The Tuskegee Study had nothing to do with treatment. Its purpose was to trace the spontaneous evolution of the disease in order to learn how syphilis affected black subjects.The men were not told they had syphilis; they were not warned about what the disease might do to them; and, with the exception of a smattering of medication during the first few months, they were not given health care. Instead of the powerful drugs they required, they were given aspirin for their aches and pains. Health officials systematically deceived the men into believing they were patients in a government study of “bad blood”, a catch-all phrase black sharecroppers used to describe a host of illnesses. At the end of this 40 year deathwatch, more than 100 men had died from syphilis or related complications.“Bad Blood” provides compelling answers to the question of how such a tragedy could have been allowed to occur. Tracing the evolution of medical ethics and the nature of decision making in bureaucracies, Jones attempted to show that the Tuskegee Study was not, in fact, an aberration, but a logical outgrowth of race relations and medical practice in the United States.Now, in this revised edition of “Bad Blood”, Jones traces the tragic consequences of the Tuskegee Study over the last decade. A new introduction explains why the Tuskegee Study has become a symbol of black oppression and a metaphor for medical neglect, inspiring a prize-winning play, a Nova special, and a motion picture. A new concluding chapter shows how the black community's wide-spread anger and distrust caused by the Tuskegee Study has hampered efforts by health officials to combat AIDS in the black community. “Bad Blood” was nominated for the Pulitzer Prize and was one of the “N.Y. Times” 12 best books of the year.

    America faced a troubling question: What happened? How was this epidemic allowed to spread so far before it was taken seriously? In answering these questions, Shilts weaves the disparate threads into a coherent story, pinning down every evasion and contradiction at the highest levels of the medical, political, and media establishments. Shilts shows that the epidemic spread wildly because the federal government put budget ahead of the nation's welfare; health authorities placed political expediency before the public health; and scientists were often more concerned with international prestige than saving lives. Against this backdrop, Shilts tells the heroic stories of individuals in science and politics, public health and the gay community, who struggled to alert the nation to the enormity of the danger it faced. And the Band Played On is both a tribute to these heroic people and a stinging indictment of the institutions that failed the nation so badly.

    It's a tremendous opportunity for tens of thousands of IT professionals, but it's also a huge challenge: the program requires a complete makeover of archaic records systems, workflows, and other practices now in place.This book points out how hospitals and doctors' offices differ from other organizations that use IT, and explains what's necessary to bridge the gap between clinicians and IT staff.Get an overview of EHRs and the differences among medical settingsLearn the variety of ways institutions deal with patients and medical staff, and how workflows varyDiscover healthcare's dependence on paper records, and the problems involved in migrating them to digital documentsUnderstand how providers charge for care, and how they get paidExplore how patients can use EHRs to participate in their own careExamine healthcare's most pressing problem--avoidable errors--and how EHRs can both help and exacerbate it

    From its origins in 1738 as an almshouse and pesthouse, Bellevue today is a revered public hospital bringing first-class care to anyone in need. With its diverse, ailing, and unprotesting patient population, the hospital was a natural laboratory for the nation's first clinical research. It treated tens of thousands of Civil War soldiers, launched the first civilian ambulance corps and the first nursing school for women, pioneered medical photography and psychiatric treatment, and spurred New York City to establish the country's first official Board of Health. As medical technology advanced, "voluntary" hospitals began to seek out patients willing to pay for their care. For charity cases, it was left to Bellevue to fill the void. The latter decades of the twentieth century brought rampant crime, drug addiction, and homelessness to the nation's struggling cities problems that called a public hospital's very survival into question. It took the AIDS crisis to cement Bellevue's enduring place as New York's ultimate safety net, the iconic hospital of last resort.

    . . when it comes to the legacy of this country's war on drugs, we should all share his outrage." --The New York Times Book Review From one of the world's foremost experts on the subject, a powerful argument that the greatest damage from drugs flows from their being illegal, and a hopeful reckoning with the possibility of their use as part of a responsible and happy lifeDr. Carl L. Hart, Ziff Professor at Columbia University and former chair of the Department of Psychology, is one of the world's preeminent experts on the effects of so-called recreational drugs on the human mind and body. Dr. Hart is open about the fact that he uses drugs himself, in a happy balance with the rest of his full and productive life as a colleague, husband, father, and friend. In Drug Use for Grown-Ups, he draws on decades of research and his own personal experience to argue definitively that the criminalization and demonization of drug use--not drugs themselves--have been a tremendous scourge on America, not least in reinforcing this country's enduring structural racism.Dr. Hart did not always have this view. He came of age in one of Miami's most troubled neighborhoods at a time when many ills were being laid at the door of crack cocaine. His initial work as a researcher was aimed at proving that drug use caused bad outcomes. But one problem kept cropping up: the evidence from his research did not support his hypothesis. From inside the massively well-funded research arm of the American war on drugs, he saw how the facts did not support the ideology. The truth was dismissed and distorted in order to keep fear and outrage stoked, the funds rolling in, and Black and brown bodies behind bars.Drug Use for Grown-Ups will be controversial, to be sure: the propaganda war, Dr. Hart argues, has been tremendously effective. Imagine if the only subject of any discussion about driving automobiles was fatal car crashes. Drug Use for Grown-Ups offers a radically different vision: when used responsibly, drugs can enrich and enhance our lives. We have a long way to go, but the vital conversation this book will generate is an extraordinarily important step.

     Elinor Cleghorn became an unwell woman ten years ago. She was diagnosed with an autoimmune disease after a long period of being told her symptoms were anything from psychosomatic to a possible pregnancy. As Elinor learned to live with her unpredictable disease she turned to history for answers, and found an enraging legacy of suffering, mystification, and misdiagnosis.In Unwell Women, Elinor Cleghorn traces the almost unbelievable history of how medicine has failed women by treating their bodies as alien and other, often to perilous effect. The result is an authoritative and groundbreaking exploration of the relationship between women and medical practice, from the wandering womb of Ancient Greece to the rise of witch trials across Europe, and from the dawn of hysteria as a catchall for difficult-to-diagnose disorders to the first forays into autoimmunity and the shifting understanding of hormones, menstruation, menopause, and conditions like endometriosis.Packed with character studies and case histories of women who have suffered, challenged, and rewritten medical orthodoxy--and the men who controlled their fate--this is a revolutionary examination of the relationship between women, illness, and medicine. With these case histories, Elinor pays homage to the women who suffered so strides could be made, and shows how being unwell has become normalized in society and culture, where women have long been distrusted as reliable narrators of their own bodies and pain. But the time for real change is long overdue: answers reside in the body, in the testimonies of unwell women--and their lives depend on medicine learning to listen.

    Nadine Burke Harris was already known as a crusading physician delivering targeted care to vulnerable children. But it was Diego — a boy who had stopped growing after a sexual assault — who galvanized her journey to uncover the connections between toxic stress and lifelong illnesses.The news of Burke Harris’s research is just how deeply our bodies can be imprinted by ACEs—adverse childhood experiences like abuse, neglect, parental addiction, mental illness, and divorce. Childhood adversity changes our biological systems, and lasts a lifetime.  For anyone who has faced a difficult childhood, or who cares about the millions of children who do, the scientific insight and innovative, acclaimed health interventions in The Deepest Well represent hope for preventing lifelong illness for those we love and for generations to come​.

    In the intervening years, Herman’s volume has changed the way we think about and treat traumatic events and trauma victims. In a new afterword, Herman chronicles the incredible response the book has elicited and explains how the issues surrounding the topic have shifted within the clinical community and the culture at large. Trauma and Recovery brings a new level of understanding to a set of problems usually considered individually. Herman draws on her own cutting-edge research in domestic violence as well as on the vast literature of combat veterans and victims of political terror, to show the parallels between private terrors such as rape and public traumas such as terrorism. The book puts individual experience in a broader political frame, arguing that psychological trauma can be understood only in a social context. Meticulously documented and frequently using the victims’ own words as well as those from classic literary works and prison diaries, Trauma and Recovery is a powerful work that will continue to profoundly impact our thinking.

    With swashbuckling wit and fierce honesty, she dishes on herself and her colleagues as they try to prod reluctant governments to fund HIV prevention for the people who need it most—drug injectors, gay men, sex workers, and johns.Pisani chats with flamboyant Indonesian transsexuals about their boob jobs and watches Chinese streetwalkers turn away clients because their SUVs aren't nice enough. With verve and clarity, she shows the general reader how her profession really works; how easy it is to draw wrong conclusions from "objective" data; and, shockingly, how much money is spent so very badly. "Exhibit A": the 45 billion taxpayer dollars the Bush administration is committing to international AIDS programs.

    It’s a fly-on-the-wall account of the titanic fight to pass a 961-page law aimed at fixing America’s largest, most dysfunctional industry. It’s a penetrating chronicle of how the profiteering that Brill first identified in his trailblazing Time magazine cover story continues, despite Obamacare. And it is the first complete, inside account of how President Obama persevered to push through the law, but then failed to deal with the staff incompetence and turf wars that crippled its implementation.   But by chance America’s Bitter Pill ends up being much more—because as Brill was completing this book, he had to undergo urgent open-heart surgery. Thus, this also becomes the story of how one patient who thinks he knows everything about healthcare “policy” rethinks it from a hospital gurney—and combines that insight with his brilliant reporting. The result: a surprising new vision of how we can fix American healthcare so that it stops draining the bank accounts of our families and our businesses, and the federal treasury. Praise for America’s Bitter Pill   “A tour de force . . . a comprehensive and suitably furious guide to the political landscape of American healthcare . . . persuasive, shocking.”—The New York Times   “An energetic, picaresque, narrative explanation of much of what has happened in the last seven years of health policy . . . [Brill] has pulled off something extraordinary.” —The New York Times Book Review   “A thunderous indictment of what Brill refers to as the ‘toxicity of our profiteer-dominated healthcare system.’ ”—Los Angeles Times  “A sweeping and spirited new book [that] chronicles the surprisingly juicy tale of reform.”—The Daily Beast  “One of the most important books of our time.”—Walter Isaacson   “Superb . . . Brill has achieved the seemingly impossible—written an exciting book about the American health system.”—The New York Review of Books

    Improper use of antibiotics. Local warfare. Massive refugee migration. Changing social and environmental conditions around the world have fostered the spread of new and potentially devastating viruses and diseases—HIV, Lassa, Ebola, and others. Laurie Garrett takes you on a fifty-year journey through the world's battles with microbes and examines the worldwide conditions that have culminated in recurrent outbreaks of newly discovered diseases, epidemics of diseases migrating to new areas, and mutated old diseases that are no longer curable. She argues that it is not too late to take action to prevent the further onslaught of viruses and microbes, and offers possible solutions for a healthier future.

    As gripping as CSI and as eye-opening as Mary Roach’s Stiff, Carney’s The Red Market sheds a blazing new light on the disturbing, billion-dollar business of trading in human body parts, bodies, and child trafficking, raising issues and exposing corruptions almost too bizarre and shocking to imagine.

    Famously bipartisan, he advised presidents and Congress on health reform and originated central features of the Affordable Care Act. In Priced Out, Reinhardt offers an engaging and enlightening account of today's U.S. health care system, explaining why it costs so much more and delivers so much less than the systems of every other advanced country, why this situation is morally indefensible, and how we might improve it.The problem, Reinhardt says, is not one of economics but of social ethics. There is no American political consensus on a fundamental question other countries settled long ago: to what extent should we be our brothers' and sisters' keepers when it comes to health care? Drawing on the best evidence, he guides readers through the chaotic, secretive, and inefficient way America finances health care, and he offers a penetrating ethical analysis of recent reform proposals. At this point, he argues, the United States appears to have three stark choices: the government can make the rich help pay for the health care of the poor, ration care by income, or control costs. Reinhardt proposes an alternative path: that by age 26 all Americans must choose either to join an insurance arrangement with community-rated premiums, or take a chance on being uninsured or relying on a health insurance market that charges premiums based on health status.An incisive look at the American health care system, Priced Out dispels the confusion, ignorance, myths, and misinformation that hinder effective reform.

    Starting with the earliest encounters between black Americans and Western medical researchers and the racist pseudoscience that resulted, it details the ways both slaves and freedmen were used in hospitals for experiments conducted without their knowledge—a tradition that continues today within some black populations. It reveals how blacks have historically been prey to grave-robbing as well as unauthorized autopsies and dissections. Moving into the twentieth century, it shows how the pseudoscience of eugenics and social Darwinism was used to justify experimental exploitation and shoddy medical treatment of blacks, and the view that they were biologically inferior, oversexed, and unfit for adult responsibilities. Shocking new details about the government’s notorious Tuskegee experiment are revealed, as are similar, less-well-known medical atrocities conducted by the government, the armed forces, prisons, and private institutions.The product of years of prodigious research into medical journals and experimental reports long undisturbed, Medical Apartheid reveals the hidden underbelly of scientific research and makes possible, for the first time, an understanding of the roots of the African American health deficit. At last, it provides the fullest possible context for comprehending the behavioral fallout that has caused black Americans to view researchers—and indeed the whole medical establishment—with such deep distrust. No one concerned with issues of public health and racial justice can afford not to read Medical Apartheid, a masterful book that will stir up both controversy and long-needed debate.

    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.