Gerard, PhD, its chief learning officer, candidly describe the triumphs and stumbles of a seven-year journey to lean healthcare, an effort that continues today and that has slashed medical errors, improved patient outcomes, raised staff morale, and saved $27 million dollars in costs without layoffs. Find out:> How lean techniques of value-stream-mapping and rapid improvement events cut the average “door-to-balloon” time for heart attack patients at two hospitals from 90 minutes to 37.> What ThedaCare leaders did to replace medicine’s “shame and blame” culture with a lean culture based on continuous improvement and respect for people.> How the lean principle of “building in quality at the source” broke down divisions among medical specialties allowing teams to develop patient care plans faster.> Why traditional modern management is the single biggest impediment to lean healthcare.> How the plan-do-study-act cycle coupled with rapid improvement events cut the wait time at a robotic radiosurgery unit from 26 days to six.> How the lean concept of “one piece flow” saved time in treating ischemic stroke patients, increasing the number of patients receiving a CT scan within 25 minutes from 51% to 89%.> How senior leaders at other healthcare organizations can begin their own lean transformations using a nine-step action plan based on what ThedaCare did — and what it would do differently.Toussaint and Gerard prove that lean healthcare does not mean less care. On the Mend shows that when care is truly re-designed around patients, waste and errors are eliminated, quality improves, costs come down, and healthcare professionals have more time to spend with patients, who get even better care.

    Marcia Angell had a front-row seat on the appalling spectacle of the pharmaceutical industry. She watched drug companies stray from their original mission of discovering and manufacturing useful drugs and instead become vast marketing machines with unprecedented control over their own fortunes. She saw them gain nearly limitless influence over medical research, education, and how doctors do their jobs. She sympathized as the American public, particularly the elderly, struggled and increasingly failed to meet spiraling prescription drug prices. Now, in this bold, hard-hitting new book, Dr. Angell exposes the shocking truth of what the pharmaceutical industry has become–and argues for essential, long-overdue change.Currently Americans spend a staggering $200 billion each year on prescription drugs. As Dr. Angell powerfully demonstrates, claims that high drug prices are necessary to fund research and development are unfounded: The truth is that drug companies funnel the bulk of their resources into the marketing of products of dubious benefit. Meanwhile, as profits soar, the companies brazenly use their wealth and power to push their agenda through Congress, the FDA, and academic medical centers.Zeroing in on hugely successful drugs like AZT (the first drug to treat HIV/AIDS), Taxol (the best-selling cancer drug in history), and the blockbuster allergy drug Claritin, Dr. Angell demonstrates exactly how new products are brought to market. Drug companies, she shows, routinely rely on publicly funded institutions for their basic research; they rig clinical trials to make their products look better than they are; and they use their legions of lawyers to stretch out government-granted exclusive marketing rights for years. They also flood the market with copycat drugs that cost a lot more than the drugs they mimic but are no more effective.The American pharmaceutical industry needs to be saved, mainly from itself, and Dr. Angell proposes a program of vital reforms, which includes restoring impartiality to clinical research and severing the ties between drug companies and medical education. Written with fierce passion and substantiated with in-depth research, The Truth About the Drug Companies is a searing indictment of an industry that has spun out of control.

    . . . The only crime equaling inhumanity is the crime of indifference, silence, and forgetting.—James OrbinskiIn 1988, James Orbinski, then a medical student in his twenties, embarked on a year-long research trip to Rwanda, a trip that would change who he would be as a doctor and as a man. Investigating the conditions of pediatric AIDS in Rwanda, James confronted widespread pain and suffering, much of it preventable, much of it occasioned by political and economic corruption. Fuelled by the injustice of what he had seen in Rwanda, Orbinski helped establish the Canadian chapter of Médecins Sans Frontières (Doctors Without Borders/MSF). As a member of MSF he travelled to Peru during a cholera epidemic, to Somalia during the famine and civil war, and to Jalalabad, Afghanistan.In April 1994, James answered a call from the MSF Amsterdam office. Rwandan government soldiers and armed militias of extremist Hutus had begun systematically to murder Tutsis. While other foreigners were evacuated from Rwanda, Orbinski agreed to serve as Chef de Mission for MSF in Kigali. As Rwanda descended into a hell of civil war and genocide, he and his team worked tirelessly, tending to thousands upon thousands of casualties. In fourteen weeks 800,000 men, women and children were exterminated. Half a million people were injured, and millions were displaced. The Rwandan genocide was Orbinski’s undoing. Confronted by indescribable cruelty, he struggled to regain his footing as a doctor, a humanitarian and a man. In the end he chose not to retreat from the world, but resumed his work with MSF, and was the organization’s president when it was awarded the Nobel Peace Prize in 1999.An Imperfect Offering is a deeply personal, deeply political book. With unstinting candor, Orbinski explores the nature of humanitarian action in the twenty-first century, and asserts the fundamental imperative of seeing as human those whose political systems have most brutally failed. He insists that in responding to the suffering of others, we must never lose sight of the dignity of those being helped or deny them the right to act as agents in their own lives. He takes readers on a journey to some of the darkest places of our history but finds there unimaginable acts of courage and empathy. Here he is doctor as witness, recording voices that must be heard around the world; calling on others to meet their responsibility.Ummera, ummera–sha is a Rwandan saying that loosely translated means ‘Courage, courage, my friend–find your courage and let it live.’ It was said to me by a patient at our hospital in Kigali. She was slightly older than middle aged and had been attacked with machetes, her entire body rationally and systematically mutilated. Her face had been so carefully disfigured that a pattern was obvious in the slashes. I could do little more for her at that moment than stop the bleeding with a few sutures. We were completely overwhelmed. She knew and I knew that there were so many others. She said to me in the clearest voice I have ever heard, “Allez, allez. Ummera, ummera-sha”–‘Go, go. Courage, courage, my friend–find your courage and let it live.’—From An Imperfect Offering

    Although this social revolution created a firestorm of controversy, no one questioned the idea that women's involvement in the workforce was certain to improve families' financial lot. Until now.In this brilliantly argued book, Harvard Law School bankruptcy expert Elizabeth Warren and business consultant Amelia Tyagi show that today's middle-class parents are suffering from an unprecedented and totally unexpected economic meltdown. Astonishingly, sending mothers to work has made families more vulnerable than ever before. Today's two-income family earns 75% more money than its single-income counterpart of a generation ago, but actually has less discretionary income once their fixed monthly bills are paid.How did this happen? Warren and Tyagi provide convincing evidence that the culprit is not "overconsumption," as many critics have charged. Instead, they point to the ferocious bidding war for housing and education that has quietly engulfed America's suburbs. Stay-at-home mothers once provided a financial safety net if disaster struck; their move into the workforce has left today's families chillingly at risk. The authors show why the usual remedies--child-support enforcement, subsidized daycare, and higher salaries for women--won't solve the problem, and propose a set of innovative solutions, from rate caps on credit cards to open-access public schools, to restore security to the middle class.

    But satisfactory answers have been hard to find for lack of adequate data and clear guiding theories. In Capital in the Twenty-First Century, Thomas Piketty analyzes a unique collection of data from twenty countries, ranging as far back as the eighteenth century, to uncover key economic and social patterns. His findings will transform debate and set the agenda for the next generation of thought about wealth and inequality.Piketty shows that modern economic growth and the diffusion of knowledge have allowed us to avoid inequalities on the apocalyptic scale predicted by Karl Marx. But we have not modified the deep structures of capital and inequality as much as we thought in the optimistic decades following World War II. The main driver of inequality—the tendency of returns on capital to exceed the rate of economic growth—today threatens to generate extreme inequalities that stir discontent and undermine democratic values. But economic trends are not acts of God. Political action has curbed dangerous inequalities in the past, Piketty says, and may do so again.

    In the span of twelve hours, lives can be lost, life-altering medical treatment decisions made, and dreams fulfilled or irrevocably stolen. In Brown’s skilled hands--as both a dedicated nurse and an insightful chronicler of events--we are given an unprecedented view into the individual struggles as well as the larger truths about medicine in this country, and by shift’s end, we have witnessed something profound about hope and healing and humanity. Every day, Theresa Brown holds patients' lives in her hands. On this day there are four. There is Mr. Hampton, a patient with lymphoma to whom Brown is charged with administering a powerful drug that could cure him--or kill him; Sheila, who may have been dangerously misdiagnosed; Candace, a returning patient who arrives (perhaps advisedly) with her own disinfectant wipes, cleansing rituals, and demands; and Dorothy, who after six weeks in the hospital may finally go home. Prioritizing and ministering to their needs takes the kind of skill, sensitivity, and, yes, humor that enable a nurse to be a patient’s most ardent advocate in a medical system marked by heartbreaking dysfunction as well as miraculous success.

    This new edition includes an all-embracing and incisive afterword that examines the current state of health care and our relationship with life as it approaches its terminus. It also discusses how we can take control of our own final days and those of our loved ones.Shewin Nuland's masterful How We Die is even more relevant than when it was first published.

    While it is one of the largest scientific projects ever attempted—as breathtaking as the first moon landing or the Human Genome Project—the questions it answers are meaningful for every one of us: What are the world’s health problems? Who do they hurt? How much? Where? Why?Murray argues that the ideal existence isn’t simply the longest but the one lived well and with the least illness. Until we can accurately measure how people live and die, we cannot understand what makes us sick or do much to improve it. Challenging the accepted wisdom of the WHO and the UN, the charismatic and controversial health maverick has made enemies—and some influential friends, including Bill Gates who gave Murray a $100 million grant.In Epic Measures, journalist Jeremy N. Smith offers an intimate look at Murray and his groundbreaking work. From ranking countries’ healthcare systems (the U.S. is 37th) to unearthing the shocking reality that world governments are funding developing countries at only 30% of the potential maximum efficiency when it comes to health, Epic Measures introduces a visionary leader whose unwavering determination to improve global health standards has already changed the way the world addresses issues of health and wellness, sets policy, and distributes funding.

    Debbie Preece’s fight for accountability for her brother’s death took her well beyond the Sav-Rite Pharmacy in coal country, ultimately leading to three of the biggest drug wholesalers in the country. She was joined by a crusading lawyer and by local journalist, Eric Eyre, who uncovered a massive opioid pill-dumping scandal that shook the foundation of America’s largest drug companies—and won him a Pulitzer Prize. Death in Mud Lick details the clandestine meetings with whistleblowers; a court fight to unseal filings that the drug distributors tried to keep hidden, a push to secure the DEA pill-shipment data, and the fallout after Eyre’s local paper, the Gazette-Mail, the smallest newspaper ever to win a Pulitzer Prize for investigative reporting, broke the story.

    Any ambitious proposal, however, inevitably runs into the buzz saw of how to find the money to pay for it, rooted in myths about deficits that are hobbling us as a country.Kelton busts through the myths that prevent us from taking action: that the federal government should budget like a household, that deficits will harm the next generation, crowd out private investment, and undermine long-term growth, and that entitlements are propelling us toward a grave fiscal crisis.MMT, as Kelton shows, shifts the terrain from narrow budgetary questions to one of broader economic and social benefits. With its important new ways of understanding money, taxes, and the critical role of deficit spending, MMT redefines how to responsibly use our resources so that we can maximize our potential as a society. MMT gives us the power to imagine a new politics and a new economy and move from a narrative of scarcity to one of opportunity.

    Lisa Sanders, author of the monthly New York Times Magazine column "Diagnosis," the inspiration for the hit Fox TV series House, M.D.The experience of being ill can be like waking up in a foreign country. Life, as you formerly knew it, is on hold while you travel through this other world as unknown as it is unexpected. When I see patients in the hospital or in my office who are suddenly, surprisingly ill, what they really want to know is, ‘What is wrong with me?’ They want a road map that will help them manage their new surroundings. The ability to give this unnerving and unfamiliar place a name, to know it–on some level–restores a measure of control, independent of whether or not that diagnosis comes attached to a cure. Because, even today, a diagnosis is frequently all a good doctor has to offer.A healthy young man suddenly loses his memory–making him unable to remember the events of each passing hour. Two patients diagnosed with Lyme disease improve after antibiotic treatment–only to have their symptoms mysteriously return. A young woman lies dying in the ICU–bleeding, jaundiced, incoherent–and none of her doctors know what is killing her. In Every Patient Tells a Story, Dr. Lisa Sanders takes us bedside to witness the process of solving these and other diagnostic dilemmas, providing a firsthand account of the expertise and intuition that lead a doctor to make the right diagnosis.Never in human history have doctors had the knowledge, the tools, and the skills that they have today to diagnose illness and disease. And yet mistakes are made, diagnoses missed, symptoms or tests misunderstood. In this high-tech world of modern medicine, Sanders shows us that knowledge, while essential, is not sufficient to unravel the complexities of illness. She presents an unflinching look inside the detective story that marks nearly every illness–the diagnosis–revealing the combination of uncertainty and intrigue that doctors face when confronting patients who are sick or dying. Through dramatic stories of patients with baffling symptoms, Sanders portrays the absolute necessity and surprising difficulties of getting the patient’s story, the challenges of the physical exam, the pitfalls of doctor-to-doctor communication, the vagaries of tests, and the near calamity of diagnostic errors. In Every Patient Tells a Story, Dr. Sanders chronicles the real-life drama of doctors solving these difficult medical mysteries that not only illustrate the art and science of diagnosis, but often save the patients’ lives.

    But American Overdose exposes the powerful forces they were up against, including the pharmaceutical industry's coopting of the Food and Drug Administration and Congress in the drive to push painkillers--resulting in the resurgence of heroin cartels in the American heartland. McGreal tells the story, in terms both broad and intimate, of people hit by a catastrophe they never saw coming. Years in the making, its ruinous consequences will stretch years into the future.

    It is fundamentally about protecting and promoting the country’s interests, preferably by being nice but, if necessary, by other appropriate means.” —Bilahari Kausikan Small states are always vulnerable. It is this sense of vulnerability that keeps Singapore alert. As a small country in Southeast Asia seeking to survive and prosper, Singapore cannot be ordinary. It must be extraordinary. Otherwise, why would anyone want to deal with Singapore rather than with larger countries? Herein lies the central challenge for Singapore in every area, including foreign policy. Singapore is Not An Island: Views on Singapore Foreign Policy is a compilation of essays and public speeches by Bilahari Kausikan over the last 25 years. His is a frank and ispassionate assessment of the geopolitical realities to date, and the uncertainties that have emerged. It is for anyone interested to know about protecting Singapore’s interests, nicely or otherwise, in a rapidly changing and complex world. The book, to be launched on 21 June 2017 by Professor S Jayakumar, will be supported by an aggressive print advertisement campaign in The Straits Times, Business Times and The New Paper from 22 to 30 June 2017. “Bilahari is one of the finest minds in Singapore’s public service. His unvarnished analysis of foreign policy trends is refreshing as are his thoughts on what they portend for Singapore. This collection should interest anyone who seeks an insight to Singapore’s foreign policy.” —Prof S Jayakumar, Former Senior Minister (2009-2011), Deputy Prime Minister (2004–2009) and Minister for Foreign Affairs (1994–2004), Singapore About the Author | Bilahari P S Kausikan is a veteran Singapore diplomat who retired in 2013, after serving in the Ministry of Foreign Affairs (MFA) for 32 years. He was Second Permanent Secretary and subsequently Permanent Secretary of MFA from 2001 to 2013. He is now Ambassador-at-Large. Bilahari is known nationally and internationally for his strategic analyses, and has a following in international foreign policy circles. He has also established a reputation in social media circles, especially among young Singaporeans. About the Editor | Tan Lian Choo joined The Straits Times in 1973 and later reported extensively on Southeast Asia. Winner of the Asia Press Foundation Mitsubishi Asian Journalist of the Year 1984, she was conferred the 1990 Asean Award for Communication for her outstanding achievements and contributions to journalism. In 1995, she joined MFA, serving as the ministry’s first Director of Public Affairs, Spokesperson for the Ministry and Press Secretary to the Foreign Minister. Her latter overseas diplomatic assignments included being Singapore’s Permanent Delegate to UNESCO in Paris (2007–2009) and Head of Mission, Singapore Embassy in Brasilia, Brazil (2012–2015). She retired from the Singapore Foreign Service in 2015.

    Lester Award for the Outstanding Book in Industrial Relations and Labor Economics, Princeton UniversityAn Economist Best Economics and Business Book of the YearA Financial Times Best Economics Book of the YearInequality is one of our most urgent social problems. Curbed in the decades after World War II, it has recently returned with a vengeance. We all know the scale of the problem--talk about the 99% and the 1% is entrenched in public debate--but there has been little discussion of what we can do but despair. According to the distinguished economist Anthony Atkinson, however, we can do much more than skeptics imagine."[Atkinson] sets forth a list of concrete, innovative, and persuasive proposals meant to show that alternatives still exist, that the battle for social progress and equality must reclaim its legitimacy, here and now... Witty, elegant, profound, this book should be read."--Thomas Piketty, New York Review of Books"An uncomfortable affront to our reigning triumphalists. [Atkinson's] premise is straightforward: inequality is not unavoidable, a fact of life like the weather, but the product of conscious human behavior.--Owen Jones, The Guardian

    Explaining the truth behind the screening statistics and investigating the evidence behind the hype, Margaret McCartney, an award-winning writer and doctor, argues that this patient paradox - too much testing of well people and not enough care for the sick - worsens health inequalities and drains professionalism.