Friday, May 19, 2017

Quick scan: An American Sickness

I found out today about this new book published this past April: An American Sickness: How Healthcare Became Big Business and How You Can Take It Back, by a tweet linking to a Medium post by the author Elisabeth Rosenthal. I instantly recognized this as an important read (maybe I even pride myself on that skill).


Certainly books and commentary about the broken delivery in the US healthcare system are the rage now, and justifiably so, but I hope to find an author who can do a better treatment (pun!) of the topic than the sanctimonious rest.

I had to run out and buy the book, but had to give it a quick scan just to confirm my intuition.

Rosenthal starts the book by exploring the American system and its ills (the hot mess that it is), by using the traditional way a new patient is interview by the clinician: History & Physical, which includes the chief complaint, history of present illness, the review of systems, of course the physical exam and any labs or imaging results that may be available. The a diagnosis is offered, actually a series of diagnoses based on probability called the differential diagnosis, if one diagnosis is not immediately apparent. Treatment option could then be explained.

This might seem like a cute trick if you've been to medical school, but I think it is important for everyone to be familiar with this procedure. People should understand and let's hope practice being a good historian when it comes to their medical histories.

Now the carnage begins on Medicine USofA, a kind of vivisection of the beast but in a thoughtful, analytical way that only someone with clinical experience could do a good job of.

I skipped to chapter 12 "The High Price of Patient Complacency." It rightly suggests the need for everyone to learn the knowledge and skills necessary to be an assertive patient. Unfortunately entering the medical system these days requires a battle mindset, anticipating the various traps and deceptions all meant to increase profits of the providers. This sounds very cynical, but hospitals and clinics have in mind to keep their practices should be moving from a cost to a profit center.

During this past election cycle, I felt that the American public would benefit from a full week of reports about how to become an engaged patient in a failing healthcare system, but we got something else.

I hope social can embrace later chapters of this book, and realize they is more hope than being stuck with a victim mentality, being a passive aggressive participant in a pursuit towards health both physical and financial.


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