H. Gilbert Welch “Screening is Not a Medical Health Imperative - It Is a Choice”

Disclaimer/Warning: The American FDA is in complete disagreement with the views presented on this page. It is the FDA’s position that mammograms continue to be the best primary tool for breast cancer screening. Thermography has only been cleared by the FDA as an “adjunctive” tool—meaning for use alongside a primary test like mammography, ultrasound, or MRI.

H. Gilbert Welch, M.D.: "Women Deserve to Know the Truth"

Dr. H. Gilbert Welch (Dartmouth) & Dr. Archie Bleyer (OHSU) found in their study, published in The New England Journal of Medicine, that alarming numbers of women are enduring body and life altering treatments for cancers that would not have affected them negatively in their lifetimes.

Overdiagnosis: Bad for You, Good for Business article by Dr. Welch

So all cancer is treated as if it will progress. “We're finding double the early and not less late stage breast cancers,” says Welch. “That's a big problem of over-diagnosis,” says this medical doctor, mathmetician, general internist, & public health advocate.

Pathologists can't distinguish the non-aggressive, cold, “indolent” lumps from the lethal breast cancers.

“Unfortunately, pathologists are not yet able to distinguish cancers that will be lethal if left untreated from those that do not need treatment.”

Dr. Daniel Kopans, Inventor of 3D Mammography, Harvard Medical School, New England Journal of Medicine article: 1.3 Million Overdiagnosed Breast Cancers in 30 Years - Nov 2012

Overdiagnosis is Unnecessary Harm Inflicted Upon the Healthy

Overdiagnosis is explained in this Dallas Morning News article by Welch Too Many Mammograms Don't Help and also in these 4 short videos by Welch:

Cancer Screening I - Benefits and Harms

Cancer Screening II - False Positive Results

Cancer Screening III - Overdiagnosis

Cancer Screening IV - Overdiagnosis (longterm RCT followup)

Welch authored these books:

1) Should I be Tested for Cancer? Maybe Not and Here’s Why

“This thought-provoking book offers a unique perspective on cancer screening.”—Barbara Bibel Library Journal

“Intelligent and eminently readable . . . a timely reminder that screening is not all it’s all cracked up to be. This is a book that should be read by all healthcare providers and all symptom-free individuals who are being coerced into a screening test.”—Michael Baum New Scientist

2) Overdiagnosed: Making People Sick in the Pursuit of Health

3) Less Medicine, More Health: 7 Assumptions that Drive Too Much Medical Care

Debate Over The Benefits Of Routine Mammograms

Hear Welch in the Debate Over The Benefits Of Routine Mammograms, an amazing exchange about perhaps the most controversial medical issue today, the value of mammography screening. It includes these participants:

Dr. Daniel Kopans professor of radiology at Harvard Medical School, invented tomosynthesis known as 3D mammography
Dr. Gil Welch professor of medicine at Dartmouth Institute for Health Policy and Clinical Research and internist, VA Outcomes Group
Shannon Brownlee acting director of the Health Policy Program at New America Foundation

As an example of harms of screening, Welch uses the prostate cancer "epidemic" that led to surgeries removing prostates before we knew prostate cancer isn't always life-threatening, and certainly not worth losing bladder and sexual function in asymptomatic healthy men.

In this 2015 interview on Science Friday Avoid the Doctor - For Your Health Welch discusses how technology advances of seeing tiny things set us up for radical treatment before symptoms arrive and may not ever..

H. Gilbert Welch MD, MPH, Dartmouth Institute, Professor, Author, Internist

“Last month, a study raised questions about over-treatment of ductal carcinoma in situ, more commonly known as DCIS. It’s the earliest form of breast cancer and some doctors don’t even think it warrants the label “cancer.” Suffice it to say: DCIS is the poster child of the need for a new research agenda in American medicine — research on when it’s safe, even beneficial, to have less medical care.”

H. Gilbert Welch Professor of Medicine, Dartmouth Institute for Health Policy and Clinical Practice Huffpost Healthy Living DCIS and Research on Less

“I have a strong respect for clinical medicine,” says Dartmouth’s H. Gilbert Welch. “I did it for many years. But I’ve always recognized that we can create as many problems as we solve.”

- From interview article: H. Gilbert Welch on the Nuances of Medical Care

Goals of The Dartmouth Institute

To maintain our position as the leading academic center monitoring and questioning current medical practice in the United States.
To become the preferred academic partner for those building sustainable health care systems that address the challenges and measurably improve population health.

Dr. Welch has been published in the Los Angeles Times, New York Times, Washington Post and Wall Street Journal, and has appeared on Today.

Links to more of his published work and media appearances here.