An overview of the complications plaguing an increasingly “by-the-numbers” American health care system provides some possible solutions.
A former physician–turned–health care executive, Fischer-Wright (Tribal Leadership, 2008) examines the imbalance between the business-minded side of medical treatment and the critical, compassionate, humane part (dubbed the “art of medicine”) that she believes “is on life support” these days. While these separate components are important, she stresses, a balance needs to be struck in order for each to be mutually beneficial. The author offers a smoothly written combination of personal and clinical anecdotes, some hitting very close to home, as in her descriptions of her father’s stroke and her husband’s kidney stones. She also adds relevant case notes and intelligent deliberation on how the health care industry should be radically reformed. As a doctor, Fischer-Wright always considered “things like compassion and empathy and effective care that produces good results to be the key to patient satisfaction,” yet her book begins with a chapter on the hospital gown and how medical environment administrators have been attempting to redesign and overhaul the inexpensive apparel to make it more user-friendly and comfortable. The author concurs with the difference it might make to the patient experience yet believes there are much more important ways to improve health care in America. She considers the deterioration of the doctor-patient relationship and its foundation of trust as a key concern. In order to rebuild this component, a paradigm shift must occur away from prioritizing science and business toward patients and the delivery of compassionate, personalized, and humane medical care.
Fischer-Wright effectively adopts many different perspectives to demonstrate that the issues facing health care don’t just stem from one source, but from a collective of financial, political, social, and scientific territories. To encompass all demographics of her readership (from young medical students to veteran clinical professionals to the simply curious) in this timely, astute, and pivotal discussion, the author describes the serpentine chronology of a typical medical claim. She makes great use of pop culture, tying together Marcus Welby, M.D. and Star Trek references and Converse high top sneakers and the novels of Michael Crichton. She also employs a keen sense of humor throughout, which keeps the narrative grounded yet accessible and flexible, and concludes with a smart, multipronged strategy that “truly moves American health care in a new direction—one that puts the needs of people at the center of the industry again.” While acknowledging that there are no quick fixes, the author encourages readers to educate themselves and their loved ones on insurance, procedures, personal maintenance, and the myriad pathways of health care. With small, incremental steps forward, she believes true progress will be made toward improving patient-physician relationships, refocusing on personalizing care, and accessing the kind of world-class clinical treatment everyone deserves.
A motivational and elucidating appeal for health system reform and a return to patient-centered medical care.