Jerry Avorn has some sobering news. Drawing on more than twenty-five years of patient care, teaching, and research at Harvard Medical School, he shares his firsthand experience of the wide gap in our knowledge of the effectiveness of one medication as compared to another. In Powerful Medicines, he reminds us that every pill we take represents a delicate compromise between the promise of healing, the risk of side effects, and an increasingly daunting price. The stakes on each front grow higher every year as new drugs with impressive power, worrisome side effects, and troubling costs are introduced.This is a comprehensive behind-the-scenes look at issues that affect everyone: our shortage of data comparing the worth of similar drugs for the same condition; alarming lapses in the detection of lethal side effects; the underuse of life-saving medications; lavish marketing campaigns that influence what doctors prescribe; and the resulting upward spiral of costs that places vital drugs beyond the reach of many Americans.In this engagingly written book, Dr. Avorn asks questions that will interest every consumer: How can a product judged safe by the Food and Drug Administration turn out to have unexpectedly lethal side effects? Why has the nation’s drug bill been growing at nearly 20 percent per year? How can physicians and patients pick the best medication in its class? How do doctors actually make their prescribing decisions, and why do those decisions sometimes go wrong? Why do so many Americans suffer preventable illnesses and deaths that proper drug use could have averted? How can the nation gain control over its escalating drug budget without resorting to rationing or draconian governmental controls?Using clinical case histories taken from his own work as a practitioner, researcher, and advocate, Dr. Avorn demonstrates the impressive power of the well-conceived prescription as well as the debacles that can result when medications are misused. He describes an innovative program that employs the pharmaceutical industry’s own marketing techniques to reduce use of some of the most overprescribed and overpriced products. Powerful Medicines offers timely and practical advice on how the nation can improve its drug-approval process, and how patients can work with doctors to make sure their prescriptions are safe, effective, and as affordable as possible. This is a passionate and provocative call for action as well as a compelling work of clear-headed science.From the Hardcover edition.

    This book offers an excellent foundation in ethical decision-making for current and future business managers and IT professionals.

    Service business authority Leonard Berry and Mayo Clinic marketing administrator Kent Seltman explain how the Clinic implements and maintains its strategy, adheres to its management system, executes its care model, and embraces new knowledge - invaluable lessons for managers and service providers of all industries.Drs. Berry and Seltman had the rare opportunity to study Mayo Clinic's service culture and systems from the inside by conducting personal interviews with leaders, clinicians, staff, and patients, as well as observing hundreds of clinician-patient interactions. The result is a book about how the Clinic's business concept produces stellar clinical results, organizational efficiency, and interpersonal service.By examining the operating principles that guide every management decision at this legendary healthcare institution, the authors Demonstrate how a great service brand evolves from the core values that nourish and protect it Extrapolate instructive business lessons that apply outside healthcare Illustrate the benefits of pooling talent and encouraging teamwork Relate historical events and perspectives to the present-day Mayo Clinic Share inspiring stories from staff and patientsAn innovative analysis of this exemplary institution, "Management Lessons from Mayo Clinic" presents a proven prescription for creating sustainable service excellence in any organization.

    The late-night passing of a beloved aunt summons a childhood bully who shows up minutes later, after twenty-five years, to be forgiven and to heal a broken doctor. This ER doctor finds God's opposite in: a battered child's bruises covered over by make-up, a dying patient whose son finally shows up at the end to reclaim the man's high-top sneakers, the rich or celebrity patients loaded with prescription drugs from doctor friends who end up addicted. But, his real outrage is directed at our cavalier treatment of the elderly, If you put a G-tube in your 80-year-old mother with Alzheimer's because she's no longer eating, you will probably have a fast track to hell.

    

    These writers recount intensely personal and profoundly moving end-of-life accounts that cover a wide spectrum of human experience. All six authors are donating their royalties to a Maine hospice; Down East will also donate 10 percent of proceeds to the same cause.

    But most don't realize that the father of modern medicine was an avid listener and a constant bedside presence. Hippocrates believed in the doctor-patient connection and gained worldwide renown for championing science over mysticism while respecting and advocating the potency of human healing. Today, argues Dr. David H. Newman, medicine focuses narrowly on the rewards of technology and science, exaggerating their benefits and ignoring or minimizing their perils. Dr. Newman sees a disconnect between doctor and patient, a disregard for the healing power of the bond, and, ultimately, a disconnect between doctors and their Oath.The root of this divergence, writes Dr. Newman, lies in the patterns of secrecy and habit that characterize the "House of Medicine," modern medicine's entrenched and carefully protected subculture. In reflexive, often unconscious defense of this subculture, doctors and patients guard medical authority, cling to tradition, and yield to demands that they "do" something or "prescribe" something. The result is a biomedical culture that routinely engages in unnecessary and inefficient practices, and leaves both patient and doctor dissatisfied. While demonstrating an abiding respect for, and a deep understanding of, the import of modern science, Dr. Newman reviews research that refutes common and accepted medical wisdom. He cites studies that show how mammograms may cause more harm than good; why antibiotics for sore throats are virtually always unnecessary and therefore dangerous; how cough syrup is rarely more effective than a sugar pill; the power and paradox of the placebo effect; how statistics and studies themselves are frequently deceptive; and why CPR is violent, invasive -- and almost always futile.Through an engaging, deeply researched, and eloquent narrative laced with rich and riveting case studies, Newman cuts to the heart of what really works -- and doesn't -- in medicine and rebuilds the bridge between physicians and their patients.

    An intern makes his first cut and is ridiculed by his tutor. An old woman is brought back to life against her will, only for the unexpected to strike a week later. A notorious surgeon is driven crazy by a massive brain tumour. The mother of a leukemia-ridden child is driven to desperation... In this compelling and beautifully written impressionistic memoir, Mohamed Khadra recounts stories from his life as a surgeon, from the gruelling years of training to the debilitating sleepless nights on call. He looks back at the doctors and patients who shaped his career; at the endless stream of humanity - courageous, pitiful, admirable and dislikable - who passed under his knife, as he recalls shocking tales of mistakes in theatre and the shattered lives of doctors defeated by the stresses of the job. Documenting the soul-destroying choices made for patients and the misplaced hope so common in the face of death, his dramatic account of a surgical life shows what happens when extraordinary events overtake everyday lives - including, even, his own.

    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.

    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.

    This former senior VP of CIGNA explained how health insurers make promises they have no intention of keeping, how they flout regulations designed to protect consumers, and how they skew political debate with multibillion-dollar PR campaigns designed to spread disinformation.Potter had walked away from a six-figure salary and two decades as an insurance executive because he could no longer abide the routine practices of an industry where the needs of sick and suffering Americans take a backseat to the bottom line. The last straw: when he visited a rural health clinic and saw hundreds of people standing in line in the rain to receive treatment in stalls built for livestock.In Deadly Spin, Potter takes readers behind the scenes to show how a huge chunk of our absurd healthcare spending actually bankrolls a propaganda campaign and lobbying effort focused on protecting one thing: profits. Whatever the fate of the current health care legislation, it makes no attempt to change that fundamental problem. Potter shows how relentless PR assaults play an insidious role in our political process anywhere that corporate profits are at stake-from climate change to defense policy. Deadly Spin tells us why-and how-we must fight back.

    The convergence of the two impulses forms what Williamson calls a "holistic politics."With the publication of "The Healing of America," Williamson becomes a powerful voice for social conscience in American society. While citing the virtual abandonment of social justice as a dominant political theme since the 1960's, Williamson notes historian Arthur Schlesinger's contention that Americans express renewed political interest every thirty years. This is a time, according to Williamson, for Americans to return once again to our first principles -- political and spiritual. In this landmark work, Williamson draws plans for the transformation of American political consciousness and the reemergence of powerful citizen involvement in a genuine healing of American society.

    These professional men and women deliver emergency aid to victims of armed conflict, epidemics and natural disasters as well as to many others who lack reliable health care. Each year, more than 2,500 volunteer doctors, nurses and other professionals join locally hired staff to provide medical aid and health care in more than 80 countries.At the forefront of this organization and its work are the volunteer doctors and other health professionals who risk their lives to perform surgery, establish or rehabilitate hospitals and clinics, run nutrition and sanitation programs, and train local medical personnel. This book follows these men and women on location as they risk their own health, well-being and lives to treat patients in desperate need.These engaging true stories with dramatic color photographs examine the lives of individual volunteer medical professionals from around the world who:Perform emergency surgery in the war-torn regions of Africa and Asia Treat the homeless in the streets of Europe Understand cultural customs and societal differences that affect health care Witness and report genocidal atrocities. This new paperback edition is updated to include events that occurred following publication of the hardcover.Hope in Hell chronicles the raucous founding of Doctors Without Borders (MSF) and the awarding of the Nobel Peace Prize to the organization. If there is a horrific event, MSF will be there. This book tells why and how.

    It tells two stories: the first that of an American company, which starts as a small family soap and candle-making firm in the early 1800s, and ends as a vast pharmaceuticals-to-pesticides combine in the 1990s. The second is that of a contemporary woman, living in the company town, who during the course of the novel is diagnosed and then finally dies of cancer, a cancer that is almost certainly caused by exposure to chemical wastes from the company's factories.Richly intellectually stimulating, deeply moving and beautifully written, Gain is very much a 'Great American Novel', an exploration of the history, uniqueness and soul of America, in the tradition of Underworld. But it is most reminiscent of Graham Swift's Waterland, another novel that combines history, both public and private, with contemporary lives, showing how individuals are both the victims and shapers of large-scale historical and economic forces