When I was a child doctors fell only slightly under the Trinity
in the esteem of most people including my mother. Decades later when
my children were young many parents like me brought our children for
medical treatment with a great deal less trust. Would a doctor
prescribe an unneeded medicine because Big Pharma was making offers he/
she could not refuse?That was a frequent concern of mine.
Sandeep Jauhar, author of Doctored: The Disillusionment of an
American Physician, discusses this loss of special status from the
physician's perspective. "Today medicine is just another profession,
and doctors have become like everyone else: insecure, discontented,
and anxious about the future...American doctors are suffering from a
collective mallaise. We strove, made sacrifices, and for what?..."
In Doctored, Jauhar interweaves two strands of a profoundly
disturbing story. There is his narrative of his struggle to establish
himself professionally and earn enough to support a wife and child.
There is also his growing recognition of the Faustian bargains
required to thrive and even survive as a cardiologist.
This is scary stuff. Americans, according to Jauhar, spend over
$2.5 trillion on health care only have our country come in last in
health care quality, almost last in infant mortality, and behind
Bosnia in life expectancy. If you're like me, you'll be thinking,
What the Hell? This is exactly the question the book sets out to
answer. Doctors order unnecessary tests just so they can break even.
The different specialists on a patient's case give fragmented and
sometimes contradictory recommendations. The politics behind doctors
referring patients (and income) to one another make the Mafia look
like Mr. Rogers' Neighborhood... Even intended reforms can have
decidedly dark sides. Surgical report cards, intending to prove
quality of care, can inspire doctors to cherry pick the patients most
likely to survive and thrive, leaving too few willing to take on
patients most in need of help.
In Jauhar's words, "The practice of medicine today is as fraught
as it's ever been, and the doctor-patient relationship is in serious
trouble...These are not trivial problems. How they are resolved will
in no small part determine the future of health care in this country."
That's for damn sure!
On a personal note, I could only read a little over half the book. In
terms of scariness it makes Stephen King's works seem suitable for
publication as Little Golden Books. It is excellent as human interest
story and document/call for action. If you can read it cover to
cover, you have my sincere admiration.
A great big shout out goes out to those doctors who are doing their
best to buck the system and treat patients as people.
Julia Emily Hathaway
Sent from my iPod