Bottle of Lies: The Inside Story of the Generic Drug Boom


Katherine Eban - 2019
    Drawing on exclusive accounts from whistleblowers and regulators, as well as thousands of pages of confidential FDA documents, Eban reveals an industry where fraud is rampant, companies routinely falsify data, and executives circumvent almost every principle of safe manufacturing to minimize cost and maximize profit, confident in their ability to fool inspectors. Meanwhile, patients unwittingly consume medicine with unpredictable and dangerous effects.The story of generic drugs is truly global. It connects middle America to China, India, sub-Saharan Africa and Brazil, and represents the ultimate litmus test of globalization: what are the risks of moving drug manufacturing offshore, and are they worth the savings? A decade-long investigation with international sweep, high-stakes brinkmanship and big money at its core, Bottle of Lies reveals how the world’s greatest public-health innovation has become one of its most astonishing swindles.

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America


Robert Whitaker - 2010
    What is going on? Anatomy of an Epidemic challenges readers to think through that question themselves. First, Whitaker investigates what is known today about the biological causes of mental disorders. Do psychiatric medications fix “chemical imbalances” in the brain, or do they, in fact, create them? Researchers spent decades studying that question, and by the late 1980s, they had their answer. Readers will be startled—and dismayed—to discover what was reported in the scientific journals. Then comes the scientific query at the heart of this book: During the past fifty years, when investigators looked at how psychiatric drugs affected long-term outcomes, what did they find? Did they discover that the drugs help people stay well? Function better? Enjoy good physical health? Or did they find that these medications, for some paradoxical reason, increase the likelihood that people will become chronically ill, less able to function well, more prone to physical illness?  This is the first book to look at the merits of psychiatric medications through the prism of long-term results. Are long-term recovery rates higher for medicated or unmedicated schizophrenia patients? Does taking an antidepressant decrease or increase the risk that a depressed person will become disabled by the disorder? Do bipolar patients fare better today than they did forty years ago, or much worse? When the National Institute of Mental Health (NIMH) studied the long-term outcomes of children with ADHD, did they determine that stimulants provide any benefit?  By the end of this review of the outcomes literature, readers are certain to have a haunting question of their own: Why have the results from these long-term studies—all of which point to the same startling conclusion—been kept from the public?  In this compelling history, Whitaker also tells the personal stories of children and adults swept up in this epidemic. Finally, he reports on innovative programs of psychiatric care in Europe and the United States that are producing good long-term outcomes. Our nation has been hit by an epidemic of disabling mental illness, and yet, as Anatomy of an Epidemic reveals, the medical blueprints for curbing that epidemic have already been drawn up.

Pain Killer: A "Wonder" Drug's Trail of Addiction and Death


Barry Meier - 2003
    From the start, the drug's manufacturer aggressively marketed its patented time-release formula as a breakthrough in the effort to reduce prescription drug abuse. It wasn't long, however, before thrill-seeking teenagers shattered that illusion of safety; by simply crushing an "Oxy," they were able to tap into a high so seductive it would come to dominate their lives. Some patients, seeking relief from pain, also found themselves drawn to the drug's dark side. Pain Killer takes readers on a journey of discovery that begins with the true story of Lindsay, a high-school cheerleader in Virginia who gets hooked on Oxys, and expands outward to explore the critical issues of legitimate pain management, prescription drug abuse, and how the misuse of science by the drug industry threatens the public good. With the fast-rising abuse of prescription drugs by young people ringing alarm bells within government, the how and why behind the OxyContin disaster is a gripping read not only for parents, but also for medical professionals, community leaders, business executives, and all those concerned with this crisis. The dangers described in Pain Killer also reverberate far beyond the threat from a single drug at a particular moment in time. The focus of our government's war on drugs has clearly misled many of us into thinking that only illegal drugs smuggled from beyond our borders can be abused. As Meier tells the dramatic story, some of the most deadly substances are produced and sold legally right here at home.THE EXTRAORDINARY AND TRUE STORY OF OXYCONTIN EQUAL PARTS crime thriller, medical detective story, and business exposé, Pain Killer takes a hard-hitting look at how a powerful drug touted as the salvation for millions triggered a national tragedy. At its inception, the legal narcotic OxyContin was seen as a pharmaceutical dream, a "wonder" drug that would herald a sea change in medical care while reaping vast profits for its maker. It did do that; but it also unleashed a public health crisis that cut a swath of despair and crime through unsuspecting small towns, suburbs, and cities across the country. As reports of OxyContin overdoses made front-page and network news, doctors, narcotics agents, regulators, industry executives, and lawmakers raced in, scrambling to slow the damage. Behind it all stood one of America's wealthiest families, and a drug company whose relentless promotion helped fuel the problem Written by award-winning journalist Barry Meier, whose special report in the New York Times triggered national interest in OxyContin, Pain Killer chronicles the rise of the multibillion dollar pain management industry and lays bare its excesses and abuses.

The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care


T.R. Reid - 2009
    R. Reid shows how all the other industrialized democracies have achieved something the United States can’t seem to do: provide health care for everybody at a reasonable cost. In his global quest to find a possible prescription, Reid visits wealthy, free market, industrialized democracies like our own—including France, Germany, Japan, the U.K., and Canada—where he finds inspiration in example. Reid sees problems too: He finds poorly paid doctors in Japan, endless lines in Canada, mistreated patients in Britain, spartan facilities in France. In addition to long-established systems, Reid also studies countries that have carried out major health care reform. The first question facing these countries—and the United States, for that matter—is an ethical issue: Is health care a human right?The Healing of America lays bare the moral question at the heart of our troubled system, dissecting the misleading rhetoric surrounding the health care debate: Is health care a human right?

An American Sickness: How Healthcare Became Big Business and How You Can Take It Back


Elisabeth Rosenthal - 2017
    In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast?Breaking down this monolithic business into the individual industries--the hospitals, doctors, insurance companies, and drug manufacturers--that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw.The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.

Transforming Health Care: Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience


Charles Kenney - 2010
    In 2001, Virginia Mason Medical Center, an integrated healthcare delivery system in Seattle, Washington set out to achieve its compelling vision to become The Quality Leader and to fulfill that vision, adopted the Toyota Production System as its management method.Transforming Health Care: Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience takes you on the journey of of Virginia Mason Medical Center's pursuit of the perfect patient experience through the application of lean principles, tools, and methodology. Over the last several years Virginia Mason has become internationally known for its journey towards perfection by applying the Toyota Production System to healthcare. The book takes readers step by step through Virginia Mason's journey as it seeks to provide perfection to its customer - the patient. This book shows you how you use this system to transform your own organization.

Better: A Surgeon's Notes on Performance


Atul Gawande - 2007
    But nowhere is this drive to do better more important than in medicine, where lives are on the line with every decision. In his new book, Atul Gawande explores how doctors strive to close the gap between best intentions and best performance in the face of obstacles that sometimes seem insurmountable. Gawande's gripping stories of diligence, ingenuity, and what it means to do right by people take us to battlefield surgical tents in Iraq, to labor and delivery rooms in Boston, to a polio outbreak in India, and to malpractice courtrooms around the country. He discusses the ethical dilemmas of doctors participation in lethal injections, examines the influence of money on modern medicine, and recounts the astoundingly contentious history of hand washing. And as in all his writing, Gawande gives us an inside look at his own life as a practicing surgeon, offering a searingly honest firsthand account of work in a field where mistakes are both unavoidable and unthinkable. At once unflinching and compassionate, Better is an exhilarating journey narrated by arguably the best nonfiction doctor-writer around (Salon). Gawande's investigation into medical professionals and how they progress from merely good to great provides rare insight into the elements of success, illuminating every area of human endeavor.

To Err Is Human: Building a Safer Health System


Linda T. Kohn - 2000
    That's more than die from motor vehicle accidents, breast cancer, or AIDS--three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems.To Err Is Human breaks the silence that has surrounded medical errors and their consequence--but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agenda--with state and local implications--for reducing medical errors and improving patient safety through the design of a safer health system.This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes.Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errors--which begs the question, "How can we learn from our mistakes?"Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care.To Err Is Human asserts that the problem is not bad people in health care--it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocates--as well as patients themselves.First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine

The Patient Will See You Now: The Future of Medicine is in Your Hands


Eric J. Topol - 2015
    You'll make an appointment months in advance. You'll probably wait for several hours until you hear "the doctor will see you now"—but only for fifteen minutes! Then you'll wait even longer for lab tests, the results of which you'll likely never see, unless they indicate further (and more invasive) tests, most of which will probably prove unnecessary (much like physicals themselves). And your bill will be astronomical.In The Patient Will See You Now, Eric Topol, one of the nation’s top physicians, shows why medicine does not have to be that way. Instead, you could use your smartphone to get rapid test results from one drop of blood, monitor your vital signs both day and night, and use an artificially intelligent algorithm to receive a diagnosis without having to see a doctor, all at a small fraction of the cost imposed by our modern healthcare system.The change is powered by what Topol calls medicine's "Gutenberg moment." Much as the printing press took learning out of the hands of a priestly class, the mobile internet is doing the same for medicine, giving us unprecedented control over our healthcare. With smartphones in hand, we are no longer beholden to an impersonal and paternalistic system in which "doctor knows best." Medicine has been digitized, Topol argues; now it will be democratized. Computers will replace physicians for many diagnostic tasks, citizen science will give rise to citizen medicine, and enormous data sets will give us new means to attack conditions that have long been incurable. Massive, open, online medicine, where diagnostics are done by Facebook-like comparisons of medical profiles, will enable real-time, real-world research on massive populations. There's no doubt the path forward will be complicated: the medical establishment will resist these changes, and digitized medicine inevitably raises serious issues surrounding privacy. Nevertheless, the result—better, cheaper, and more human health care—will be worth it.Provocative and engrossing, The Patient Will See You Now is essential reading for anyone who thinks they deserve better health care. That is, for all of us.

Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients


Ben Goldacre - 2012
    We like to imagine that it’s based on evidence and the results of fair tests. In reality, those tests are often profoundly flawed. We like to imagine that doctors are familiar with the research literature surrounding a drug, when in reality much of the research is hidden from them by drug companies. We like to imagine that doctors are impartially educated, when in reality much of their education is funded by industry. We like to imagine that regulators let only effective drugs onto the market, when in reality they approve hopeless drugs, with data on side effects casually withheld from doctors and patients.All these problems have been protected from public scrutiny because they’re too complex to capture in a sound bite. But Dr. Ben Goldacre shows that the true scale of this murderous disaster fully reveals itself only when the details are untangled. He believes we should all be able to understand precisely how data manipulation works and how research misconduct on a global scale affects us. In his own words, “the tricks and distortions documented in these pages are beautiful, intricate, and fascinating in their details.” With Goldacre’s characteristic flair and a forensic attention to detail, Bad Pharma reveals a shockingly broken system and calls for something to be done. This is the pharmaceutical industry as it has never been seen before.

Being Mortal by Atul Gawande - A 20-minute Summary: Medicine and What Matters in the End


Instaread Summaries - 2014
    Being Mortal by Atul Gawande - A 20-minute Summary Inside this Instaread Summary: • Overview of the entire book• Introduction to the important people in the book• Summary and analysis of all the chapters in the book• Key Takeaways of the book• A Reader's Perspective Preview of this summary: Chapter 1 Gawande grew up in Ohio. His parents were immigrants from India and both were doctors. His grandparents stayed in India, and there were few older people in his neighborhood, so he had little experience with aging or death until he met his wife’s grandmother, Alice Hobson. Hobson was seventy-seven and living on her own in Virginia. She was a spirited widow who fixed her own plumbing and volunteered with Meals On Wheels. However, Hobson was losing strength and height steadily each year as her arthritis worsened.Gawande’s father enthusiastically adopted the customs of his new country, but he could not understand the way in which seniors were treated in the US. In India, the elderly were treated with great respect and lived out their lives with family.In the United States, Sitaram Gawande, Gawande’s grandfather, likely would have been sent to a nursing home like most of the elderly who cannot handle the basics of daily living by themselves. However, in India, Sitaram Gawande was able to live in his own home and manage his own affairs, with family constantly around him. He died at the age of one hundred and ten when he fell off a bus during a business trip.Until recently, most elderly people stayed with their families. Even as the nuclear family unit became predominant, replacing the multi-generational family unit, people cared for their elderly relatives. Families were large and one child, usually a daughter, would not marry in order to take care of the parents.This has changed in much of the world, where elderly people end up struggling to live alone, like Hobson, rather than living with dignity amid family, like Sitaram Gawande.One cause of this change can be found in the nature of knowledge. When few people lived to be very old, elders were honored. Their store of knowledge was greatly useful. People often portrayed themselves as older to command respect. Modern society’s emphasis on youth is a complete reversal of this attitude. Technological advances are perceived as the territory of the young, and everyone wants to be younger. High-tech job opportunities are all over the world, and young people do not hesitate to leave their parents behind to pursue them.In developed countries, parents embrace the concept of a retirement filled with leisure activities. Parents are happy to begin living for themselves once children are grown. However, this system only works for young, healthy retirees, but not for those who cannot continue to be independent. Hobson, for example, was falling frequently and suffering memory lapses. Her doctor did tests and wrote prescriptions, but did not know what to do about her deteriorating condition. Neither did her family… About the Author With Instaread Summaries, you can get the summary of a book in 30 minutes or less. We read every chapter, summarize and analyze it for your convenience.

The Health Care Handbook: A Clear and Concise Guide to the American Health Care System


Elisabeth Askin - 2012
    This updated edition of the Health Care Handbook covers:• New sections on health IT, team-based care and health care quality• A clear summary of health policy and the Affordable Care Act• Inpatient & outpatient health care and delivery systems• Health insurance and the factors that make health care so expensive• Concise summaries of 32 different health professions• Medical devices, pharmaceuticals, and the research world• And much, much moreThe Handbook is the one-stop guide to the people, organizations and industries that make up the U.S. health care system and major issues the system faces today. It is rigorously researched and scrupulously unbiased yet written in a conversational and humorous tone that's a pleasure to read and illuminates the convoluted health care system and its many components. The Handbook is now used by hundreds of academic programs and health care companies.Each section of the book includes an introduction to the key facts and foundations that make the health care system work along with balanced analyses of the major challenges and controversies within health care, including medical errors, government regulation, medical malpractice, and much more. Suggested readings are included for readers who wish to learn more about specific topics.

The Finest Traditions of My Calling: One Physician’s Search for the Renewal of Medicine


Abraham M. Nussbaum - 2016
    We live in an era of continuous healthcare reforms, many of which focus on high volume, efficiency, and cost-effectiveness. This compelling, thoughtful book is the response of a practicing psychiatrist who explains how population-based reforms have diminished the relationship between doctors and patients, to the detriment of both. As an antidote to failed reforms and an alternative to stubbornly held traditions, Dr. Abraham M. Nussbaum suggests ways that doctors and patients can learn what it means to be ill and to seek medical assistance.   Using a variety of riveting stories from his own and others’ experiences, the author develops a series of metaphors to explore a doctor’s role in different healthcare reform scenarios: scientist, technician, author, gardener, teacher, servant, and witness. Each role influences what a physician sees when examining a person as a patient. Dr. Nussbaum cautions that true healthcare reform can happen only when those who practice medicine can see, and be seen by, their patients as fellow creatures. His memoir makes a hopeful appeal for change, and his insights reveal the direction that change must take.

Your Money or Your Life: Strong Medicine for America's Health Care System


David M. Cutler - 2003
    Medical care is in crisis, we are repeatedly told, and so it is. Barely one in five Americans thinks the medical system works well. Enter David M. Cutler, a Harvard economist who served on President Clinton's health care task force and later advised presidential candidate Bill Bradley. One of the nation's leading experts on the subject, Cutler argues in Your Money or Your Life that health care has in fact improvedexponentially over the last fifty years, and that the successes of our system suggest ways in which we might improve care, make the system easier to deal with, and extend coverage to all Americans. Cutler applies an economic analysis to show that our spending on medicine is well worth it--and thatwe could do even better by spending more. Further, millions of people with easily manageable diseases, from hypertension to depression to diabetes, receive either too much or too little care because of inefficiencies in the way we reimburse care, resulting in poor health and in some cases prematuredeath. The key to improving the system, Cutler argues, is to change the way we organize health care. Everyone must be insured for the medical system to perform well, and payments should be based on the quality of services provided not just on the amount of cutting and poking performed. Lively and compelling, Your Money or Your Life offers a realistic yet rigorous economic approach to reforming health care--one that promises to break through the stalemate of failed reform.

Sonic Boom: Globalization at Mach Speed


Gregg Easterbrook - 2009
    So what comes next? Growth will resume. But economic uncertainty will worsen, making what comes next not just a boom but a nerve-shattering SONIC BOOM. Gregg Easterbrook - who "writes nothing that is not brilliant" ("Chicago Tribune") - is a fount of unconventional wisdom, and over time, he is almost always proven right. Throughout 2008 and 2009, as the global economy was contracting and the experts were panicking, Easterbrook worked on a book saying prosperity is about to make its next big leap. Will he be right again? SONIC BOOM: Globalization at Mach Speed presents three basic insights. First, if you don't like globalization, brace yourself, because globalization has barely started. Easterbrook contends the world is about to become "far "more globally linked. Second, the next wave of global change will be primarily positive: economic prosperity, knowledge and freedom will increase more in the next 50 years than in all of human history to this point. But before you celebrate, Easterbrook further warns that the next phase of global change is going to drive us crazy. Most things will be good for most people - but nothing will seem certain for anyone. Each SONIC BOOM chapter is based on examples of cities around the world - in the United States, Europe, Russia, China, South America - that represent a significant Sonic Boom trend. With a terrific sense of humor, pitch-perfect reporting and clear, elegant prose, Easterbrook explains why economic recovery is on the horizon but why the next phase of global change will also give everyone one hell of a headache. "Forbes" calls Easterbrook "the best writer on complex topics in the United States" and SONIC BOOM will show you why.