Johnson Foundation, and Singh, a World Bank economist with health policy expertise, look not only at the overtreatment encouraged by our current payment systems (and sometimes the greed of individual doctors) but how too much treatment can be harmful. I particularly liked the chapter they called, "Marinated Minds."

Think of barbecue sauce. Or a special homemade recipe for marinating steaks. Marinades make food more attractive and palatable. To be effective, they must be acidic. Acid destroys the boundaries of cells created by nature for protection. As the marinade permeates, the food is forever changed. it becomes more malleable, or more precisely, like gelatin.

Today our minds are marinated in news, so-called news, marketing, television dramas and internet advertising... The  media marinade disconnects us from the reality of what we allow others to do to our bodies. We suspend our critical thinking.

Gibson and Singh call for ending fee-for-service medicine, more comparative effectiveness research, better tools for patients to sort through complex decisions, and more scrutiny and audits -- in public -- from Medicare from hospitals that are known to have high rates of certain procedures. Some of the solutions they suggest -- like having patients sort through multiple medical studies online to learn about options -- may be too daunting for some individuals, but they also call for efforts to strengthen, simplify and spread decision-making tools like those produced by the Foundation for Informed Medical Decision-Making.

(We’ve written previously about shared decision-making, and our New America colleague Shannon Brownlee explores related themes in her book Overtreated.)