Showing posts with label health care. Show all posts
Showing posts with label health care. Show all posts

9/25/2012

This Won't Hurt a Bit: (And Other White Lies): My Education in Medicine and Motherhood Review

This Won't Hurt a Bit: (And Other White Lies): My Education in Medicine and Motherhood
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I only recently started following Michelle's blog and pre-ordered the book on a whim, but I'm so glad I did. I will be recommending this book to all of my med school friends. Her writing is clever and intelligent and I couldn't stop reading this account of her journey to being a doctor and a mother. As a first year medical student, I've worried about exactly the same issues that she went through. The relentless candor of this book combined with her witty patient stories makes for an entertaining read in which, for the first time, I truly felt that I understood what it's like to be a resident. Her account is inspiring, and brightens the light at the end of the tunnel for those of us who place highest priority on both our family and our work.

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Michelle Au started medical school armed only with a surfeit of idealism, a handful of old ER episodes for reference, and some vague notion about "helping people."This Won't Hurt a Bit is the story of how she grew up and became a real doctor.It's a no-holds-barred account of what a modern medical education feels like, from the grim to the ridiculous, from the heartwarming to the obscene. Unlike most medical memoirs, however, this one details the author's struggles to maintain a life outside of the hospital, in the small amount of free time she had to live it. And, after she and her husband have a baby early in both their medical residencies, Au explores the demands of being a parent with those of a physician, two all-consuming jobs in which the lives of others are very literally in her hands.Au's stories range from hilarious to heartbreaking and hit every note in between, proving more than anything that the creation of a new doctor (and a new parent) is far messier, far more uncertain, and far more gratifying than one could ever expect.

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8/28/2012

Partners in Health: How Physicians and Hospitals can be Accountable Together (J-B Public Health/Health Services Text) Review

Partners in Health: How Physicians and Hospitals can be Accountable Together (J-B Public Health/Health Services Text)
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A review of the need for collaboration between hospitals and doctors to improve quality and safety while increasing cost. Demonstrates how the reimbursement and legal environment create skewed and inappropriate incentives, but leaves out nursing and addresses outpatient medicine only superficially. As far as it goes, it is timely and practical. Its insights are useful for physicians in particular, especially physician managers. It does give an impression of some of the successful institutions, but the discussions are dry and technical but leave one wishing for more depth and detail. Storytelling would have strengthened the arguments.

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8/26/2012

Physical Rehabilitation (O'Sullivan, Physical Rehabilitation) Review

Physical Rehabilitation (O'Sullivan, Physical Rehabilitation)
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This is probably what I consider as the Bible in the realm of Physical Therapy. I have had this book ever since I was in college and it has proven to be valuable to me now that I am in my 11th year of practice as it was when I was still in my budding internship. I consider the cases found at the end of every chapter as the most helpful and insightful and for anyone hooked on evidence-based treatment strategies, this book is a must. Ms. Sullivan's work is seminal and phenomenal!

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Here is the only comprehensive,curriculum-spanning text for students and a key reference for practitioners! Itfocuses on the rehabilitation management of adult patients, integrating basicsurgical, medical, and therapeutic concepts to explain how to selectappropriate examination procedures and to develop treatment goals and plans.The more user friendly 5th Edition features a new, two-color design and more photographs, illustrations andtables.

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8/19/2012

Healthcare Investing: Profiting from the New World of Pharma, Biotech, and Health Care Services (McGraw-Hill Finance & Investing) Review

Healthcare Investing: Profiting from the New World of Pharma, Biotech, and Health Care Services (McGraw-Hill Finance and Investing)
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Healthcare is such a dynamic field with so much complexity and change that even a seasoned expert must constantly amass new knowledge. As a finance professional who previously worked as a healthcare sector analyst at a prominent Wall Street investment bank, I obtained this book with the goal of complementing my understanding and hopefully, finding some new investment ideas.
Les Funtleyder takes on a rather daunting task: explain everything there is to know about investing in healthcare within a brief 259 pages. I have mixed feelings about his success in accomplishing this goal. While this book has plenty of merit, its good points are countered by some whopping downsides.
The Strengths:
Most healthcare literature is purely about political, administrative, or moral dilemmas, but few sources are purely directed at investment as this. I like the unique, business-minded approach this book takes. The front end of is loaded with facts and statistics relevant to this country's health care crisis. Les does a fair job educating the reader on healthcare's current systemic challenges, and outlines the big game played between the ill, providers of treatment, and the private and governmental insurers. Overall he does a terrific job presenting a great deal of topics in laymen's terms, avoiding most of the technical jargon used in the field. Furthermore, this book is thoroughly researched with an excellent bibliography for further reading. A professional like myself would probably be compelled to look up a few of those sources.
The Weaknesses:
The biggest downside of this book is that it does not have the guts to name names - it does not mention specific companies! By failing to talk about specific players in the industry, a healthcare "investing" book, is somewhat self-defeating. I am not sure if this is due to legal reasons or to keep the book from getting dated too soon. Whatever the reason, this insufficiency reduces most of the book's discussion to generalized conjecture of "what-if" scenarios in the market.
With such breadth covered, this book also can't do justice to every subtopic. Understanding specifics is the key to success in a game like healthcare investing, but the book fails in this regard. In many cases, the beneficiaries of certain movements are not clear because there are so few pure plays in healthcare. For example, the book gives a generalized rundown on the future of personalized medicine. One of the major players I know of in personalized medicine is Medco Health Solutions (not mentioned specifically in the book), but pharmagenomics comprises only a small slice of their business with a questionable bottom line impact.
Finally, to whom is this writing directed? I could not tell if Les is targeting retail investors or investment professionals. It feels that his audience lies in some sort of limbo between the two categories. Not good.
Conclusion: I only rate this book two stars because although I found it useful for plugging a few holes in my warehouse of knowledge, its shortcomings override its practical benefits.

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Is your portfolio in peak health?

Ranking among the world's largest markets, the $2.5 trillion health care industry is growing at an unprecedented rate. According to Miller Tabak + Co.'s health care strategist Les Funtleyder, major structural renovations to the system are imminent. "Health care is entering an era of reform," Funtleyder writes, "and with reform comes change and the opportunity for investment gain."

Health-Care Investing provides a thorough explanation of how the industry's mammoth size and complexity can be worked to your advantage and why health care is more resistant to changes in economic cycles than other markets. Funtleyder gives you a comprehensive overview of the industry, from both macro and micro points of view, so you can make informed decisions regarding your investments. You'll find critical information concerning
The natural inelasticity of health care and how to profit from it
How to take advantage of the market's complexities and inefficiencies
Issues and policy changes you need to know
The social responsibility aspect of investing in health care
Why this market is essential for diversified portfolios

In Health-Care Investing, Funtleyder provides the tools you need to dig up the richest opportunities possible and build them into your investment strategy. You'll get a detailed look at traditional market patterns and the events that have shaped--and will continue to shape--the industry. Then you'll find specific strategies you can use to maximize your profits, whether you invest in pharma, biotech, managed services, or a combination of them. This informative and practical guide also includes a list of questions you can use as an investment "template," which will help guide your decision-making process.

With Health Care Investing, you'll be armed with the know-how to make the right decisions today in order to fully capitalize on events of the future.


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8/16/2012

Demanding Medical Excellence: Doctors and Accountability in the Information Age Review

Demanding Medical Excellence: Doctors and Accountability in the Information Age
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The National Academy Institute of Medicine reports in their new book "To Err is Human":
"Two large studies, one conducted in Colorado and Utah and the other in New York, found that adverse events occurred in 2.9 and 3.7 percent of hospitalizations, respectively. In Colorado and Utah hospitals, 8.8 percent of adverse events led to death, as compared with 13.6 percent in New York hospitals. In both of these studies, over half of these adverse events resulted from medical errors and could have been prevented. When extrapolated to the over 33.6 million admissions to U.S. hospitals in 1997, the results of the study in Colorado and Utah imply that at least 44,000 Americans die each year as a result of medical errors. The results of the New York Study suggest the number may be as high as 98,000. Even when using the lower estimate, deaths due to medical errors exceed the number attributable to the 8th leading cause of death. More people die in a given year as a result of medical errors than from motor vehicle accidents (43,458), breast cancer (42,297), or AIDS (16,516)."
These are only confirmed and documented hospital deaths induced by error (wrong medication, wrong operation, failure to deal with documented symptomology, etc.) For example, Millenson points out one study that showed in a single hospital there were 51000 errors in a year and only 36 reported. There are at least 180,000 deaths and over a million injuries caused by medical error every year in the U.S. Many professionals (including the reviewer who was funded by NIH for eight years to do risk analysis in healthcare) believe that these numbers are severely undereported and that medical error is the third leading cause of death after heart disease and cancer.
This book is the best available overview on the topic. If you value your life you will read it. The patient must take responsibility for monitoring treatment. If the patient is unable, family or friends must closely monitor it. Every time I give a talk on this subject someone in the audience has a personal horror story to share. Last month it was the son of the Chair of a conference I was attending whose child had a brain tumor and was in surgery the week before my talk. After surgery, the nurse was about to overdose the kid on morphine. A family member had been sleeping with the child in the hospital and logging every medication in a notebook. When they showed the log to the nurse and prevented her from administering the drug, she was shocked.
These stories are not isolated events. If airlines were like hospitals, every time 200 people disembarked from a flight, 7 passengers would be injured or dead.
The most tragic part of this story is that if healthcare institutions where automated like most industries, over 50% of these errors would disappear the first day they turned on the computers.

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8/03/2012

Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, Fifth Edition Review

Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, Fifth Edition
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Any book of thys type that has gone through five editions has to have something going for it, and This book has many. Perhaps the most important is the writing style which is as light and casual as it can be considering the subject. The goal is, of course, to prepare the student for a career. The book combined instructional material with case histories that illustrate how a particular case, situation, or patient was successfully handled. Each chapter starts with a page entitles 'A Nurse Speaks.' Here practicing nurses relate some of their history
In addition to the text, the book is supplied with a CD-ROM oriented to preparation for the NCLEX examination. A companion web site for the book provides yet more information to help the student.
This is one of the standard books in the field, and it's easy to see why. This book convey's the information the student needs to know in a style that makes it as easy as possible.

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The new edition of this popular text offers a clear, straightforward way to understand the often intimidating subject of psychiatric nursing. Its practical, clinical perspective and user-friendly writing style engage the reader in a learning process that both informs and enlightens. Clinical chapters progress consistently and logically from theory to application. Specific psychobiological disorders are organized from moderate to severe along the mental health continuum. The nursing process is the strong, visible framework throughout.
User-friendly writing style and a full-color design make psychiatric nursing content come alive! Case studies and personal stories show a compassion and understanding unique among psychiatric nursing texts. Special features are easily located and identified.
Nursing process framework provides a strong underpinning for all clinical chapters. A sixth step, Outcome Criteria, identifies specific patient outcomes, then justifies the subsequent nursing interventions based on results.
Assessment Guidelines boxes provide summary points for client assessment.
Spiritual assessment is found in Assessment Strategies and the Nursing Process and Care for the Dying and for Those Who Grieve.
Biologic Basis for Understanding Psychotropic Drugs lays the foundation for the study of psychotropic drug therapy to treat psychobiologic disorders.
Care for the Dying and for Those Who Grieve chapter provides holistic nursing interventions related to end-of-life care for clients and families.
Case Studies and Nursing Care Plans present individualized histories of clients with specific psychiatric disorders, and include interventions with rationales and evaluation statements for each client goal.
Vignettes offer brief, descriptive characterizations of clients with specific psychiatric disorders.
A Nurse Speaks spotlights individual psychiatric nurses and their personal stories.
Key Terms and Concepts with page number references allow for quick review.
Critical Thinking and Chapter Review sections offer scenario-based critical thinking problems and NCLEX-style multiple-choice questions, allowing students to test themselves on the chapter content.
Nurse, Client, and Family Resources lists are provided on the book's Evolve website.

A dynamic author team offers a breadth of experience in nursing education and practice.
Tear-out Comprehensive Psychiatric Assessment Card is a valuable tool for students to use in clinicals.
Completely revised Culturally Relevant Mental Health Nursing: A Global Perspective provides basic information on culture, worldviews, and what is necessary for culturally competent care.
Psychiatric Forensic Nursing discusses this new and expanding specialty involving nursing, forensics, and the criminal justice system.
Forensic Highlights boxes focus on the nurse's role in dealing with sexual assault, family violence, and incarcerated persons.
Evidence-Based Practice boxes demonstrate how research findings affect psychiatric nursing practice and standards of care.
Integrative Therapy boxes discuss the increasing popularity and significance of complementary and alternative therapies.
Culturally Speaking boxes reinforce the importance of culturally competent care.
A Client Speaks and A Family Speaks bring to life disorders and their effects on clients, their families, and those who care for them.
Back by popular demand: communication tables in The Clinical Interview and Communication Skills.
Key Points to Remember appear at the end of each chapter to reinforce essential information.


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7/17/2012

Chasing Medical Miracles: The Promise and Perils of Clinical Trials Review

Chasing Medical Miracles: The Promise and Perils of Clinical Trials
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As a diabetic author Alex O'Meara had given up hope for a cure and for thirty years had to take two or more shots of insulin daily. But in 2004 he signed up for a clinical trial involving an experimental transplant - and his experience led to an investigation of the industry in CHASING MEDICAL MIRACLES; THE PROMISE AND PERILS OF CLINICAL TRIALS. It's the first book to offer a behind-the-scenes view of clinical trails and how they operate and are funded, and is key for any medical student and consumer who wishes to understand their organization and importance.

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7/12/2012

Overdiagnosed: Making People Sick in the Pursuit of Health Review

Overdiagnosed: Making People Sick in the Pursuit of Health
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Conventional wisdom is that more diagnosis, especially early diagnosis, means better medical care. Reality, says Dr. Gilbert Welch - author of "Overdiagnosed," is that more diagnosis leads to excessive treatment that can harm patients, make healthy people feel less so and even cause depression, and add to escalating health care costs. In fact, physician Welch believes overdiagnosis is the biggest problem for modern medicine, and relevant to almost all medical conditions. Welch devotes most of his book to documenting his concerns via examples of early diagnosis efforts for hypertension, prostate cancer, breast cancer, etc. that caused patient problems.

Welch provides readers with four important and generalizable points. The first is that, while target guidelines are set by panels of experts, those experts bring with them biases and sometimes even monetary incentives from drug-makers, etc. Over the past decades many target levels have been changed (eg. blood pressure, cholesterol levels, PSA levels), dramatically increasing the number classified as having a particular condition. (Welch adds that prostate cancer can be found at any PSA level - about 8% for those with a PSA level of 1 or less, over 30% for those with a level exceeding 4; most are benign.)

The second is that treating those with eg. severe hypertension benefits those patients much more than treating those with very mild hypertension or 'prehypertension;' the result is treating those with lesser 'symptoms' can easily cause new problems that outweigh the value of the hypertension treatment.

The third is that Welch believes it is usually more important to treat those with disease symptoms (eg. pain) than those without. For example, almost 70% of men 60-69 have prostate cancer, as well as about 10% of those aged 20-29 - a large number are better left untreated because their particular cases involve a very slow-growing form and the side-effects of treatment outweigh the benefits. Welch also reports that a study of over 1,000 symptom-free people that underwent total-body CT screens found 86% had at least one detected abnormality, with an average of 2.8. Many of these abnormalities later disappear (some cancers disappear), while others grow very slowly, if at all. Providing unneeded treatment subjects patients to unneeded pain, risk of adverse outcomes (including death), and unneeded expense.

Examples: Welch cites the example of a mildly hypertensive older man that he treated; unfortunately, while shoveling snow the individual passed out from a combination of sweating and the diuretic prescribed for his high blood pressure. Welch discontinued the man's medication. Similarly, Dr. Welch treated a patient with mild diabetes - the result was she fainted from low blood sugar (the level fluctuates around a mean) while driving just after a meal and was severely injured in an accident. Dr. Welch discontinued her medication as well.

Meanwhile, at the same time that a number of target guidelines have been tightened, the availability and capability of scanning and other detection devices to find abnormalities has also increased. For example, since the early 1990s, Welch tells us that the Medicare per capita use of head scans has doubled, the rates of abdominal scans have tripled, chest scans quintupled, brain MRI rates quadrupled, etc. New biopsy methods for detecting prostate cancer (eg. sampling from 18 points rather than 12 or fewer) also increase the number of benign 'false-positive' diagnoses, probably much more so than true positives.

Why is there so much testing? Dr. Welch attributes it to well-meaning disease advocacy groups, testimonials (eg. ex-Senator Dole regarding his prostate cancer), quality-improvement efforts that include testing as one of their criteria, malpractice awards, hospital/specialist/drug company marketing (beware of these, says Welch), and honest disagreement over its value. He's also concerned about what lower-cost DNA testing will add to the overdiagnosis problem, contending that everyone's genes will reveal heightened susceptibility to some ailments and diseases, with little that can be done despite the knowledge. The author would probably also be concerned about new Medicare requirements to provide a battery of up to 45 medical tests ("The Wall Street Journal" - 1/18/2011). That article also reports that a "New England Journal of Medicine" review of hundreds of preventive-care studies showed that fewer than 20% saved money.

Bottom-Line: Dr. Welch raises an important topic for improving health care while reducing costs. His main recommendation, more data from clinical trials showing the outcomes of choosing one diagnosing standard/method over another, is important and appropriate.

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7/03/2012

Just Like Someone Without Mental Illness Only More So: A Memoir Review

Just Like Someone Without Mental Illness Only More So: A Memoir
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Mark Vonnegut, son of Kurt Vonnegut, Jr., first wrote about his struggle with mental illness in The Eden Express. His newest book has an updated focus, written from a seasoned perspective, with doses of humor which make the book very engaging. To get a fuller perspective about how the newer volume fits into Mark's life, I'd strongly suggest reading The Eden Express first. No, it isn't necessary, but does add perspective and a historical comparison between views about mental health in the 70s and now. It also makes it easier to grasp Vonnegut's changed views of mental health diagnosis and treatment.
By Mark Vonnegut's own admission, "craziness" ran in his family and manic depression affected at least four generations of the Vonneguts - and maybe even more. Alcoholism also seemed to be a common theme, with his great-grandfather drinking when he needed to escape from the voices he heard in his head. His maternal grandmother went through periods of psychiatric hospitalization.
When he wrote The Eden Express, Mark believed he had schizophrenia and was even formally diagnosed as schizophrenic. But he later decided that he actually had a form of bipolar illness, characterized by periods of mania as well as depression. Perhaps that is the prime reason his new book has more of an emphasis on bipolar illness. Vonnegut now questions the vitamin therapy which he credited in The Eden Express for much of his recovery. He has revisited that treatment option, noting it didn't work for many others.
Having read The Eden Express, I was eager to find out what had happened to Mark Vonnegut in the years since its publication. As it turns out, he'd not only gone to Harvard Medical School but became a practicing physician, all described in detail in his latest work. He also had to deal with the loss of his famous father and other blows. He eventually had a relapse (his fourth), complete with hallucinations, hearing voices and delusions that led to potentially lethal acts.
For those who are familiar with some of the biographical information about the Vonnegut family, it is relevant to keep in mind how the family history of depression may have made Mark particularly vulnerable. Mark's father (Kurt Vonnegut,Jr) had spells of depression so severe that he couldn't write for long periods of time. Mark's grandmother (Kurt's mother) committed suicide. So there is a case to be made that a tendency towards depression, bipolar illness, and alcoholism was inherited and may have played no small part in Mark Vonnegut's psychotic breaks.
Adding to the complexities, Vonnegut came of age in the 70s, a time when there was some support for the belief that there was no such thing as "mental illness" and that it was society which was "crazy" or out of whack. This was the time period and social construct when The Eden Express was written - but not the same time frame for his newest book. Finally, like so many in the late 60s and early to mid 70s, Mark took drugs and this complicated things even further. He joined a commune and was seen as a mystical figure, helping to obscure his increasingly disjointed thinking and delusions.
When Just Like Someone Without Mental Illness..etc...was written, drugs were still a factor but consisted primarily of Xanax and alcohol (never a good combination, potentially fatal). After Mark recovered from his first breakdown, the one chronicled in The Eden Express, and became a physician he also became a fairly heavy drinker, although he was careful not to drink at work. He'd sometimes add a bit of Xanax to the mix. Then he stopped drinking, quit the Xanax and everything went haywire again. He started to hear voices, something which hadn't happened to him in 14 years. Then he spiraled downward, began listening to the voices and ended up leaping through a glass window as an act of faith. In short order, he was back in a mental hospital and put on a daily dose of Xanax which seemed to be the bright spot in his day. At one point, he was also put on Haldol. All of this is chronicled very well by Vonnegut.
Maybe all this seems too grim for the average reader. But this isn't just a memoir about very bad periods in Vonnegut's life but also serves as an inspiring and truthful look at getting on with life, in spite of the possibility of regression. It took some bumpy years for Vonnegut to find some sort of equilibrium. After taking a close look at his past, Vonnegut began going to AA meetings and worked hard on his marriage. Although he was out of the psychiatric unit of a hospital, he still had to face a wealth of continuing problems - that turbulent marriage, a dying mother, uncertain funds, and more. And yet he persevered and became a practicing physician again. His success came in bits and pieces and this book chronicles his journey, from the lowest moments to the decisions he made to find some normalcy again.
Whether potential readers of Vonnegut's book have experienced mental illness or known someone who has, this memoir is worth reading. I hope it dispels some of the stigma about bipolar illness and other forms of mental illness. It is a courageous and open account. Vonnegut's memoir also lends credence to the fact that mental illness is a condition which can affect anyone, including those who are highly creative and famous as well as the poor and homeless. Vonnegut is proof that even a respected physician, someone named a leading physician by Boston Magazine, could be seriously impacted by bipolar illness. Vonnegut also doesn't take the stance that there is such a thing as complete mental wellness.
But he does find a way to schedule his life in hopes of staying well enough to be happy, function in the world and (hopefully) avoid any recurrence of severe episodes. He attends AA meetings and adds creative activities, including remodeling homes, to his life. All of this seems to help. I found the tone of the book to be best described as one of cautious optimism, of learning to be "comfortable with being uncomfortable" (as Vonnegut puts it). In his own way, he seems to have come to terms with his family's history of psychiatric problems and found his unique methods for maintaining some balance.
Perhaps Vonnegut expresses it best when he writes: "None of us are entirely well, and none of us are irrevocably sick. At my best I have islands of being sick entirely. At my worst I had islands of being well. Except for a reluctance to give up on myself there isn't anything I can claim credit for that helped me recover from my breaks. Even that doesn't count. You either have or don't have a reluctance to give up on yourself. It helps a lot if others don't give up on you."

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6/17/2012

Medical Tourism in Developing Countries Review

Medical Tourism in Developing Countries
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If you want to know Medical Tourism from an economist point of view and the implications for everyone in the health and tourism business, this is the book to get. The authors really did their work. The have a wealth of information for those who are involved in these industries. However, it is not the book to read if you are planning of becoming a medical tourist yourself. There are other books for that particular purpose.

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6/10/2012

Forgive and Remember: Managing Medical Failure Review

Forgive and Remember: Managing Medical Failure
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As a medical student at the University of Chicago, Forgive and Remember helped shape my view of what good, caring physicians need to do when policing their own. I am currently on the quality assurance committees at three hospitals where I practice. I am buying several copies of Forgive and Remember for my committee colleagues who have not read this book.
The temptations of money over our patient's best interest, the medical malpractice environment, and the difficulties of practicing medicine in the era of managed care have made it diffuclt for well intentioned physicians to make a difference in the quality of care provided in our communities. I think this book will help me and my colleagues fufill the responsibilities the hospitals and our commununities have given us.
I truly believe all health care providers, attorneys involved with medical malpractice cases, and people interested in the delivery of healthcare need to read this book. It brings into perspective how all health care providers, from surgeons to orderlies, are human and make mistakes. It also shows how some mistakes are hard to forgive. As physicians we have to take this into account while assuring we always keep the interest of all patients, our own and those of other physicians, are well looked after.
I hope that in my local community all people will trust that their health care providers, despite the outcome of their care, did a good, competent job. Everyone alive, including physicians and our families, will someday become a patient.
In life it is important for all of us to learn from our mistakes.

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On its initial publication, Forgive and Remember emerged as the definitive study of the training and lives of young surgeons. Now with an extensive new preface, epilogue, and appendix by the author, reflecting on the changes that have taken place since the book's original publication, this updated second edition of Charles L. Bosk's classic study is as timely as ever.

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4/27/2012

A Not Entirely Benign Procedure Review

A Not Entirely Benign Procedure
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I am a biology major/ pre-med student at UCLA, though it is through my English class that I found this book. Simply put, this novel made me think. I continuously wondered, "can i handle 'dog dissection'... will I be able to memorize all of the countless facts about all these rare diseases?" An entire section of the book is devoted to bioethical issues, including one essay entitled, "DNR," (do not resuscitate). I began questioning myself, "is it fair to bring someone back just so that they can suffer longer with the same disease?" If you plan on going to medical school, reading this book is a must, and a joy; it is perfect for pre-meds.

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4/18/2012

Cardiovascular and Pulmonary Physical Therapy, Second Edition: An Evidence-Based Approach Review

Cardiovascular and Pulmonary Physical Therapy, Second Edition: An Evidence-Based Approach
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Great Info, can get long winded at times. Also its very hard to find things in the index. Overall I like Brannon's text for my CV rehab.

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A comprehensive textbook spanning the entire scope of cardiovascular and pulmonary practice

Includes CD-ROM with interactive case studies

Cardiovascular and Pulmonary Physical Therapy reflects the broadest possible spectrum of cardiovascular and pulmonary practice and draws upon the expertise of more than two dozen internationally recognized contributors.The second edition has been updated to cover the sweeping changes that have occurred in both the practice of physical therapy and the education of physical therapy students. These changes include health care cost containment, the introduction of the Guide to Physical Therapist Practice, and the utilization of the disablement model.

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2/08/2012

Who Killed Health Care?: America's $2 Trillion Medical Problem - and the Consumer-Driven Cure Review

Who Killed Health Care: America's $2 Trillion Medical Problem - and the Consumer-Driven Cure
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According to information released by the Centers for Disease Control and Prevention on June 24, 2007, about 43.6 million people in the United States, or 14.8 percent of the population, had no health insurance in 2006. The finding, based on a survey of 100,000 people, is lower than previous federal estimates of 46 million. The estimate is based on those who did not have insurance at the time of the interview. About 54.5 million people in the country, or 18.6 percent of the population, had no insurance for at least part of 2006. Whatever the exact numbers, there is obviously a very serious problem with health care provision in the U.S. In fact, dozens.
In her previously published book, Consumer-Driven Health Care, Regina Herzlinger explains that consumer-driven health care is "fundamentally about empowering health care consumers - all of us - with control, choice, and information." Such control will "reward innovative insurers and providers for creating the higher-quality, lower-cost services we want and deserve." What would be the role of government? She asserts that "government will protect us with financial assistance and oversight, not micromanagement." The material in this substantial volume is organized within five Parts. Herzlinger wrote the first, "Why We Need Consumer-Driven Health Care," then edited the contributions by others that comprise Parts Two-Five. She also wrote Chapter 78, "A Health Care SEC: The Truth, the Whole Truth, and Nothing But the Truth." For most of us who are not health care professionals, this volume provides about as much information as we could possibly need, much less process. I especially appreciate the fact that Herzlinger and her associate contributors make a conscious effort to avoid jargon, vague theories, oblique hypotheses, etc. They obviously believe that major health care issues are too important to be packaged as flimflam, swamp gas, and flapdoodle. Hence their rigorous focus on explaining (from a variety of perspectives) why consumer-driven health care is needed, and, how to establish and then sustain it.
In this volume, Herzlinger focuses her attention on what she describes as "America's $2 trillion medical problem" (about the current size of the economy in China) and explains why consumer-driven initiatives offer a "cure." More specifically, she exposes "the iron triangle" of third parties (i.e. Congress, health insurers, and hospital administrators) that have opposed consumer-driven health care and thereby subordinated, if not totally ignored the welfare of patients as well as their personal physicians (if they have any). These third-parties are the ones who have "killed" health care for tens of millions of uninsured or under-insured people who, Herzlinger insists, have been deprived of power, information, and choice. She is a passionate and well-informed advocate of nothing less than major, extensive, and comprehensive health care reform.
"Four armies are battling to gain control [of health care]: the health insurers, hospitals, government, and doctors. Yet you and I, the people who use the health care system and who pay for all of it, are not even combatants. And the doctors, the group whose interests are most closely aligned with our welfare, are losing the war." What to do? Herzlinger's convincing, indeed compelling and eloquent response to that question is best revealed within her narrative. However, for present purposes, here are a few key recommendations:
1. Consumers must take back the money their employers and government now take from their salaries and taxes to buy health insurance on their behalf so they can make their own purchase decisions.
2. Physicians must be empowered to design better, cheaper health care.
3. The destitute must be subsidized by "the rest of us" so that can purchase health insurance "like everybody else."
4. The federal government must help subsidize the destitute, provide transparency (a key factor for all consumers, actually), and prosecute fraud and abuse.
In Parts 1 and 2, Herzlinger explains who is killing health care and how they are doing it. She identifies both "villains" and "heroes." In Part 3, she "lays out the principles as well as the specifics of consumer-driven health care - what it is, why it will work, what it offers to all of us - and analyzes the lessons from consumer-driven systems like Switzerland's." Then in Part 4, Herzlinger provides a step-by-step plan "of the carrots, the sticks, and the laws that will make this consumer-driven system happen."
Many of those who read this brief commentary of mine may ask "So what?" Perhaps they are satisfied with their current health care coverage. It is possible but unlikely that many (if any) of those who are destitute - who have no health care insurance coverage whatsoever - check out reviews of books, much less purchase and then read them. The fact is, those who are satisfied with their current health insurance coverage are probably paying too much for their share of its total cost. And a separate but related fact is that their employer is also paying too much for its share of the health care coverage that it is required by law to provide to its full-time employees.
Herzlinger has a crystal clear vision of what health care should be and do but she is also a pragmatist. She fully understands that unless and until, in a democratic capitalistic society such as the U.S., incentives and rewards are changed, there can be no reform of the current health care system. It is wholly understandable that "the iron triangle" of third parties (i.e. Congress, health insurers, and hospital administrators) oppose consumer-driven heath care, especially given the fact that about $2 trillion is involved and would be at risk if (huge "if") patients were entrusted with the power to decide how that money would be spent.
My concerns, frankly, are these: How many people will read this review and others, then purchase and read Herzlinger's book? Then what (if anything) will they do? All change initiatives inevitably encounter what James O'Toole has aptly characterized as "the ideology of comfort and the tyranny of custom." The power and resources of those who defend the status quo of "the iron triangle" must not be underestimated. All by herself, Regina Herzlinger cannot reform the current health care system. Who will join her in doing everything humanly possible to make consumer-driven health care a reality? If you think you wish to enlist in this "war" and help win it, I suggest you read and then re-read Pages 254-258, then contact your representatives in the House and Senate and insist - not request - that they read this book or at least have a staff member do so. Will that do any good? I have no idea. But I do know that by remaining silent and compliant, we empower "the iron triangle" rather than ourselves.

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1/26/2012

Life After Medical School: Thirty-Two Doctors Describe How They Shaped Their Medical Careers Review

Life After Medical School: Thirty-Two Doctors Describe How They Shaped Their Medical Careers
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This book is a breath of fresh air for those who are applying to or are planning to attend medical school. The perspectives from physicians (both practicing and not) in a range of careers are insightful and provide a glimpse into the many weaves and turns a medical career can take. My only criticism (and the author notes this, too) is that the profiled physicians are all very similar in terms of region where they work (mostly New England) and ethnicity, thus this book does not address such concerns as racism in medicine that may be important to minorities like myself who wonder about how such challenges can affect one's career choices. With that caveat, I fully recommend this book.

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1/15/2012

State of the Heart: A Medical Tourist's True Story of Lifesaving Surgery in India Review

State of the Heart: A Medical Tourist's True Story of Lifesaving Surgery in India
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I borrowed the book "State of the Heart" from a friend and, at about the same time, I saw the movie "Sicko". What an experience, like a double whammy to our health care system in America. "State of the Heart" reflects many of the disturbing situations found in the movie. The book could be used as a guide to someone who might need to do the same thing, but it was like hearing someone tell a story of an incredible experience with major consequences. I enjoyed it so much I just bought my own copy of it tonight. It is so interesting to see how the same scenarios from the movie happened to two people who took a chance to get the medical help they needed and ended up being in the news. This book is timely and a great pleasure to read.

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1/03/2012

Medical Terminology Systems: A Body Systems Approach Fifth Edition (Medical Terminology (W/CD & CD-ROM) (Davis)) Review

Medical Terminology Systems: A Body Systems Approach Fifth Edition (Medical Terminology (W/CD and CD-ROM) (Davis))
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I received the book with CD as a gift because I will be entering the field of medicine. The book and CD are easy to follow and I have learned more than I ever expected in medical terminology.
The book is easy to follow and prepares you to read medical reports and to learn thousands of medical terms, including diagnostic, symptomatic, and surgical terms. The pronunciations help me pronounce words correctly when I talk to the medical staff at the hospital.
I recommend this book highly.

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