Faculty Directory

H. Gilbert Welch

Adjunct Professor of Business Administration

Email

h.gilbert.welch@dartmouth.edu

Phone

603-653-0836

Degree

MPH, University of Washington, 1990; MD, University of Cincinnati Medical Center, 1982; BA, Harvard University (Economics), 1976

Areas of Expertise

Medical screening, early disease detection, clinical epidemiology

Bio

Dr. Gilbert Welch is a general internist whose research focuses on the problems created by medicine’s efforts to detect disease early: physicians test too often, treat too aggressively, and tell too many people that they are sick. Most of his work has focused on overdiagnosis in cancer screening: in particular, screening for melanoma, thyroid, breast, and prostate cancer. He teaches “Introduction to the Science of Inference: Basic Skills & Disturbing Truths” in the Tuck/TDI Masters of Health Care Delivery Science program for health care executives.

Current Research Topics

  • Scrutiny-dependent cancer and self-fulfilling risk factors
  • Income and cancer overdiagnosis
  • Misleading numbers in medicine
  • Quantifying the benefits and harms of screening mammography


Professional Activities

Academic positions

  • Adjunct Professor of Business Administration, Tuck School of Business, 2011–present
  • Professor of Medicine and Community & Family Medicine, Dartmouth Medical School, 2000–present
  • Adjunct Professor of Public Policy, Dartmouth College, 2010–present
  • Visiting Professor, WWAMI Program, Montana State University, Bozeman, 2008–09
  • Visiting Scientist, International Agency for Research on Cancer, Lyon, France, 2001–02
  • Associate Professor, Dartmouth Medical School, 1995–2000
  • Co-Director, VA Outcomes Group, 1991–2011
  • Assistant Professor, Dartmouth Medical School, 1990–95
  • Acting Instructor, Department of Medicine, University of Washington, 1998–90
  • Instructor, University of Pittsburgh at Johnstown, 1982–83
  • Master, Brooks School, North Andover, Massachusetts, 1976–77

Editorial positions

  • Editor, Effective Clinical Practice, 1998–2002


Selected Publications

Op-eds

Books

  • Less Medicine, More Health: 7 Assumptions that Drive Too Much Medical Care, Beacon Press, 2015
  • With L.M. Schwartz and S. Woloshin, Overdiagnosed: Making People Sick in the Pursuit of Health, Beacon Press, 2012 paperback, 2011 hard cover
  • Should I Be Tested for Cancer? Maybe Not and Here’s Why, University of California Press, 2006 paperback, 2004 hard cover

Scientific publications

  • With E.S. Fisher, “Income and Cancer Overdiagnosis—When Too Much Care is Harmful,” New England Journal of Medicine, 376, 2017
  • “Cancer Screening, Overdiagnosis, and Regulatory Capture,” Journal of the American Medical Association Internal Medicine, 177, 2017
  • With P.C. Prorok, A.J. O’Malley, and B.S. Kramer, “Breast-Cancer Tumor Size, Overdiagnosis, and Mammography Screening Effectiveness,” New England Journal of Medicine, 375, 2016
  • With D.J. Robertson, “Colorectal Cancer on the Decline—Why Screening Can’t Explain It All,” New England Journal of Medicine, 374, 2016
  • With D.H. Gorski and P.C. Albertsen, “Trends in Metastatic Breast and Prostate Cancer- Lessons in Cancer Dynamics,” New England Journal of Medicine, 373, 2015
  • With C. Harding, F. Pompei, D. Burmistrov, R. Abebe, and R. Wilson, “Breast Cancer Screening, Incidence, and Mortality Across U.S. Counties,” Journal of the American Medical Association Internal Medicine, 175, 2015
  • With H.S. Ahn and H.J. Kim, “Korea’s Thyroid Cancer ‘Epidemic’–Screening and Overdiagnosis,” New England Journal of Medicine, 371, 2014
  • With H.J Passow, “Quantifying the Benefits and Harms of Screening Mammography,” Journal of the American Medical Association Internal Medicine, 174, 2014
  • With A. Bleyer, “Effect of Three Decades of Screening Mammography on Breast-Cancer Incidence: 1998-2005,” New England Journal of Medicine, 367, 2012
  • With B.A. Frankel, “Likelihood that a Woman with Screen-Detected Breast Cancer Has Had Her ‘Life Saved’ by that Screening,” Archives of Internal Medicine, 171, 2011
  • With S.M. Sharp, D.J. Gottlieb, J.S. Skinner, and J.E. Wennberg, “Geographic Variation in Diagnosis Frequency and Risk of Death among Medicare Beneficiaries,” Journal of the American Medical Association, 305, 2011
  • “Screening Mammography—a Long Run for a Short Slide?”, New England Medical Journal, 363, 2010
  • With W.C. Black, “Overdiagnosis in Cancer,” Journal of the National Cancer Institute, 102, 2010
  • With P.C. Albertsen, “Prostate Cancer Diagnosis and Treatment after the Introduction of Prostate-Specific Antigen Screening: 1986-2005,” Journal of the National Cancer Institute, 101, 2009
  • With P.H. Zahl and J. Maehlen, “The Natural History of Invasive Breast Cancers Detected by Screening Mammography,” Archives of Internal Medicine, 168, 2008
  • With S. Woloshin and L.M. Schwartz, “The Sea of Uncertainty Surrounding Ductal Carcinoma In Situ—the Price of Screening Mammography,” Journal of the National Cancer Institute, 100, 2008
  • With L. Davies, “The Increasing Incidence of Thyroid Cancer in the United States, 1973-2002,” Journal of the American Medical Association, 295, 2006
  • With S. Woloshin and L.M. Schwartz, “Skin Biopsy Rates and Incidence of Melanoma: Population-Based Ecological Study,” the BMJ, 331, 2005
  • With L.M. Schwartz and S. Woloshin, “Prostate-Specific Antigen Levels in the United States: Implications of Various Definitions for abnormal,” Journal of the National Cancer Institute, 97, 2005
  • With W.C. Black and D.A. Haggstrom, “All-Cause Mortality in Randomized Trials of Cancer Screening,” Journal of the National Cancer Institute, 94, 2002
  • With J. Mogielnicki, “Presumed Benefit: Lessons from the American Experience with Marrow Transplantation for Breast Cancer,” the BMJ, 324, 2002
  • “Informed Choice in Cancer Screening,” Journal of the National Cancer Institute, 285, 2001
  • With L.M. Schwartz and S. Woloshin, “Are Increasing 5-Year Survival Rates Evidence of Success Against Cancer?” Journal of the National Cancer Institute, 283, 2000