No-punches-pulled scrutiny of the flawed system that produces our nation's doctors. As the husband of an overstressed, overworked, and overtired resident in pediatrics, Duncan (Hernando de Sota, 1995, etc.) saw firsthand the impact our present residency system had on one doctor. Here he looks at the bigger picture: how it affects not just doctors but patients and society in general. For four years he followed hospital residents on call, keeping records of their actions, attitudes, hours, supervision, and patient outcomes; he also interviewed dozens of doctors, medical educators, patients, and nurses. The result is an anecdote-filled account of what's wrong with the system and how it came to be the way it is. Where statistics are available, he cites them, but one of the flaws of the present system is its failure to collect hard data on its own level of safety or effectiveness. Where reforms have been made— as in New York State, where the famous Libby Zion case led to legislation restricting the number of hours residents can work— he describes them, but these are few and far between. Duncan is persuasive in his argument that a system that once worked fairly well when medical knowledge was limited now drops inexperienced and minimally supervised young physicians into complex, difficult situations, that it overworks and underpays them, and that it too often fails to protect patients from the hazards of treatment by sleep-deprived and undersupervised residents. Concluding with a warning that the very survival of our nation's teaching hospitals is being threatened as managed care reshapes the medical marketplace, Duncan offers no solutions to that problem but has some practical suggestions for revamping residency programs. An up-close and sobering picture of medical education's imperfections. (Author tour)
Pub Date: June 1, 1996
ISBN: 0-684-19709-X
Page Count: 304
Publisher: Scribner
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: April 15, 1996
This is not the Nutcracker sweet, as passed on by Tchaikovsky and Marius Petipa. No, this is the original Hoffmann tale of 1816, in which the froth of Christmas revelry occasionally parts to let the dark underside of childhood fantasies and fears peek through. The boundaries between dream and reality fade, just as Godfather Drosselmeier, the Nutcracker's creator, is seen as alternately sinister and jolly. And Italian artist Roberto Innocenti gives an errily realistic air to Marie's dreams, in richly detailed illustrations touched by a mysterious light. A beautiful version of this classic tale, which will captivate adults and children alike. (Nutcracker; $35.00; Oct. 28, 1996; 136 pp.; 0-15-100227-4)
Pub Date: Oct. 28, 1996
ISBN: 0-15-100227-4
Page Count: 136
Publisher: Harcourt
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: Aug. 15, 1996
BOOK REVIEW
BOOK REVIEW
Stricter than, say, Bergen Evans or W3 ("disinterested" means impartial — period), Strunk is in the last analysis...
Privately published by Strunk of Cornell in 1918 and revised by his student E. B. White in 1959, that "little book" is back again with more White updatings.
Stricter than, say, Bergen Evans or W3 ("disinterested" means impartial — period), Strunk is in the last analysis (whoops — "A bankrupt expression") a unique guide (which means "without like or equal").Pub Date: May 15, 1972
ISBN: 0205632645
Page Count: 105
Publisher: Macmillan
Review Posted Online: Oct. 28, 2011
Kirkus Reviews Issue: May 1, 1972
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