WHY WE REVOLT

A discourse on the need for improved patient-centered health care.

Montori, a Mayo Clinic physician and clinical researcher, sternly criticizes the shortcomings of the contemporary medical establishment and discusses the barriers in place that prevent patients from accessing the compassionate, effective treatment that they deserve. His nonprofit organization, The Patient Revolution, was founded in 2016 to advance and promote more thoughtful and careful clinical care, and all the proceeds from sales of this book will support its work. Its tenets are fully represented in the text, which aims to draw attention to the benefits of a doctor-patient relationship that is built on personalized communication and unhurried professionalism. “Industrial healthcare is killing the healer’s soul,” Montori writes, and his proactive, multipart work moves through varying aspects of modern health care while taking direct aim at the problems plaguing it. In a series of illuminating and provocative essays and patient profiles, the author draws on positive and negative field observations from his own medical training in Peru and from his clinical practice in the United States. He spotlights an illogical patient prescription system that he says “fails the stress test of kindness”; how hospital accounting departments partner with agencies to pressure patients for payment; and how executive corruption scandals have fractured industry reputations. All of these aspects dehumanize patients, Montori notes, and systematically cause the overall deterioration of medical-care consortiums. Perhaps the most indicting and distressing chapter is one on corporate avarice. The author cites greed as the motivating principle in modern health care, writing that the industry “has shifted its focus from patient care and instead has honed in on achieving goals that are industrial and financial.” Money is the primary focus now, he insists, with industry establishments enticing consumers with advertisements and promises of results that play on their hopes, fears, and primal insecurities. Not one to shy away from provocative declarations, Montori openly accuses pharmaceutical and medical device companies of extortion, and, in laymen’s terms, he tells how their profit-over-patient concept operates. He also incorporates patient stories from his own practice as a diabetes physician which effectively shows how consumers manage chronic ailments in addition to the struggles and demands of modern life. Many things get lost as patients rush into and out of doctors’ offices, Montori asserts, including patients’ personal lives, support for self-care, and even baseline humanity—all in an effort to increase efficiency and profit margins. As one possible solution among many others, the author advocates for what he calls “minimally disruptive care,” promoting easily accessible programs with continuous, coordinated services. On the whole, Montori’s treatise is both manageably sized and authoritatively written, and it delivers a powerful, revolutionary manifesto. It includes curative action items to abolish what the author sees as the incidental cruelty of medical care. Readers who are similarly frustrated with the state of the American health care industry will find an ally and a sympathetic voice in Montori’s work.

A thoroughly convincing, mobilizing, and supremely optimistic call to action for medical industry reform.