MEDICINE, MONEY, AND MORALS

PHYSICIANS' CONFLICTS OF INTEREST

A convincing case for resolving financial conflicts of interest that compromise the judgment of doctors and that bias the clinical choices they make. Whereas lawyers, certain financial professionals, and government officials are considered by law to be fiduciaries- -i.e., obligated to work for the benefit of those they represent- -there's as yet no effective policy to hold doctors accountable in this way. The medical profession has never developed a framework to address this problem, and, according to Rodwin (Law and Public Policy/Indiana University-Bloomington), it's unlikely to do so. Here, Rodwin examines seven activities that lead to significant conflicts of interest among physicians: kickbacks; referral to facilities in which physicians have a financial interest; the selling of medical products that they themselves prescribe; hospital purchases of private practices; payments by hospitals for patient referrals; gifts by pharmaceutical firms; and risk-sharing in health-maintenance organizations (HMOs). Disturbing examples of each of these activities dot the text and dramatize how patients can be adversely affected by them. Rodwin draws on the regulatory approaches of other professions to offer recommendations for solving the medical establishment's conflict- of-interest problems. He argues for setting up new institutions and rules to hold physicians to fiduciary standards, with legislatures taking the lead in laying down the ground rules, and with courts, regulatory agencies, third-party payers, and state attorneys general enforcing them. One interesting concept the author examines is the regulation of the medical industry by a federal commission, similar to the regulation of the securities business by the SEC. A constructive contribution—featuring a well-presented analysis as well as concrete proposals for reform—to the ongoing discussion of our national health-care crisis.

Pub Date: May 1, 1993

ISBN: 0-19-508096-3

Page Count: 400

Publisher: Oxford Univ.

Review Posted Online: May 20, 2010

Kirkus Reviews Issue: March 15, 1993

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If the authors are serious, this is a silly, distasteful book. If they are not, it’s a brilliant satire.

THE 48 LAWS OF POWER

The authors have created a sort of anti-Book of Virtues in this encyclopedic compendium of the ways and means of power.

Everyone wants power and everyone is in a constant duplicitous game to gain more power at the expense of others, according to Greene, a screenwriter and former editor at Esquire (Elffers, a book packager, designed the volume, with its attractive marginalia). We live today as courtiers once did in royal courts: we must appear civil while attempting to crush all those around us. This power game can be played well or poorly, and in these 48 laws culled from the history and wisdom of the world’s greatest power players are the rules that must be followed to win. These laws boil down to being as ruthless, selfish, manipulative, and deceitful as possible. Each law, however, gets its own chapter: “Conceal Your Intentions,” “Always Say Less Than Necessary,” “Pose as a Friend, Work as a Spy,” and so on. Each chapter is conveniently broken down into sections on what happened to those who transgressed or observed the particular law, the key elements in this law, and ways to defensively reverse this law when it’s used against you. Quotations in the margins amplify the lesson being taught. While compelling in the way an auto accident might be, the book is simply nonsense. Rules often contradict each other. We are told, for instance, to “be conspicuous at all cost,” then told to “behave like others.” More seriously, Greene never really defines “power,” and he merely asserts, rather than offers evidence for, the Hobbesian world of all against all in which he insists we live. The world may be like this at times, but often it isn’t. To ask why this is so would be a far more useful project.

If the authors are serious, this is a silly, distasteful book. If they are not, it’s a brilliant satire.

Pub Date: Sept. 1, 1998

ISBN: 0-670-88146-5

Page Count: 430

Publisher: Viking

Review Posted Online: May 20, 2010

Kirkus Reviews Issue: July 15, 1998

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A timely, vividly realized reminder to slow down and harness the restorative wonders of serenity.

STILLNESS IS THE KEY

An exploration of the importance of clarity through calmness in an increasingly fast-paced world.

Austin-based speaker and strategist Holiday (Conspiracy: Peter Thiel, Hulk Hogan, Gawker, and the Anatomy of Intrigue, 2018, etc.) believes in downshifting one’s life and activities in order to fully grasp the wonder of stillness. He bolsters this theory with a wide array of perspectives—some based on ancient wisdom (one of the author’s specialties), others more modern—all with the intent to direct readers toward the essential importance of stillness and its “attainable path to enlightenment and excellence, greatness and happiness, performance as well as presence.” Readers will be encouraged by Holiday’s insistence that his methods are within anyone’s grasp. He acknowledges that this rare and coveted calm is already inside each of us, but it’s been worn down by the hustle of busy lives and distractions. Recognizing that this goal requires immense personal discipline, the author draws on the representational histories of John F. Kennedy, Buddha, Tiger Woods, Fred Rogers, Leonardo da Vinci, and many other creative thinkers and scholarly, scientific texts. These examples demonstrate how others have evolved past the noise of modern life and into the solitude of productive thought and cleansing tranquility. Holiday splits his accessible, empowering, and sporadically meandering narrative into a three-part “timeless trinity of mind, body, soul—the head, the heart, the human body.” He juxtaposes Stoic philosopher Seneca’s internal reflection and wisdom against Donald Trump’s egocentric existence, with much of his time spent “in his bathrobe, ranting about the news.” Holiday stresses that while contemporary life is filled with a dizzying variety of “competing priorities and beliefs,” the frenzy can be quelled and serenity maintained through a deliberative calming of the mind and body. The author shows how “stillness is what aims the arrow,” fostering focus, internal harmony, and the kind of holistic self-examination necessary for optimal contentment and mind-body centeredness. Throughout the narrative, he promotes that concept mindfully and convincingly.

A timely, vividly realized reminder to slow down and harness the restorative wonders of serenity.

Pub Date: Oct. 1, 2019

ISBN: 978-0-525-53858-5

Page Count: 288

Publisher: Portfolio

Review Posted Online: July 21, 2019

Kirkus Reviews Issue: Aug. 15, 2019

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