Welcome to the world of sexed-up medicine, where patients have been turned into customers, and clinics and waiting rooms are jammed with healthy people, lured in to have their blood pressure taken and cholesterol, smear test, bowel or breast screening done.
In the world of sexed-up medicine pharmaceutical companies gloss over research they don’t like and charities often use dubious science and dodgy PR to 'raise awareness' of their disease, leaving a legacy of misinformation in their wake. Our obsession with screening swallows up the time of NHS staff and the money of healthy people who pay thousands to private companies for tests they don’t need. Meanwhile, the truly sick are left to wrestle with disjointed services and confusing options.
Explaining the truth behind the screening statistics and investigating the evidence behind the hype, Margaret McCartney, an award-winning writer and doctor, argues that this patient paradox – too much testing of well people and not enough care for the sick – worsens health inequalities and drains professionalism, harming both those who need treatment and those who don't.
'It is a brave doctor who argues in opposition to the medical dogma of the day... Dr McCartney offers convincing arguments... I hope this book provokes an intelligent national debate.' Nursing Standard
'The arguments are measured and well-referenced; the conclusions are distressing... Read this book. But don't expect to be able to practice medicine in the same way again.' British Journal of General Practice
'Everyone who is interested in the UK National Health Service (NHS) should read this magnificent book.' HealthWatch newsletter
'McCartney is diligent enough to dig deep into the evidence, brave enough to name names where necessary and lucid enough to capture a concept in a memorable sentence, such as, 'When you replace the doctor-patient relationship with a doctor-customer relationship, there is almost no point having a doctor in the equation'. Pulse
'Margaret McCartney’s writings are appealing. This is not only because she is an excellent writer, but also because they mix insufficiently uttered common sense with iconoclasm and challenges to mainstream thinking. The Patient Paradox is packed with these things.' Sir Iain Chalmers, James Lind Alliance
Posted by email@example.com on 12th May 2013
This book by Margaret McCartney elegantly explains why the modern scientific medicine project fails to deliver its promise through corporatisation of its core values and a moribund dissociation of supply and demand.
Modern scientific medicine with its blind worship of and commitment to protect intellectual property actually leads to a perverse supply-driven, rather than demand-led growth of services even in the land of plenty (i.e. the industrialised world inhabited by about 16% of the world's population). It is high time that the benevolent medical scientists of the world take translational research and scientific studies into healthcare delivery models as the focus of clinical research to replace the production, promotion and preservation of intellectual property as the central theme....
For those who have read my essays on Globalisation and Global Health from the perspective of physicians practising Medicine in the industrialised world published in 2006 by Shramajibi Swasthya Udyog, Kolkata, India, in 2006 and then by Nagarik Mancha (Citizens' Forum, Kolkata Book Fair) in 2007, will see how corporate medicine is bad for health everywhere!
Posted by Jil on 22nd May 2012
This is the book to read if you want to know what the hidden agenda is when you visit the doctor’s surgery, and whether the screenings you are offered from NHS and private companies are really risk-free, beneficial or even necessary.
It is no surprise that the pharmaceutical industry has an unhealthy and powerful influence on clinical practice, but Margaret McCartney will shock you by revealing study results and parliamentary inquiry conclusions on just how controlling this heartless industry is.
The ‘inverse care law’, the phenomenon of the most ill people having the least access to care, was first described by a Welsh GP nearly 40 years ago. Rather than adjusting the balance in favour of caring for the most needy, our healthcare system has perpetuated this law by focussing even more intensely upon the ‘worried well’ who are made vulnerable by clever advertising then parted from their cash in return for screenings they don’t need.
Margaret McCartney offers a lively and impassioned explanation of the hidden facts about screening for the illnesses we are told we should be most concerned about. She reveals facts about tests whose accuracy and value we take for granted, and how screenings are introduced by vote-seeking politicians rather than clinicians on the basis of hard evidence.
This is an important book…you’d have to be living in a bubble to not be exposed to the public ’fight’ against cancer, cholesterol and other threats to wellbeing. The Patient Paradox encourages a closer look at the weapons used in this ’fight’ and redefines terms like ’wellbeing’ and ’risk’.
Posted by Claire on 21st May 2012
In a world where we seem to take everything we are told by health professionals and organisations as THE WORD, it is eye opening to read how misleading some of the information we are given can be.The book is written in a way that it is easily readable and clear to understand. The research is fascinating and certainly leaves one rethinking their own personal health care. Well worth a read!
Posted by Dr Ulrich Pfeiffer on 10th May 2012
A brilliant book that questions the usefulness of a very large part of my GP workload in a well founded and referenced manner. How much money does the NHS spend on useles programmes just because they are popular with the voting public that could be much better spent on treating ill people. This book should be compulsory reading for every budding GP as well as being refreshing reading for old cynics like me. I wonder if I can make it count towards continous professional education?
Posted by Suzanne on 7th May 2012
There is a very strong history of breast cancer in my family. Nevertheless, when I'm offered regular screening mammograms in a couple of years time, I will probably refuse them. It's also unlikely that I will go for any more smear tests, despite the recent 'Jade Goody effect'. Controversial? Margaret McCartney's book separates the facts from the headlines, explains the encroaching position of government and pharmaceutical companies on our welfare, and explains how thousands of healthy people are being turned into patients. She looks at the influence of charity and celebrity, and emphasises the increasingly difficult position that our GPs are placed in today. This is a fascinating, well-researched and easy to read book that should make you question how the NHS works, how it ought to work, and how you want it to work for you.
Posted by Helen on 6th Apr 2012
This is an excellent book. Using clear language, straightforward diagrams and plenty of examples, McCartney (who is also a practising GP) takes the mystery out of medical screening, reviews and statistics. Her analysis reveals some surprising and negative results, including overdiagnosis, further testing and anxiety, and increased costs. The arguments are persuasive and challenging, but ultimately positive: "Addressing inequalities is where the biggest gains in health are to me made, not our current model of taking well people and screening them into diagnoses they don't need and won't benefit from" Accessible and easy to read, with a narrative grounded in personal experience backed up with well referenced, evidence based research, this fascinating book would appeal to anyone with an interest in healthcare, be it professional or personal.
Posted by Toni Tweddle on 6th Apr 2012
This well researched, evidence based book challenges readers to take a second look at the the way health and medicine is viewed in the modern world. Taking on subjects from screening to "health MOTs" to charity campaigning this book pulls out the bare facts and statistics and argues that maybe doctors should just go back to their jobs of helping sick people to get better. I have found this a very interesting read, and I have to admit that it is quite alarming to see how misrepresented the facts can be in the mainstream media. A fascinating book which will change the way many people veiw their health.