Uncaring : how the culture of medicine kills doctors & patients / Robert Pearl, MD.

Title :

Uncaring : how the culture of medicine kills doctors & patients

Author:

Pearl, Robert,

Format:

Books

Summary:

"The spread of COVID-19 has brought the lives of doctors into sharper focus than ever before. We now see how the daily work of making important, even life-and-death decisions is frequently made harder. Hospitals and medical offices face budget problems, the influence of big pharmaceutical and insurance companies, as well as stress and long hours and massive amounts of bureaucracy and paperwork. And that was before the pandemic. As we engage in a public debate about the appropriate role of government, technology, big pharma and insurance companies in our health care, we've paid little attention to what it actually feels like to be a doctor. This simple ingredient -- medical culture -- argues for a simpler and more humane health care policy. And it also signals that necessary change must be made with care and attention. Saying thank you and applauding out the window for their life-saving work during the pandemic won't be enough. If we don't take care of our doctors, they can't take care of us. In this important book, Robert Pearl -- the former CEO of the Permanente Medical Group and a Stanford professor -- argues for the importance of culture to the future of medicine. No matter who is president, or how our laws change, his book makes it obvious that we can no longer afford to ignore it"--

Language:

English

ISBN - ISSN:

9781541758278

1541758277

Physical Description:

viii, 379 pages ; 25 cm

Contents:

Diagnosing physician culture -- The physician's pain -- Helping or harming patients? -- The social ladder -- The evolution of physician culture.

Subject:

Physician and patient -- United States.

Physicians -- United States.

Physicians -- United States -- Psychology.

Medical care -- United States.

Medical care -- Quality control.

Physicians -- Psychology.

Physician and patient.

Medical care.

Physicians.

United States.

First Title value, for Searching:

Uncaring : how the culture of medicine kills doctors & patients / Robert Pearl, MD.

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Summary

Doctors are taught how to cure people. But they don't always know how to care for them.

Hardly anyone is happy with American healthcare these days. Patients are getting sicker and going bankrupt from medical bills. Doctors are burning out and making dangerous mistakes. Both parties blame our nation's outdated and dysfunctional healthcare system. But that's only part of the problem.

In this important and timely book, Dr. Robert Pearl shines a light on the unseen and often toxic culture of medicine. Today's physicians have a surprising disdain for technology, an unhealthy obsession with status, and an increasingly complicated relationship with their patients. All of this can be traced back to their earliest experiences in medical school, where doctors inherit a set of norms, beliefs, and expectations that shape almost every decision they make, with profound consequences for the rest of us.

Uncaring draws an original and revealing portrait of what it's actually like to be a doctor. It illuminates the complex and intimidating world of medicine for readers, and in the end offers a clear plan to save American healthcare.

Author Notes

Dr. Robert Pearl is the former CEO of The Permanente Medical Group. Named one of Modern Healthcare 's 50 most influential physician leaders, Pearl is a clinical professor of plastic surgery at Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business, where he teaches courses on strategy and leadership, and lectures on information technology and health care policy. He is the author of the Washington Post bestseller Mistreated, hosts the popular podcast Fixing Healthcare, publishes a newsletter with over 10,000 subscribers, and is a regular contributor to Forbes. He has been featured on CBS This Morning, CNBC, NPR, and in TIME, USA Today and Bloomberg News, and is a frequent keynote speaker at healthcare and medical technology conferences.

Reviews (1)

Kirkus Review

The former CEO of the Permanente Medical Group takes readers into the world that shapes the medical practitioner's mindset and lays out necessary changes for a broken system. By the early 2000s, the U.S. health care system, once a global leader, had become the most expensive and least effective in the developed world. Of course, Covid-19 has only exacerbated the situation. Among the number of factors that have led to our current state of affairs--a situation that implicates everyone from hospital administrators to insurers, regulators, and pharmaceutical giants--Pearl singles out for examination the flawed culture that guides doctors in their practice. Physician culture, writes the author, "elevates intervention over prevention," resulting in a lack of effective treatment for chronic killers such as diabetes, obesity, hypertension, and heart disease. In a brightly delineated--and highly disturbing--dissection, Pearl lays out the rituals, rules, and beliefs that often isolate physicians from their colleagues and their patients. The foundation of the culture may rest on concepts of healing, resilience, and artistry, but it also breeds a hierarchical sense of individual exceptionalism, heroism, and invincibility. This entitlement and autonomy often clash with the implementation of advanced diagnostic technology, undercutting the doctor's sense of status and control. In this new environment, characterized by long hours, lowered pay, diminished decision-making, and erasure of prestige, more and more physicians are experiencing burnout. Pearl sensibly advocates a coevolution of these two streams, taking advantage of a doctor's experience and independent judgement while tapping into the structural and scientific changes in medical practice. Incorporating peer-reviewed research, personal experience, and anecdotal evidence, the author excoriates overtesting and overprescribing as well as institutionalized racism within the medical community, and he advocates for "broadly available, prepaid, integrated, high-quality healthcare," a system that is open to change, collaboration, and "safe, effective, patient-centered, timely, efficient, and equitable" care. In a well-documented, panoramic narrative, an insider demystifies what makes many doctors tick. Copyright (c) Kirkus Reviews, used with permission.

Introduction	p. 1
Part 1 Diagnosing Physician Culture
Chapter 1 Bloodletting, Handwashing, and Gorilla Watching	p. 13
Chapter 2 A First Look at Physician Culture	p. 24
Chapter 3 Heroes and Fools	p. 30
Chapter 4 A Two-Part History of Today's Physician Culture	p. 35
Chapter 5 The People v. Physician Culture	p. 50
Part 2 The Physician's Pain
Chapter 1 Did We Kill One of Our Own?69
Chapter 2 The Rise of Burnout, the Rebirth of Moral Injury	p. 81
Chapter 3 The Problem with Prestige	p. 90
Chapter 4 How the Mighty Fell	p. 99
Chapter 5 Doctors and Self-Determination Theory	p. 104
Chapter 6 Bored Stiff	p. 114
Part 3 Helping Or Harming Patients?
Chapter 1 Quality Isn't a Given	p. 123
Chapter 2 A Tale of Two Emergencies	p. 127
Chapter 3 Human Shields	p. 133
Chapter 4 The Real Price of Rx	p. 141
Chapter 5 A Great Inconvenience	p. 149
Chapter 6 The Language Barrier	p. 155
Chapter 7 Impersonalized Medicine	p. 161
Chapter 8 The Truth Is Complicated	p. 169
Chapter 9 The Doctor's Double Standard	p. 177
Part 4 The Social Ladder
Chapter 1 A Culture Without Answers	p. 187
Chapter 2 On Death and Dying	p. 191
Chapter 3 The Young and the Breathless	p. 206
Chapter 4 Colorblind	p. 219
Chapter 5 Does Sex Matter?	p. 230
Chapter 6 Discomfort with Difference	p. 237
Chapter 7 The Last Straw	p. 252
Part 5 The Evolution of Physician Culture
Chapter 1 Economic Desperation	p. 263
Chapter 2 Between Scylla and Charybdis	p. 271
Chapter 3 Two Paths, Both Fraught with Peril	p. 277
Chapter 4 Denial, Anger, Bargaining, and Depression	p. 289
Chapter 5 Acceptance and the Five Cs of Cultural Change	p. 295
Chapter 6 The Virtues of Being Difficult	p. 312
Chapter 7 Medicine: A Love Story	p. 322
Acknowledgments	p. 335
Bibliography	p. 339
Index	p. 367

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Summary

Summary

Author Notes

Reviews (1)

Kirkus Review

Table of Contents