Occupational Musculoskeletal Disorders

Rating:
Summary: Obfuscation meets Occupation
Review: Dr. Hadler has written here a book that is turgid, but not so much with content. Rather, the book is a reliquary for 50 cent words and abstruse sentence structure. Although I purchased the book to augment my diagnosis and treatment of work-related musculoskeletal disease (MSD), I ended up reading passages to challenge my fellow workers to decipher.

Here's an example:
"Seduced by the promise of dramatic diagnosis, of unbridled interventions for cure, and the largesse of wage replacement or more, the American worker has been urged on by surgeons, lawyers, and common practice to confront the contest of causation with escalating vigor." -- page 231

and:

"Medicine has been remiss in focusing on that portion of the experience of morbidity that operates within and under medical purview." -- page 19

In addition, Dr. Hadler seems obsessed with the use of the words "predicament" and "ubiquitous".

Beyond the prose, I have a problem with the book's presentation of subject matter. Rather than a authoritative textbook format with citations, Dr. Hadler meanders through conjecture, anecdotes and fact, citing supporting studies from time to time. Sometimes, the paragraphs tighten into textbook format statements. But, given the brief nature of the discussion, it appears that these paragraphs are written in haste. These paragraphs lack essential physical diagnosis and treatment details.

In summary, this book lacks the crucial information that physicians need to develop good practice skills. Instead, it is filled with flowery conversation written in a Jane Austin-style circumlocution. Unless you are a very un-busy physician, you won't enjoy this book.

Rating:
Summary: Obfuscation meets Occupation
Review: Dr. Hadler has written here a book that is turgid, but not so much with content. Rather, the book is a reliquary for 50 cent words and abstruse sentence structure. Although I purchased the book to augment my diagnosis and treatment of work-related musculoskeletal disease (MSD), I ended up reading passages to challenge my fellow workers to decipher.

Here's an example:
"Seduced by the promise of dramatic diagnosis, of unbridled interventions for cure, and the largesse of wage replacement or more, the American worker has been urged on by surgeons, lawyers, and common practice to confront the contest of causation with escalating vigor." -- page 231

and:

"Medicine has been remiss in focusing on that portion of the experience of morbidity that operates within and under medical purview." -- page 19

In addition, Dr. Hadler seems obsessed with the use of the words "predicament" and "ubiquitous".

Beyond the prose, I have a problem with the book's presentation of subject matter. Rather than a authoritative textbook format with citations, Dr. Hadler meanders through conjecture, anecdotes and fact, citing supporting studies from time to time. Sometimes, the paragraphs tighten into textbook format statements. But, given the brief nature of the discussion, it appears that these paragraphs are written in haste. These paragraphs lack essential physical diagnosis and treatment details.

In summary, this book lacks the crucial information that physicians need to develop good practice skills. Instead, it is filled with flowery conversation written in a Jane Austin-style circumlocution. Unless you are a very un-busy physician, you won't enjoy this book.

Rating:
Summary: Dr. Hadler's Occupational Musculoskeletal Disorders, 2nd Ed.
Review: Few problems that patients have are more contentious and confusing than the occupational musculoskeletal disorders. As Dr. Hadler documents, conditions like persistent low back pain, neck pain, and arm pain have not yielded to simple mechanical explaniations nor to simple mechanical cures. This book is about why that is. In his passionate, lively, inimitable way, Dr. Hadler examines the physiology, the social psychology, and even the policies that influence these disorders. In the process, he has written a medical textbook unlike any other you will come across. It is part practical guide to the care of the patient with regional musculoskeletal symptoms, part history text, and part polemic. And it could change the way we all think about these common and troubling conditions.

Rating:
Summary: Best book ever written on this topic
Review: The outmoded management of occupational musculoskeletal disorders robs millions of workers of their productivity, their dignity, and their sense of well-being. It engulfs the medical system with desperate patients. It fills disability rolls and tears at the fabric of our economy and social safety net.
The new edition of Occupational Musculoskeletal Disorders (3rd edition, 2004) is perhaps the best book ever written on this topic. It describes a scientific revolution in thinking about back pain, arm pain, knee problems, fibromyalgia, and the suffering that accompanies them.
For the physician, this is a hands-on guide to the intricacies of occupational musculoskeletal illnesses-their natural history, their diagnosis and management, and their regulatory and legal implications. For the ailing worker, it is an essential roadmap to coping with these illnesses and to navigating the medical and disability systems
Author Nortin M. Hadler, MD, was recently described in JAMA-the official journal of the American Medical Association-as a "philosopher and consummate physician." He has an encyclopedic knowledge of the scientific evidence and the courage to challenge the thinking that has created the current crisis.
This book is full of new evidence, elegant thought, and writing to match. Read this book. And then, as Hadler suggests, spread the word.

Mark Schoene
Editor, the BackLetter


p.s. Readers may be also be interested in Hadler's other recent book The Last Well Person: How to Stay Well Despite the Healthcare System. It is a guide to preserving a sense of health and well-being in a medical culture that would turn all of us into "ticking disease time bombs." The Last Well Person provides a valuable counterpoint to Occupational Musculoskeletal Disorders.