When I was applying to get into a Masters program for Physician Assistant Studies, I was recommended that for my interviews, I should read some relevant books on healthcare and medicine to be able to bring up in conversation - some extra brownie points, you know?
What I did not expect was to enjoy such a book wholeheartedly. This book seems like it attracts more to the health care audience rather than our non-health counterparts, but I would argue that this book is a great read for anyone who has an interest in their own well-being.
What I love about this book is that Dr. Webb Brawley, an oncologist by training, delves into the broken American Healthcare system in a way that is tactful and mindful of both treating providers and their patients. His argument is that treatment has become so constrained to payment and outcome scores that we forget we are not just rectifying diseases, but treating people, too. It is a vicious cycle for providers who are required to see more patients, order more tests, and act as though medicine is all about customer service and patient satisfaction. If we as providers don't get paid, our office doors shut, and now we cannot treat anyone.
On the other hand, if we treat too much, focusing on disease process rather than human variables (ie age, religion, socioeconomic status), although we may be successful at curing the disease, we create more of a problem for the person we were treating.
There is one example from this book that stands out to me and has been a foundation of how I practice medicine. It is a story of a sixty-something-year-old man recently diagnosed with prostate cancer. If you do not know anything about cancers, prostate cancer is one of the most slow-growing cancers we know of. It can take over twenty years to manifest into a bigger problem, and most men diagnosed with prostate cancer are older in age. Dr. Webb Brawley explains two potential outcomes for this patient in detail in his book. The first outcome is that the Oncologist removes the prostate and its cancer and starts a radiation treatment. This treatment then affects the man's genitourinary system making him urinary incontinent and unable to perform sexually. His quality of life is reduced to wearing Depends, using a catheter, and unable to have an intimate relationship with his wife. The cancer is cured, but the quality of life is severely diminished. Dr. Webb Brawley then goes on to describe a second scenario - one where the man does nothing. He lives his life as he always has, and dies at the ripe old age of ninety from heart failure in his sleep.
The idea behind this is that we as clinicians and even patients, become too fixated on needing to know what is wrong and how to "get rid of it". This is a great book to understand from both prospective of clinician and patient how we can make more informed decisions and provide more quality treatment overall. As the title implies, this book is a great reminder of how we as clinicians can keep our Hippocratic Oath to our patients to "Do No Harm".
Click here to find a copy of this book.
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