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THE DOCTOR CRISIS

HOW PHYSICIANS CAN, AND MUST, LEAD THE WAY TO BETTER HEALTH CARE

While the book gives outsiders a peek into the inner workings of a large medical group, its message is directed primarily at...

The executive director of the Permanente Foundation argues that physicians are the key to creating a health care system that is patient-centered, safe, equitable, accessible and affordable.

With the assistance of former Boston Globe journalist Kenney (Transforming Health Care: Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience, 2010), Cochran draws on his years as president and chairman of the board of the Kaiser Permanente Medical Group in Colorado, where he developed and tested many of the ideas presented here. When he took over, the morale among physicians was low, and turnover was high; the group was losing members. Working with a team—he had not been a manager before and was learning on the job—Cochran set specific priorities for the group: preserving and enhancing physicians’ careers, optimizing the patient care experience and streamlining the care process. In detailing the obstacles and solutions, he makes clear that building a culture of collegiality and teamwork was essential. Nurses and clinical pharmacists were brought into partnerships with physicians, giving them greater responsibilities and career opportunities and freeing physicians to do the kind of work that only they could do. The author is especially proud of the methods he developed to rapidly set up a massive electronic health record system that increased the efficiency of patient care. Cochran calls on doctors, who have been trained to be healers, to expand their mission and take on a combination role of healer/leader/partner, and he insists that health care be a “learning industry.” Talented people from all disciplines—clinicians, researchers, the pharmaceutical industry, etc.—must work together and learn from each other to seek out the best practices and apply them to provide the best patient care.

While the book gives outsiders a peek into the inner workings of a large medical group, its message is directed primarily at members of the medical profession, more specifically, to those in management positions.

Pub Date: May 6, 2014

ISBN: 978-1-61039-443-7

Page Count: 240

Publisher: PublicAffairs

Review Posted Online: April 9, 2014

Kirkus Reviews Issue: May 1, 2014

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BETWEEN THE WORLD AND ME

NOTES ON THE FIRST 150 YEARS IN AMERICA

This moving, potent testament might have been titled “Black Lives Matter.” Or: “An American Tragedy.”

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The powerful story of a father’s past and a son’s future.

Atlantic senior writer Coates (The Beautiful Struggle: A Father, Two Sons, and an Unlikely Road to Manhood, 2008) offers this eloquent memoir as a letter to his teenage son, bearing witness to his own experiences and conveying passionate hopes for his son’s life. “I am wounded,” he writes. “I am marked by old codes, which shielded me in one world and then chained me in the next.” Coates grew up in the tough neighborhood of West Baltimore, beaten into obedience by his father. “I was a capable boy, intelligent and well-liked,” he remembers, “but powerfully afraid.” His life changed dramatically at Howard University, where his father taught and from which several siblings graduated. Howard, he writes, “had always been one of the most critical gathering posts for black people.” He calls it The Mecca, and its faculty and his fellow students expanded his horizons, helping him to understand “that the black world was its own thing, more than a photo-negative of the people who believe they are white.” Coates refers repeatedly to whites’ insistence on their exclusive racial identity; he realizes now “that nothing so essentialist as race” divides people, but rather “the actual injury done by people intent on naming us, intent on believing that what they have named matters more than anything we could ever actually do.” After he married, the author’s world widened again in New York, and later in Paris, where he finally felt extricated from white America’s exploitative, consumerist dreams. He came to understand that “race” does not fully explain “the breach between the world and me,” yet race exerts a crucial force, and young blacks like his son are vulnerable and endangered by “majoritarian bandits.” Coates desperately wants his son to be able to live “apart from fear—even apart from me.”

This moving, potent testament might have been titled “Black Lives Matter.” Or: “An American Tragedy.”

Pub Date: July 8, 2015

ISBN: 978-0-8129-9354-7

Page Count: 176

Publisher: Spiegel & Grau

Review Posted Online: May 5, 2015

Kirkus Reviews Issue: July 1, 2015

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WHEN BREATH BECOMES AIR

A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...

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A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer.

Writing isn’t brain surgery, but it’s rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn’t enter the field of medicine, in which his father and other members of his family excelled. “But I couldn’t let go of the question,” he writes, after realizing that his goals “didn’t quite fit in an English department.” “Where did biology, morality, literature and philosophy intersect?” So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which “would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay.” The author’s empathy undoubtedly made him an exceptional doctor, and the precision of his prose—as well as the moral purpose underscoring it—suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. “The fact of death is unsettling,” he understates. “Yet there is no other way to live.”

A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.

Pub Date: Jan. 19, 2016

ISBN: 978-0-8129-8840-6

Page Count: 248

Publisher: Random House

Review Posted Online: Sept. 29, 2015

Kirkus Reviews Issue: Oct. 15, 2015

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