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H. Gilbert Welch on the Nuances of Medical Care

By Kathryn Stearns

This Focus on Faculty Q&A is part of an ongoing series of interviews exploring what keeps Dartmouth professors busy inside—and outside—the classroom.

“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.” (Photo by Rob Strong ’04)
“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.” (Photo by Rob Strong ’04)

H. Gilbert Welch, a professor of medicine at The Dartmouth Institute for Health Policy and Clinical Practice and the Geisel School of Medicine, focuses on the problems created by medicine’s efforts to detect disease early. He is the author of several books, including Overdiagnosed: Making People Sick in Pursuit of Healthand, most recently, Less Medicine, More Health: 7 Assumptions That Drive Too Much Medical Care. He recently spoke with Dartmouth Now about his life and work.

What does H. stand for?
Handsome.

I almost fell for it.
Honorable. No, Henry. My mother descends from Gilberts. She named me after a distant ancestor, Henry Lathrop Gilbert, but she didn’t particularly like “Henry,” so she called me Gil.

You have a good sense of humor.
I don’t know if my name has anything to do with my sense of humor, but I do know that having a good sense of humor is one determinant of good health. I think mine has more to do with my father, honestly, who liked to have a good laugh.

In your latest book, Less Medicine, More Health, you describe very tenderly your father’s death from colon cancer. You were in medical school in Cincinnati at the time.
I was a first-year medical student.

Did his death influence your decision to focus much of your research on cancer screening?
Not really. His death made me care about caring for people who are dying. He happened to have a really good oncologist who knew how to back off. It was palliative care before the word existed. And Mom played a big part because she was his nurse. She was very strong in the hospice movement, which was brand new.

Do you think we’re getting better at helping people die?
A little better. It’s still awfully hard, in part because I don’t think we are as frank with patients as we should be about what’s futile and what might hurt people, because we’re so technologically intensive.

Would you describe yourself as a practicing physician or as a debunker of prevailing medical myths?
Oh, somewhere in between. I have a strong respect for clinical medicine. I did it for many years. But I’ve always recognized that we can create as many problems as we solve. I’m trying to communicate a healthy respect for the nuances of medical care: Some is good, but more is not necessarily better.

Read the full Q&A at Dartmouth Now...