An intensive, mindful critique of modern health care that confronts its flaws and proposes solutions.
A report on the complex social and economic issues that are hindering significant patient health care reforms.
Physician and former chief medical officer for Centria Healthcare Merahn’s collection of insightful essays focuses on his view that improvements to health care networks should be a “social imperative” in order to sustain educational and economic progress and avoid systemic inequities. The source of Merahn’s frustration stems from inaction from decision-makers and medical professionals to embrace patient-focused methods of care delivery. He sees health care as a critical necessity—one that’s battered by the forces of economic instability, racial injustice, unconscious bias, politics, and free market capitalist dynamics. Merahn’s research discovered many health care professionals who felt disconnected from their peers and lacking strategies to repair the devaluation of their occupation. The author takes a broad view of his subject, astutely examining the history of American health care and how it’s been incrementally destabilized by “those with less selfless and less generous agendas”; he also addresses how it’s been defined by revenue economics rather than by a philosophy of delivering quality communitywide care. The author writes that although the Covid-19 pandemic has successfully and swiftly mobilized crisis teams across the globe and, in most cases, amply supplied them with the resources they need, it’s also exposed a glaring lack of equitable access to care due in part to systemic racism. He notes that the crisis has also alarmingly revealed a distinct population with “deficient scientific literacy.”
Driven by what he perceives to be glaring systemic inadequacies, Merahn intelligently outlines an evolutionary plan that includes fundamental improvements in clinicians’ financial stability, an organizational restructuring of the care delivery system, and a revised vision of the kind of coverage and support that the American system should be providing. The author leaves little room for doubt that quality health care is urgently needed by everyone and that the system’s goals have, over time, become derailed by the desire for profit and are in need of a remedy that isn’t solely based on “how we pay for care" and is "more about how we plan for care.” Merahn advocates for increased human connection and noncategorical approaches to illness that, in his view, would “transcend diagnoses and acknowledge the power of emotion in influencing interactions in relationships.” Improved attention to patient dignity, integrity, and privacy are also key to this restructuring, he notes. The major thrust of his argument is based on the belief that health care should be free of doubt and confusion; because it’s become mired in these states, there needs to be a redesign and focused return to a “whole-person” frame of mind. Although the author’s medical industry rhetoric and densely rationalized arguments may sometimes be difficult for readers outside of clinical settings to grasp, his impassioned demands for change are unwaveringly convincing. Merahn’s persuasive call for action advocates for no less than an overhaul—one that redirects attention away from “networks of self-interest embedded throughout the healthcare ecosystem.”
An intensive, mindful critique of modern health care that confronts its flaws and proposes solutions.Pub Date: Nov. 10, 2021
ISBN: 978-1-7359415-2-3
Page Count: 149
Publisher: Conversation Publishing
Review Posted Online: Aug. 17, 2021
Kirkus Reviews Issue: Oct. 15, 2021
Review Program: Kirkus Indie
For Howard Zinn, long-time civil rights and anti-war activist, history and ideology have a lot in common. Since he thinks that everything is in someone's interest, the historian—Zinn posits—has to figure out whose interests he or she is defining/defending/reconstructing (hence one of his previous books, The Politics of History). Zinn has no doubts about where he stands in this "people's history": "it is a history disrespectful of governments and respectful of people's movements of resistance." So what we get here, instead of the usual survey of wars, presidents, and institutions, is a survey of the usual rebellions, strikes, and protest movements. Zinn starts out by depicting the arrival of Columbus in North America from the standpoint of the Indians (which amounts to their standpoint as constructed from the observations of the Europeans); and, after easily establishing the cultural disharmony that ensued, he goes on to the importation of slaves into the colonies. Add the laborers and indentured servants that followed, plus women and later immigrants, and you have Zinn's amorphous constituency. To hear Zinn tell it, all anyone did in America at any time was to oppress or be oppressed; and so he obscures as much as his hated mainstream historical foes do—only in Zinn's case there is that absurd presumption that virtually everything that came to pass was the work of ruling-class planning: this amounts to one great indictment for conspiracy. Despite surface similarities, this is not a social history, since we get no sense of the fabric of life. Instead of negating the one-sided histories he detests, Zinn has merely reversed the image; the distortion remains.
Pub Date: Jan. 1, 1979
ISBN: 0061965588
Page Count: 772
Publisher: Harper & Row
Review Posted Online: May 26, 2012
Kirkus Reviews Issue: Jan. 1, 1979
BOOK REVIEW
BOOK REVIEW
BOOK REVIEW
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...
A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer.
Writing isn’t brain surgery, but it’s rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn’t enter the field of medicine, in which his father and other members of his family excelled. “But I couldn’t let go of the question,” he writes, after realizing that his goals “didn’t quite fit in an English department.” “Where did biology, morality, literature and philosophy intersect?” So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which “would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay.” The author’s empathy undoubtedly made him an exceptional doctor, and the precision of his prose—as well as the moral purpose underscoring it—suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. “The fact of death is unsettling,” he understates. “Yet there is no other way to live.”
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.Pub Date: Jan. 19, 2016
ISBN: 978-0-8129-8840-6
Page Count: 248
Publisher: Random House
Review Posted Online: Sept. 29, 2015
Kirkus Reviews Issue: Oct. 15, 2015
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