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

7/02/2012

The Good Doctors: The Medical Committee for Human Rights and the Struggle for Social Justice in Health Care Review

The Good Doctors: The Medical Committee for Human Rights and the Struggle for Social Justice in Health Care
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John Dittmer relates the history and development of the Medical Committee for Human Rights and the involvement of the Committee and its members in not only the civil rights movement, but in every "social justice" movement of the 1960s and early 1970s. His stated intent was to give credit to the medical professionals who put themselves into difficult and sometimes dangerous situations in the interest of advancing medical care to blacks, to the poor, and to anyone deprived of access to care because of his or her status in the community. Unfortunately, despite the author's apparent substantial knowledge of the era, the book is so poorly written that it can only leave the interested reader frustrated.
At the outset, many scenes and individuals were described in a way that made me feel they were being flashed on a screen. I have read a few books about the civil rights movement, but only after I had read about two-thirds of the book did I have a real sense of who were the significant individual participants in the movement. Someone with no prior knowledge of the events of the times would be at a complete loss to understand and follow the narrative.
There are occasional glimpses of how good this book and the telling of this story could be. Chapter 6, The Last March, and Chapter 7, The War at Home, are focused and cohesive. Most of the rest of the book, however, gave the impression of reading newspaper or magazine reports that were thrown together in an attempt to write a book. The writing was anecdotal. Analysis was lacking and there were often sweeping generalizations resulting in unsupported conclusions. Transitions between chapters, and sometimes between paragraphs, were choppy and bordered on the illogical.
For those of us interested in the civil rights movement and social justice issues of the era, the subject the author tries to illuminate holds great interest. Perhaps Dittmer wrote this book in a rush. Certainly his editors did him no favors. The information is there; I would like to see the author "take a Mulligan" and do it over.

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The untold story of the courageous doctors and nurses who fought the battle for racial justice in hospitals, in clinics, and on the streets in the 1960s.

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1/23/2012

The Treatment Trap: How the Overuse of Medical Care Is Wrecking Your Health and What You Can Do to Prevent It Review

The Treatment Trap: How the Overuse of Medical Care Is Wrecking Your Health and What You Can Do to Prevent It
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I am a physician who specializes in geriatrics and palliative medicine. I work in a busy tertiary care teaching hospital where some of the world's best specialists practice. Miracles of cure and life prolongation occur every day- liver and heart transplants, for example. But much more common is patients caught up in a system- marketplace is a more accurate description- of interventions- interventions that our specialists spent years in training learning how to do, and that they strongly believe are beneficial to their patients; interventions that are generously compensated by insurers; interventions that are not coordinated with all the other interventions provided by all the other specialists; interventions that have not been studied in the patient groups who are being subjected to them; interventions with significant side effects and consequences for many of the patients receiving them. Yet the unexamined belief- almost an article of faith among doctors and their patients- is that it is always better to do something than nothing in health care. Paradoxically, the truth is often just the opposite. Much of the time it is better to follow a different set of assumptions- when uncertain "don't just do something-- stand there." The Treatment Trap brings this situation to life through stories of real people- real people and their well-intended and very well-trained doctors- all doing what they were taught was right. For patients- See a doctor- do what they recommend. For doctors- See a patient, do something to show the patient you care, to make your living, to keep your practice above water. Interestingly, in support of the thesis of this book- that overtreatment is hurting and killing us- an increasing body of research shows that patients who get palliative care and hospice actually live LONGER than control patients receiving usual care- the usual care that Gibson and Singh reveal by listening to patients and families who have been there.


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