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
Cogent, well-timed ideas for meeting today’s biggest challenges.
Helping liberals get out of their own way.
Klein, a New York Times columnist, and Thompson, an Atlantic staffer, lean to the left, but they aren’t interrogating the usual suspects. Aware that many conservatives have no interest in their opinions, the authors target their own side’s “pathologies.” Why do red states greenlight the kind of renewable energy projects that often languish in blue states? Why does liberal California have the nation’s most severe homelessness and housing affordability crises? One big reason: Liberal leadership has ensnared itself in a web of well-intentioned yet often onerous “goals, standards, and rules.” This “procedural kludge,” partially shaped by lawyers who pioneered a “democracy by lawsuit” strategy in the 1960s, threatens to stymie key breakthroughs. Consider the anti-pollution laws passed after World War II. In the decades since, homeowners’ groups in liberal locales have cited such statutes in lawsuits meant to stop new affordable housing. Today, these laws “block the clean energy projects” required to tackle climate change. Nuclear energy is “inarguably safer” than the fossil fuel variety, but because Washington doesn’t always “properly weigh risk,” it almost never builds new reactors. Meanwhile, technologies that may cure disease or slash the carbon footprint of cement production benefit from government support, but too often the grant process “rewards caution and punishes outsider thinking.” The authors call this style of governing “everything-bagel liberalism,” so named because of its many government mandates. Instead, they envision “a politics of abundance” that would remake travel, work, and health. This won’t happen without “changing the processes that make building and inventing so hard.” It’s time, then, to scrutinize everything from municipal zoning regulations to the paperwork requirements for scientists getting federal funding. The authors’ debut as a duo is very smart and eminently useful.
Cogent, well-timed ideas for meeting today’s biggest challenges.Pub Date: March 18, 2025
ISBN: 9781668023488
Page Count: 320
Publisher: Avid Reader Press
Review Posted Online: Jan. 16, 2025
Kirkus Reviews Issue: Feb. 15, 2025
BOOK REVIEW
PERSPECTIVES
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: yesterday
SEEN & HEARD
SEEN & HEARD
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