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First Published in 1997. Routledge is an imprint of Taylor & Francis, an informa company.
Written with poignancy and compassion, Do We Still NeedDoctors? is a personal account from the front lines of the moral and political battles that are reshaping America's health care system.
Every day we make decisions about our health - some big and some small. What we eat, how we live and even where we live can affect our health. But how can we be sure that the advice we are given about these important matters is right for us? This book will provide you with the right tools for assessing health advice.
Health-Care Solutions from a Distant Shore Health care in the United States and other nations is on a collision course with patient needs and economic reality. For more than a decade, leading thinkers, including Michael Porter and Clayton Christensen, have argued passionately for value-based health-care reform: replacing delivery based on volume and fee-for-service with competition based on value, as measured by patient outcomes per dollar spent. Though still a pipe dream here in the United States, this kind of value-based competition is already a reality--in India. Facing a giant population of poor, underserved people and a severe shortage of skills and capacity, some resourceful private enterprises have found a way to deliver high-quality health care, at ultra-low prices, to all patients who need it. This book shows how the innovations developed by these Indian exemplars are already being practiced by some far-sighted US providers--reversing the typical flow of innovation in the world. Govindarajan and Ramamurti, experts in the phenomenon of reverse innovation, reveal four pathways being used by health-care organizations in the United States to apply Indian-style principles to attack the exorbitant costs, uneven quality, and incomplete access to health care. With rich stories and detailed accounts of medical professionals who are putting these ideas into practice, this book shows how value-based delivery can be made to work in the United States. This "bottom-up" change doesn't require a grand plan out of Washington, DC, agreement between entrenched political parties, or coordination among all players in the health-care system. It needs entrepreneurs with innovative ideas about delivering value to patients. Reverse innovation has worked in other industries. We need it now in health care.
“A fascinating journey into the heart and mind of a physician” that explores the doctor-patient relationship, the flaws in our health care system, and how doctors’ emotions impact medical care (Boston Globe) While much has been written about the minds and methods of the medical professionals who save our lives, precious little has been said about their emotions. Physicians are assumed to be objective, rational beings, easily able to detach as they guide patients and families through some of life’s most challenging moments. But understanding doctors’ emotional responses to the life-and-death dramas of everyday practice can make all the difference on giving and getting the best medical care. Digging deep into the lives of doctors, Dr. Danielle Ofri examines the daunting range of emotions—shame, anger, empathy, frustration, hope, pride, occasionally despair, and sometimes even love—that permeate the contemporary doctor-patient connection. Drawing on scientific studies, including some surprising research, Dr. Ofri offers up an unflinching look at the impact of emotions on health care. Dr. Ofri takes us into the swirling heart of patient care, telling stories of caregivers caught up and occasionally torn down by the whirlwind life of doctoring. She admits to the humiliation of an error that nearly killed one of her patients. She mourns when a beloved patient is denied a heart transplant. She tells the riveting stories of an intern traumatized when she is forced to let a newborn die in her arms, and of a doctor whose daily glass of wine to handle the frustrations of the ER escalates into a destructive addiction. Ofri also reveals that doctors cope through gallows humor, find hope in impossible situations, and surrender to ecstatic happiness when they triumph over illness.
A playful, profound book that is not only a testament to one man's efforts to be deemed more human than a computer, but also a rollicking exploration of what it means to be human in the first place. “Terrific. ... Art and science meet an engaged mind and the friction produces real fire.” —The New Yorker Each year, the AI community convenes to administer the famous (and famously controversial) Turing test, pitting sophisticated software programs against humans to determine if a computer can “think.” The machine that most often fools the judges wins the Most Human Computer Award. But there is also a prize, strange and intriguing, for the “Most Human Human.” Brian Christian—a young poet with degrees in computer science and philosophy—was chosen to participate in a recent competition. This
There's a running joke among radiologists: finding a tumor in a mammogram is akin to finding a snowball in a blizzard. A bit of medical gallows humor, this simile illustrates the difficulties of finding signals (the snowball) against a background of noise (the blizzard). Doctors are faced with similar difficulties every day when sifting through piles of data from blood tests to X-rays to endless lists of patient symptoms. Diagnoses are often just educated guesses, and prognoses less certain still. There is a significant amount of uncertainty in the daily practice of medicine, resulting in confusion and potentially deadly complications. Dr. Steven Hatch argues that instead of ignoring this uncertainty, we should embrace it. By digging deeply into a number of rancorous controversies, from breast cancer screening to blood pressure management, Hatch shows us how medicine can fail-sometimes spectacularly-when patients and doctors alike place too much faith in modern medical technology. The key to good health might lie in the ability to recognize the hype created by so many medical reports, sense when to push a physician for more testing, or resist a physician's enthusiasm when unnecessary tests or treatments are being offered. Both humbling and empowering, Snowball in a Blizzard lays bare the inescapable murkiness that permeates the theory and practice of modern medicine. Essential reading for physicians and patients alike, this book shows how, by recognizing rather than denying that uncertainty, we can all make better health decisions.
Winner of the Los Angeles Times Book Prize "A panoramic and perfectly magnificent intellectual history of medicine…This is the book that delivers it all." —Sherwin Nuland, author of How We Die Hailed as "a remarkable achievement" (Boston Globe) and as "a triumph: simultaneously entertaining and instructive, witty and thought-provoking…a splendid and thoroughly engrossing book" (Los Angeles Times), Roy Porter's charting of the history of medicine affords us an opportunity as never before to assess its culture and science and its costs and benefits to mankind. Porter explores medicine's evolution against the backdrop of the wider religious, scientific, philosophical, and political beliefs of the culture in which it develops, covering ground from the diseases of the hunter-gatherers to the more recent threats of AIDS and Ebola, from the clearly defined conviction of the Hippocratic oath to the muddy ethical dilemmas of modern-day medicine. Offering up a treasure trove of historical surprises along the way, this book "has instantly become the standard single-volume work in its field" (The Lancet).
On average, a physician will interrupt a patient describing her symptoms within eighteen seconds. In that short time, many doctors decide on the likely diagnosis and best treatment. Often, decisions made this way are correct, but at crucial moments they can also be wrong—with catastrophic consequences. In this myth-shattering book, Jerome Groopman pinpoints the forces and thought processes behind the decisions doctors make. Groopman explores why doctors err and shows when and how they can—with our help—avoid snap judgments, embrace uncertainty, communicate effectively, and deploy other skills that can profoundly impact our health. This book is the first to describe in detail the warning signs of erroneous medical thinking and reveal how new technologies may actually hinder accurate diagnoses. How Doctors Think offers direct, intelligent questions patients can ask their doctors to help them get back on track. Groopman draws on a wealth of research, extensive interviews with some of the country’s best doctors, and his own experiences as a doctor and as a patient. He has learned many of the lessons in this book the hard way, from his own mistakes and from errors his doctors made in treating his own debilitating medical problems. How Doctors Think reveals a profound new view of twenty-first-century medical practice, giving doctors and patients the vital information they need to make better judgments together.