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WHEN DOCTORS DON'T LISTEN

HOW TO AVOID MISDIAGNOSES AND UNNECESSARY TESTS

As health care becomes more complex and political, this book provides clear direction toward better care.

A comprehensive guide to improving doctor-patient relations through empowering patients to take an active role in their care.

Managed care has put pressure on doctors to do the most work in the smallest amount of time possible, and even the best-intentioned of physicians can fall prey to corner cutting and misdiagnoses. Doctors Wen and Kosowsky suggest change can come from the ground up by making sure patients and clients are more directive in managing how their interactions progress. “We aim for this to be the opening salvo of a revolution among patients to improve the quality of their own care and to lead the way to true healthcare reform,” they write. Toward this end, the authors provide a raft of anecdotal stories that double as scenarios many patients encounter: being rushed, doctors downplaying concerns, having close-ended "cookbook medicine" questions determine the course of the interaction, and other situations leading to reductive diagnoses. All of the experiences shared lead into actionable steps patients can take toward being "better patients" as well as working to pressure doctors into providing better care—steering the conversation away from close-ended questions, insisting on both explanations for recommended tests and exploring alternatives, and making yourself an active partner in reaching a differential diagnosis. In the appendixes, which include “21 Exercises Toward Better Diagnosis,” the authors further elaborate on these recommendations and others, providing practice sets so readers won't need to wait for their appointment to learn better patient skills.

As health care becomes more complex and political, this book provides clear direction toward better care.

Pub Date: Jan. 15, 2013

ISBN: 978-0-312-59491-6

Page Count: 320

Publisher: Dunne/St. Martin's

Review Posted Online: Oct. 11, 2012

Kirkus Reviews Issue: Nov. 1, 2012

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A SHORT GUIDE TO A LONG LIFE

Useful but disappointingly commonplace tips.

In a follow-up to The End of Illness (2012), which explored how technological advances will transform medicine, Agus (Medicine and Engineering/Univ. of Southern California) restates time-tested but too often overlooked principles for healthy living.

The author outlines simple measures that average citizens can take to live healthier lives and extend their life spans by taking advantage of modern technology to develop personalized records. These would include a list of medical tests and recommended treatments. Agus also suggests keeping track of indicators that can be observed at home on a regular basis—e.g., changes in energy, weight, appetite and blood pressure, blood sugar and general appearance. He advises that all of this information be made available online, and it is also helpful to investigate family history and consider DNA testing where indicated. Along with maintaining a healthy weight, Agus emphasizes the importance of eating a balanced diet, with plenty of fresh fruits and vegetables and a minimum of red meat. Avoid packaged vitamins and food supplements, and if possible, grow your own vegetables or buy frozen vegetables, which will generally be fresher than those on supermarket shelves. The author also warns against processed foods that make health claims but contain additives or excessive amounts of sugar or fat. Regular mealtimes and plenty of sleep, frequent hand-washing and oral hygiene are a must; smoking and excessive time in the sun should also be avoided. Agus recommends that adults should consider taking statins and baby aspirin as preventative measures. He concludes with a decade-by-decade checklist of annual medical examinations that should be routine—e.g. blood pressure, diabetes and cholesterol screenings, from one’s 20s on; colonoscopies, prostate exams and mammograms later—and a variety of top-10 lists (for example, “Top 10 Reasons to Take a Walk”).

Useful but disappointingly commonplace tips.

Pub Date: Jan. 7, 2014

ISBN: 978-1-4767-3095-0

Page Count: 128

Publisher: Simon & Schuster

Review Posted Online: Sept. 30, 2013

Kirkus Reviews Issue: Oct. 15, 2013

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THE END OF ILLNESS

Oncologist Agus (Medicine and Engineering/Univ. of Southern California) predicts that the application of advanced technology for modeling complex systems will transform 21st-century medicine.

The author writes that a remark Nobel Laureate Murray Gell-Mann made to him in 2009—“Look at cancer as a system"—transformed the way he views his own specialty and the entire field of preventative medicine. It made him realize that “[r]ather than honoring the body as the exceedingly complex system that it is, we keep looking for the individual gene that has gone awry, or for the one ‘secret’ that can improve our health.” Agus writes that although the ability to sequence the entire human genome is a great step forward, it is insufficient for achieving a significant breakthrough. Even though it may start with a mutation, cancer “is a dynamic process that's happening…far from the confines of a static piece of DNA”—it involves the body's immune system, its ability to regulate cell growth, metabolism and more. Agus directs his university’s Center for Applied Molecular Medicine and is the co-founder of two personalized medicine companies, Applied Proteomics and Navigenics. His hope is that their research will contribute to developing better analytical tools for preventative medicine and for the treatment of cancers. These will address the functioning of the body as a whole, applying digital technology already used by physicists to provide virtual models of cancers and model the action of proteins that regulate cell communication in the body. He also hopes to develop tools that will provide information on the concentration of different proteins in a drop of blood taken from a patient, which may reveal the onset of disease. The author also includes some guiding principles and warnings about certain healthy practices that may not be so healthy. A refreshing change of pace in the medical field, but by venturing beyond his field of expertise to pontificate on a wide range of subjects, Agus makes his otherwise intriguing narrative difficult to follow.  

 

Pub Date: Jan. 1, 2012

ISBN: 978-1-4516-1017-8

Page Count: 288

Publisher: Free Press

Review Posted Online: Nov. 5, 2011

Kirkus Reviews Issue: Nov. 15, 2011

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