Surgery The Ultimate Placebo

A senior surgeon suggests that many commonly performed operations are not necessary and that any benefits they offer are a placebo. 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. 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. The placebo effect may be real, but is it worth the recovery time, expense and discomfort?

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, practising orthopaedic 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. The placebo effect may be real, but is it worth the recovery time, expense and discomfort?

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, practising orthopaedic 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. The placebo effect may be real, but is it worth the recovery time, expense and discomfort?

Two world-leading doctors reveal the true state of modern medicine and how doctors are letting their patients down. In Hippocrasy, rheumatologist and epidemiologist Rachelle Buchbinder and orthopaedic surgeon Ian Harris argue that the benefits of medical treatments are often wildly overstated and the harms understated. That overtreatment and overdiagnosis are rife. And the medical system is not fit for purpose: designed to deliver health care not health. This powerful exposé reveals the tests, drugs and treatments that provide little or no benefit for patients and the inherent problem of a medical system based on treating rather than preventing illness. The book also provides tips to empower patients – do I really need this treatment? What are the risks? Are there simpler, safer options? What happens if I do nothing? Plus solutions to help restructure how medicine is delivered to help doctors live up to their Hippocratic Oath. 'One of the hardest things for a doctor to do ... is nothing. This superb book explains how in medicine and surgery less is often not just more, it’s closer to the oath we’re all supposed to practise by.' — Norman Swan, award-winning producer and broadcaster of the Health Report and Coronacast 'This eye-opening and enthralling book on the medical and moral hazards which beset the health profession is a must-read for patients and practitioners alike. From ‘tooth-fairy science’ to medical disasters to the inflated business world of medicine, Hippocrasy is a profoundly thought-provoking and compelling work that challenges our perception of the practice of modern medicine.' — Kate McClymont AM, award-winning investigative journalist for the Sydney Morning Herald/The Age 'Doctors are educated to do good. Yet, as the commercial imperatives of the medical industrial complex tighten their grip, doctors are becoming more and more worried that they are inflicting harm rather than creating benefit. This book is for them and, perhaps even more importantly, for their patients. The road to hell is paved with good intentions: read Hippocrasy and turn back.' — Iona Heath CBE, former President, The Royal College of General Practitioners 'This brilliant book offers clear and compelling evidence that we’re all at risk from too much medicine. Using the best of science, these two respected doctors blow the whistle on harmful healthcare. Buchbinder and Harris reveal how overdiagnosis, overtreatment and the medicalisation of normal life are major threats to human health. But this brilliant book also brings hope that we can wind back the harm and waste of unnecessary tests and treatments, and focus more on the great benefits medicine has to offer.' — Ray Moynihan, author of Too Much Medicine? and Selling Sickness, Assistant Professor, Bond University 'About half of us in advantaged countries are now patients or ‘providers’, or both, and a third of clinical interventions are futile at best. Seeking health is daunting and we could benefit from a guide. Rachelle Buchbinder and Ian Harris have provided such with this volume.' — Nortin M Hadler, author of The Last Well Person, The Citizen Patient and Worried Sick, Emeritus Professor of Medicine and Microbiology/Immunology, University of North Carolina 'Throughout medical history, doctors have routinely ignored the fundamental Hippocratic injunction: ‘First, do no harm’. Most of their treatments produced lots of harms, with little or no benefit. This wonderful book punctures the hyped claims of modern medicine, showing that it is not nearly as scientific, safe, effective, and honest as it should be. Reading Hippocrasy is essential for doctors (to help make them become more cautious); but even more essential for patients (to help them become more self-protective).' — Allen Frances, author of Saving Normal, Professor and Chairman Emeritus of the Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine 'A timely book from two leading doctors. They present evidence that despite medicine’s lip-service to evidence-based medicine, many unnecessary, wasteful and harmful investigations and treatments abound. Increasingly, the healthy are re-defined as having ‘predisease’ and drawn into questionable investigations and monitoring programmes. The book’s core message is that medicine’s hubris and a creeping scientism has come to overshadow the doctor’s commitment to care for and comfort their patients and, above all, do no harm. It is time to step back from the brink and revisit the founding principles and core values of our profession.' — Trish Greenhalgh OBE, Professor of Primary Care Research, University of Oxford

Everyone knows that antidepressant drugs are miracles of modern medicine. Professor Irving Kirsch knew this as well as anyone. But, as he discovered during his research, there is a problem with what everyone knows about antidepressant drugs. It isn't true. How did antidepressant drugs gain their reputation as a magic bullet for depression? And why has it taken so long for the story to become public? Answering these questions takes us to the point where the lines between clinical research and marketing disappear altogether. Using the Freedom of Information Act, Kirsch accessed clinical trials that were withheld, by drug companies, from the public and from the doctors who prescribe antidepressants. What he found, and what he documents here, promises to bring revolutionary change to the way our society perceives, and consumes, antidepressants. The Emperor's New Drugs exposes what we have failed to see before: depression is not caused by a chemical imbalance in the brain; antidepressants are significantly more dangerous than other forms of treatment and are only marginally more effective than placebos; and, there are other ways to combat depression, treatments that don't only include the empty promise of the antidepressant prescription. This is not a book about alternative medicine and its outlandish claims. This is a book about fantasy and wishful thinking in the heart of clinical medicine, about the seductions of myth, and the final stubbornness of facts.

A rigorous, skeptical, deeply reported look at the new science behind the mind's surprising ability to heal the body. Have you ever felt a surge of adrenaline after narrowly avoiding an accident? Salivated at the sight (or thought) of a sour lemon? Felt turned on just from hearing your partner's voice? If so, then you've experienced how dramatically the workings of your mind can affect your body. Yet while we accept that stress or anxiety can damage our health, the idea of "healing thoughts" was long ago hijacked by New Age gurus and spiritual healers. Recently, however, serious scientists from a range of fields have been uncovering evidence that our thoughts, emotions and beliefs can ease pain, heal wounds, fend off infection and heart disease and even slow the progression of AIDS and some cancers. In Cure, award-winning science writer Jo Marchant travels the world to meet the physicians, patients and researchers on the cutting edge of this new world of medicine. We learn how meditation protects against depression and dementia, how social connections increase life expectancy and how patients who feel cared for recover from surgery faster. We meet Iraq war veterans who are using a virtual arctic world to treat their burns and children whose ADHD is kept under control with half the normal dose of medication. We watch as a transplant patient uses the smell of lavender to calm his hostile immune system and an Olympic runner shaves vital seconds off his time through mind-power alone. Drawing on the very latest research, Marchant explores the vast potential of the mind's ability to heal, lays out its limitations and explains how we can make use of the findings in our own lives. With clarity and compassion, Cure points the way towards a system of medicine that treats us not simply as bodies but as human beings. A New York Times Bestseller Finalist for the Royal Society Insight Investment Science Book Prize Longlisted for the Wellcome Book Prize