In this nonfiction exploration of the complexities and limitations of modern health care, Collins looks closely at the prescribing, testing and treatment practices of physicians across the nation and attempts to show readers how to be better informed when visiting the doctor.
Collins doesn’t simply offer a warning to get a second opinion, as many physicians do. Instead, she breaks down the industry phase by phase, exploring the factors that influence prescription writing, test ordering and diagnoses. For example, readers are warned in one chapter that doctors are provided incentives to sell one medication over others. An oblivious patient, particularly one who already feels convinced about a medication due to advertising and the media, might sign off on a medication routine, not knowing of the doctor’s questionable bias. The author spends an exhaustive chapter raising awareness about external factors that influence the treatment patients can expect from the industry. This chapter alone makes the book worthwhile to a reader less familiar with the modern, media-influenced world doctors and patients both face. Collins also discusses the phenomenon of “overtreatment” and the effects the growing pharmaceutical industry has had on providing treatment. Collins describes one point in her career as an emergency physician when four new drugs were entering the market every month—and not solely due to groundbreaking discoveries. Many new drugs are simply enhancements or variations of older drugs, and as they saturate the market, physicians have a difficult time keeping up with the information. The author paints a clear picture of the ways in which multiple industries feed off one another to create a system that appears to be more about profits and bottom lines than delivering premium health care to Americans. The book is not all gloom and doom, though. Collins also documents ways in which health care has changed for the better since she began her career in the emergency room nearly four decades ago, and while encouraging readers to become more informed and aware of healthy practices versus quick fixes, she points out that doctors are people, too. She ties up the work with suggestions for changes in the industry, including a larger focus on food as medication and preventive, rather than prescriptive, medicine.
An eye-opening study of a growing industry, featuring a plethora of tips and advice for any reader, from patient to physician.