Tuesday, August 27, 2013

ONE DOCTOR Examines The State Of Healthcare In The U.S.

As a  member of Simon & Schuster's Galley Alley, I receive promotional copies of books I've chosen to read. I'm not required to write a review. I write and share what I wish. Opinions expressed herein are my own.

Healthcare delivery in the United States is a disaster. Inflated costs by healthcare providers, incentives for non-delivery of services by insurance companies, and the  waning of medical students choosing internal medicine as their specialty contribute to a disjointed system that endangers patients' lives, rations services, and provides the greatest care to a fortunate and wealthy few. Dr. Brendan Reilly's first person account in ONE DOCTOR: Close Calls, Cold Cases, And The Mysteries Of Medicine is an empathetic and disturbing read.

It's empathetic for the medically near-impossible cases Dr. Reilly presents as he rounds with his  students. The reader doesn't meet patients and their families in a detached clinical sense, but as humans, grappling with decisions that no one should have to make. Between these cases, the author discusses his personal struggles in the profession, while sharing family history, as he decides how to manage his own elderly parents' end of life planning. What defines quality of life and when is "enough" enough? 

The disturbing nature of the book has to do with all the mishaps that occur when there's little or no continuity of care. As I read, I started making a list of the things I'll be doing differently moving forward. I learned more than I wanted to know about medical reimbursement, the dying autopsy, the unreliability of diagnostic tests, both positive and negative, the insidious nature of undetectable breast cancer, and the importance of having an advanced directive in place so that my loved ones aren't burdened with making the kinds of decisions presented in this book. Anyone who doesn't have a primary doctor should get one, now.