9/08/2011

Severed Trust: Why American Medicine Hasn't Been Fixed--and What We Can Do About It Review

Severed Trust: Why American Medicine Hasn't Been Fixed--and What We Can Do About It
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American medicine is a classic paradox, offering the best of the best alongside an embarrassing failure to provide decent care for millions.
If you have ever puzzled over how this situation came to be, Severed Trust provides an easy-to-understand, well-written explanation. This book is partly the autobiographical odyssey of America's most famous medical editor, George Lundberg, partly a social and political history of American medicine, and partly Dr. Lundberg's vision of the future, detailing what he believes must be done to put our house in order. There are rich and interesting stories alongside important historical information and discussions of social policy issues that in so many other books are......well, just boring.
The son of economically impoverished Alabama schoolteachers, Dr. Lundberg was inspired to enter medicine by his family doctor. He took his first job in medicine mopping floors at a local hospital. After medical school and a distinguished career in pathology; his greatest medical contributions started, first in the 1980s as editor of JAMA, the Journal of the American Medical Association, and, since 1999, as editor in chief of Medscape ... .
In this book, and at JAMA and Medscape, Lundberg relentlessly challenges us to think about issues that hurt the quality, availability, and compassion of care: Why is high-tech medicine, especially at the end of life, often foisted upon patients at great expense, and at times, in nonsensical and inhumane ways? Why are autopsy rates so low in the United States when it has been conclusively proven that autopsies are critical to high quality standards? Can we provide good preventive care for all Americans and if so, why don't we?
Woven through the hard data presented in the book are Lundberg's personal anecdotes from experiences with family, friends, colleagues and articles he has introduced into public discussion and debate.
Lundberg passionately believes that information is powerful medicine, and that by publishing scientifically-sound evidence society will take note, and people, professionals, markets, and politicians will join together to root out bad practices and make the world a better place. The realist in him knows it often doesn't work out that way. But sometimes it does, and the victories, failures, and recommendations are reported in the book with memorable, edgy style (bemoaning the state of autopsies, Lundberg declares "it is time for good pathologists to come out of their clinical labs and spend more time in the morgue.")
Whether you agree or disagree with Lundberg's analyses or proposed fixes, I learned a lot about medicine, health care - and, George Lundberg - from this book, and enjoyed reading it.
Peter Frishauf Founder, [Medscape] Senior Adviser, Medscape, Inc.
(Disclosure: This reviewer recruited Lundberg to Medscape In 1999, after Lundberg was fired by the AMA for publishing the now famous study on the "Is Oral Sex, Sex?" question during the Clinton impeachment hearings)

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