In a well-documented, panoramic narrative, an insider demystifies what makes many doctors tick.
The former CEO of the Permanente Medical Group takes readers into the world that shapes the medical practitioner’s mindset and lays out necessary changes for a broken system.
By the early 2000s, the U.S. health care system, once a global leader, had become the most expensive and least effective in the developed world. Of course, Covid-19 has only exacerbated the situation. Among the number of factors that have led to our current state of affairs—a situation that implicates everyone from hospital administrators to insurers, regulators, and pharmaceutical giants—Pearl singles out for examination the flawed culture that guides doctors in their practice. Physician culture, writes the author, “elevates intervention over prevention,” resulting in a lack of effective treatment for chronic killers such as diabetes, obesity, hypertension, and heart disease. In a brightly delineated—and highly disturbing—dissection, Pearl lays out the rituals, rules, and beliefs that often isolate physicians from their colleagues and their patients. The foundation of the culture may rest on concepts of healing, resilience, and artistry, but it also breeds a hierarchical sense of individual exceptionalism, heroism, and invincibility. This entitlement and autonomy often clash with the implementation of advanced diagnostic technology, undercutting the doctor’s sense of status and control. In this new environment, characterized by long hours, lowered pay, diminished decision-making, and erasure of prestige, more and more physicians are experiencing burnout. Pearl sensibly advocates a coevolution of these two streams, taking advantage of a doctor’s experience and independent judgement while tapping into the structural and scientific changes in medical practice. Incorporating peer-reviewed research, personal experience, and anecdotal evidence, the author excoriates overtesting and overprescribing as well as institutionalized racism within the medical community, and he advocates for “broadly available, prepaid, integrated, high-quality healthcare,” a system that is open to change, collaboration, and “safe, effective, patient-centered, timely, efficient, and equitable” care.
In a well-documented, panoramic narrative, an insider demystifies what makes many doctors tick.Pub Date: May 18, 2021
ISBN: 978-1-5417-5827-8
Page Count: 400
Publisher: PublicAffairs
Review Posted Online: March 12, 2021
Kirkus Reviews Issue: April 1, 2021
Striking research showing the immense complexity of ordinary thought and revealing the identities of the gatekeepers in our...
A psychologist and Nobel Prize winner summarizes and synthesizes the recent decades of research on intuition and systematic thinking.
The author of several scholarly texts, Kahneman (Emeritus Psychology and Public Affairs/Princeton Univ.) now offers general readers not just the findings of psychological research but also a better understanding of how research questions arise and how scholars systematically frame and answer them. He begins with the distinction between System 1 and System 2 mental operations, the former referring to quick, automatic thought, the latter to more effortful, overt thinking. We rely heavily, writes, on System 1, resorting to the higher-energy System 2 only when we need or want to. Kahneman continually refers to System 2 as “lazy”: We don’t want to think rigorously about something. The author then explores the nuances of our two-system minds, showing how they perform in various situations. Psychological experiments have repeatedly revealed that our intuitions are generally wrong, that our assessments are based on biases and that our System 1 hates doubt and despises ambiguity. Kahneman largely avoids jargon; when he does use some (“heuristics,” for example), he argues that such terms really ought to join our everyday vocabulary. He reviews many fundamental concepts in psychology and statistics (regression to the mean, the narrative fallacy, the optimistic bias), showing how they relate to his overall concerns about how we think and why we make the decisions that we do. Some of the later chapters (dealing with risk-taking and statistics and probabilities) are denser than others (some readers may resent such demands on System 2!), but the passages that deal with the economic and political implications of the research are gripping.
Striking research showing the immense complexity of ordinary thought and revealing the identities of the gatekeepers in our minds.Pub Date: Nov. 1, 2011
ISBN: 978-0-374-27563-1
Page Count: 512
Publisher: Farrar, Straus and Giroux
Review Posted Online: Sept. 3, 2011
Kirkus Reviews Issue: Sept. 15, 2011
BOOK REVIEW
IN THE NEWS
IN THE NEWS
Highly instructive for would-be tycoons, with plenty of entertaining interludes.
Well-crafted memoir by the noted media mogul.
Diller’s home life as a youngster was anything but happy; as he writes early on, “The household I grew up in was perfectly dysfunctional.” His mother lived in her own world, his father was knee-deep in business deals, his brother was a heroin addict, and he tried to play by all the rules in order to allay “my fear of the consequences from my incipient homosexuality.” Somehow he fell into the orbit of show business figures like Lew Wasserman (“I was once arrested for joy-riding in Mrs. Wasserman’s Bentley”) and decided that Hollywood offered the right kind of escape. Starting in the proverbial mailroom, he worked his way up to be a junior talent agent, then scrambled up the ladder to become a high-up executive at ABC, head of Paramount and Fox, and an internet pioneer who invested in Match.com and took over a revitalized Ticketmaster. None of that ascent was easy, and Diller documents several key failures along the way, including boardroom betrayals (“What a monumental dope I’d been. They’d taken over the company—in a merger I’d created—with venality and duplicity”) and strategic missteps. It’s no news that the corporate world is rife with misbehavior, but the better part of Diller’s book is his dish on the players: He meets Jack Nicholson at the William Morris Agency, “wandering through the halls, looking for anyone who’d pay attention to him”; hangs out with Warren Beatty, ever on the make; mispronounces Barbra Streisand’s name (“her glare at me as she walked out would have fried a fish”); learns a remedy for prostatitis from Katharine Hepburn (“My father was an expert urological surgeon, and I know what I’m doing”); and much more in one of the better show-biz memoirs to appear in recent years.
Highly instructive for would-be tycoons, with plenty of entertaining interludes.Pub Date: May 20, 2025
ISBN: 9780593317877
Page Count: 352
Publisher: Simon & Schuster
Review Posted Online: May 12, 2025
Kirkus Reviews Issue: June 15, 2025
SEEN & HEARD
SEEN & HEARD
SEEN & HEARD
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