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Uncaring

How the Culture of Medicine Kills Doctors and Patients

Audiobook
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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 Both parties blame our nation's outdated and dysfunctional healthcare system.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.
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    • Kirkus

      Starred review from April 1, 2021
      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(2021) Kirkus Reviews, ALL RIGHTS RESERVED.

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  • OverDrive Listen audiobook

Languages

  • English

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