Our health care is staggeringly expensive, yet one in six Americans has no health insurance. We have some of the most skilled physicians in the world, yet one hundred thousand patients die each year from medical errors. In this gripping, eye-opening book, award-winning journalist Shannon Brownlee takes readers inside the hospital to dismantle some of our most venerated myths about American medicine. Using vivid examples of real patients and physicians, Overtreated debunks the idea that most of medicine is based in sound science, and shows how our health care system delivers huge amounts of unnecessary care that is not only expensive and wasteful but can actually imperil the health of patients.The interests of politicians and the medical-industrial complex continually trump those of patients, seducing the wealthy with unnecessary procedures and leaving the poor with haphazard access to treatment. Backward economic incentives allow patients with chronic conditions to receive ineffective care, and roll after roll of red tape undermines even the best-intentioned doctors. Tens of thousands of patients die each year from overtreatment. American medicine is in desperate need of fixing.Nevertheless, Overtreated ultimately conveys a message of hope by reframing the debate over health care reform. Americans worry about rationing--that any effort to rein in the high cost of health care will result in limited access to life-saving treatments. Covering the uninsured seems like an insurmountable problem because it will drive up costs even more. Overtreated offers a way to control costs and cover the uninsured, while simultaneously improving the quality of American medicine. Shannon Brownlee's humane, intelligent, and penetrating analysis empowers readers to avoid the perils of overtreatment, as well as pointing the way to better health care for everyone.

    This encouraging change not only has benefited veterans but also provides a blueprint for salvaging America's own deeply troubled healthcare system. "Best Care Anywhere" shows how a government bureaucracy, working with little notice, is setting the standard for best practices and cost reduction while the private sector is lagging in both areas. Author Phillip Longman challenges conventional wisdom by explaining exactly how market forces work to lower quality and raise prices in the healthcare sector, and how U.S. medical practices have a weak basis in science. The book, expanded from a widely praised article in the "Washington Monthly," mixes hard facts with author Philip Longmans' compelling human story of the loss of his wife to cancer. Part manifesto, part moving memoir, "Best Care Anywhere" offers new hope for addressing a major problem of contemporary society that affects all of us.

    This study guide includes the following sections: Plot Summary, Chapter Summaries & Analysis, Characters, Objects/Places, Themes, Style, Quotes, and Topics for Discussion.

    Doctors, nurses, and clinicians swear by this code of conduct. Yet, medical errors are made every single day-avoidable mistakes that often cost lives. Inspired by two such mistakes, Dr. Peter Pronovost made it his personal mission to improve patient safety and make preventable deaths a thing of the past, one hospital at a time. Safe Patients, Smart Hospitals shows how Dr. Pronovost started a revolution by creating a simple checklist that standardized a common ICU procedure. His reforms are being implemented in all fifty states and have saved hundreds of lives by cutting hospital-acquired infection rates by 70%. Atul Gawande profiled Dr. Pronovost's reforms in a New Yorker article and his bestselling book The Checklist Manifesto is based upon Dr. Pronovost's success in patient safety. But Safe Patients, Smart Hospitals is the real story: an inspiring, thought-provoking, accessible insider's narrative about how doctors and nurses are improving patient care for all Americans, today.

    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.

    Wallace Wattles, one of the father of motivation and success, whose work inspired "the secret", is now complete in one great volume of 9 BOOKS: — The Science of Getting Rich — The Science of Being Great — The Science of Being Well — How to Get What You Want — A New Christ — Jesus: The Man and his Work — Making the Man who can (How to Promote Yourself) — The New Science of Living and Healing — Hellfire Harrison (a novel)

    Before you see a doctor, you should read this book.” —Eric Schlosser, author of Fast Food NationUsing the examples of Vioxx, Celebrex, cholesterol-lowering statin drugs, and anti-depressants, Overdosed America shows that at the heart of the current crisis in American medicine lies the commercialization of medical knowledge itselfFor twenty years, John Abramson, M.D., cared for patients of all ages in a small town north of Boston. But increasingly his role as family doctor was undermined as pressure mounted to use the latest drugs and high-tech solutions for nearly every problem. Drawing on his background in statistics and health policy research, he began to investigate the radical changes that were quietly taking place in American medicine.At the heart of the crisis, he found, lies the changed purpose of medical knowledge—from seeking to optimize health to searching for the greatest profits. The lack of transparency that has become normal in commercially sponsored medical research now taints the scientific evidence published in even our most prestigious medical journals. And unlike the recent scandals in other industries that robbed Americans of money and jobs, this one is undermining our health.Commercial distortion pervades the information that doctors rely upon to guide the prevention and treatment of common health problems, from heart disease to stroke, osteoporosis, diabetes, and osteoarthritis. The good news, as Dr. Abramson explains, is that the real scientific evidence shows that many of the things that you can do to protect and preserve your own health are far more effective than what the drug companies' top-selling products can do for you—which is why the drug companies work so hard to keep this information under wraps.In what is sure to be one of the most important and eye-opening books you or your doctor will ever read, John Abramson offers conclusive evidence that American medicine has broken its promise to best improve our health and is squandering more than $500 billion each year in the process.

    Join the revolution. Transform your organization the Cleveland Clinic way. One of the best healthcare systems in the world.President Barack ObamaAmerican healthcare is in crisis. It doesn't have to be.The Cleveland Clinic Way is a blueprint for fixing what's wrong with healthcare--and is a must-read for every leader seeking to transform his or her organization.There's a revolution going on right now. On the frontiers of medicine, some doctors have developed an approach for treating people that is more effective, more humane, and more affordable. It's an approach to healthcare that has captured the attention of the media and business elite--and the President of the United States.It's all happening at Cleveland Clinic, one of the most innovative, forward-looking medical institutions in the nation.In this groundbreaking book, the man who leads this global organization, Toby Cosgrove, MD, reveals how the Clinic works so well and argues persuasively for why it should be the model for the nation. He details how Cleveland Clinic focuses on the eight key trends that are shaping the future of medicine. Readers will learn:Why group practices provide not only better--but cheaper--care Why collaborative medicine is more effective How big data can be harnessed to improve the quality of care and lower costs How cooperative practices can be the wellspring of innovation Why empathy is crucial to better patient outcomes Why wellness of both mind and body depends on healthcare, not sickcare How care is best provided in different settings for greater comfort and value How tailor-made care treats a person instead of a disease At its core is Cleveland Clinic's emphasis on patient care and patient experience.A refreshingly positive and practical vision of healthcare, The Cleveland Clinic Way is essential reading for healthcare and business executives, medical professionals, industry analysts, and policymakers. It gives leaders lessons they can apply to their own organizations to achieve results and empowers average Americans to make more informed healthcare decisions.PRAISE FOR THE CLEVELAND CLINIC WAYA brilliant doctor and leader lays out practical and thought-provoking prescriptions for America's healthcare future. A must-read. -- Jack Welch, former Chairman and CEO of General Electric CompanyThe Cleveland Clinic Way is what the healthcare system in this country needs: honesty about the challenges, optimism about our ability to address them, and a focus on solutions. A must-read for healthcare leaders, it's written in clear, inclusive language that makes it just as valuable for the rest of us. -- John Chambers, Chairman and CEO of CiscoA pioneer in American healthcare, Toby Cosgrove shows just how the diligence and innovative thinking behind Cleveland Clinic has helped solve fundamental problems most other places barely touch. There are lessons here for everyone--patient, physician, and policymaker alike. -- Atul Gawande, MD, professor at Harvard Medical School and bestselling author of The Checklist ManifestoToby Cosgrove frames the eight important trends that will transform the U.S. healthcare system. The Cleveland Clinic Way is a good road map for those who want to make the U.S. healthcare system better. -- Jeffrey Immelt, Chairman and CEO of General Electric Company

    The year is 2005. A highly infectious, unidentified Ebola-like virus is sweeping through the slums and villages of northern Angola. Within months, more than 200 people have died, medical services have collapsed and aid workers are on the brink of exhaustion. At 23, Peter Apps was just starting out as a foreign correspondent when Reuters sent him into the heart of the outbreak to get the story. In “Before Ebola: Dispatches from a Deadly Outbreak” Apps recalls in vivid, unflinching detail the horrors of life in a hot zone, the compassion of those trying to contain it, and how a terrified young journalist came of age in a time of almost unbearable crisis. Peter Apps is a global defense correspondent for Reuters news, currently dividing his time between London and Washington, D.C. In September 2006, Apps broke his neck in a minibus crash while covering the Sri Lankan civil war, leaving him largely paralyzed from the shoulders down. Cover design by Kristen Radtke.

    health care, patients and doctors are losing. Who Killed Health Care? shows how to win the war. One of the nation's most respected health care analysts, Regina Herzlinger exposes the motives and methods of those who have crippled America's health care system-figures in the insurance, hospital, employment, governmental, and academic sectors. She proves how our current system, which is organized around payers and providers rather than the needs of its users, is dangerously eroding patient welfare and is pushing costs out of the reach of millions.Who Killed Health Care? then outlines Herzlinger's bold new plan for a consumer-driven system that will deliver affordable, high-quality care to everyone. By putting insurance money in the hands of patients, removing the middleman in the doctor-patient relationship, and giving employers cost relief, consumers and physicians will be empowered to make the system work the way it should. Herzlinger describes in precise detail how her innovative program will provideSmaller, disease-focused medical facilities that provide complete care for patientsA national system of medical records that provides privacy with confidential access by approved practitionersMandatory performance evaluations of all hospitals and all other medical organizationsMandatory health insurance with subsidies for those who cannot afford itWho Killed Health Care? is a call to arms that must be answered; the welfare of every American hangs in the balance."A brilliant analysis... A must-read." - Bill George, Professor, Harvard Business School and Former CEO of Medtronic"As it becomes more and more obvious to everyone that our current health care system is unsustainable, this is the book that had to be written." - Daniel H. Johnson, Jr. MD, former president of the American Medical Association"Regina Herzlinger's ideas to tackle the crisis of the U.S. health care system are based on keen knowledge of the system's existing difficulties along with insights that introduce the reader to new streamlined choices that have the potential of getting both quantity and cost under control." - Joseph Kennedy, founder, chairman, and president, Citizens Energy Corporation, CEO, Citizens Health Care, former representative (D-Mass)"Regina Herzlinger... offers a vision of the way things can be, should be, and will be sooner or later. The only question is: how long do we have to wait?" - Greg Scandlen, founder, Consumers for Health Choices "Regi Herzlinger has brilliantly articulated a better way - embracing the principles of competition and innovation that cause every other sector of our economy to thrive. Discharging American health care from the ICU can only happen by putting individual Americans - not politicians and bureaucrats - back in charge of their health care decisioins." - U.S. Senator Tom Coburn (R-Okla), M.D. "Following on the heels of her landmark Market-Driven Health Care, Herzlinger lays it on the line with her expose of what many who work in the health care industry have felt in their gut. Now it is articulated in an entertaining and must-read portrayal, with you and me as the only way out." - Dennis White, executive vice president for strategic development, National Business Coalition on Health "A wonderful Orwellian romp through issues which carry a deadly irony. The killers of health care are, of course, the third parties, each of which has an itchy palm and a commitment to profit or power which exceeds the commitment to service, with each engaging the others within a politically shaped box. Rarely has the case for the public been made with so much force, foresight, and wit, and a better way forward shown so clearly." - James F. Fries, MD, Professor of Medicine, Stanford University School of Medicine "You can practically hear the war chants as Professor Herzlinger sets out her view of what's wrong with the health care system and how to fix it. You'd best read it so you can decide which side you will be on when the battle is joined." - Paul Levy, CEO, Beth Israel Hospital, Boston, MA "Regina Herzlinger, the nation's leading expert on consumer-driven health care, has given us a brilliant analysis of the flaws in our health care system and what it will take to get it back on track. Her latest book is a must-read." - Bill George, Professor of Management Practice, Harvard Business School, Former CEO, Medtronic, and author of Authentic Leadership "You don't have to agree with her diagnosis and prescription for the U.S. health care system, but you do have to read her book. Once again, Professor Herzlinger has put together a well researched, well written, and very provocative blueprint for the future of health care." Peter L. Slavin, MD, President, Massachusetts General Hospital

    This is a disturbing, well-researched wake-up call for improving the current system of drug supply and manufacturing.Several decades ago, penicillin, vitamin C, and many other prescription and over-the-counter products were manufactured in the United States. But with the rise of globalization, antibiotics, antidepressants, birth control pills, blood pressure medicines, cancer drugs, among many others are made in China and sold in the United States. China's biggest impact on the US drug supply is making essential ingredients for thousands of medicines found in American homes and used in hospital intensive care units and operating rooms. The authors convincingly argue that there are at least two major problems with this scenario. First, it is inherently risky for the United States to become dependent on any one country as a source for vital medicines, especially given the uncertainties of geopolitics. For example, if an altercation in the South China Sea causes military personnel to be wounded, doctors may rely upon medicines with essential ingredients made by the adversary. Second, lapses in safety standards and quality control in Chinese manufacturing are a risk. Citing the concerns of FDA officials and insiders within the pharmaceutical industry, the authors document incidents of illness and death caused by contaminated medications that prompted reform. This probing book examines the implications of our reliance on China on the quality and availability of vital medicines.

      You might think the biggest problem in medical care is that it costs too much. Or that health insurance is too expensive, too uneven, too complicated—and gives you too many forms to fill out. But the central problem is that too much medical care has too little value. Dr. H. Gilbert Welch is worried about too much medical care. It’s not to deny that some people get too little medical care, rather that the conventional concern about “too little” needs to be balanced with a concern about “too much”: too many people being made to worry about diseases they don’t have—and are at only average risk to get; too many people being tested and exposed to the harmful effects of the testing process; too many people being subjected to treatments they don’t need—or can’t benefit from. The American public has been sold the idea that seeking medical care is one of the most important steps to maintain wellness. Surprisingly, medical care is not, in fact, well correlated with good health. So more medicine does not equal more health; in reality the opposite may be true. The general public harbors assumptions about medical care that encourage overuse, assumptions like it’s always better to fix the problem, sooner (or newer) is always better, or it never hurts to get more information. Less Medicine, More Health pushes against established wisdom and suggests that medical care can be too aggressive. Drawing on his twenty-five years of medical practice and research, Dr. Welch notes that while economics and lawyers contribute to the excesses of American medicine, the problem is essentially created when the general public clings to these powerful assumptions about the value of tests and treatments—a number of which are just plain wrong. By telling fascinating (and occasionally amusing) stories backed by reliable data, Dr. Welch challenges patients and the health-care establishment to rethink some very fundamental practices. His provocative prescriptions hold the potential to save money and, more important, improve health outcomes for us all.

    A writer for The New Yorker and The Atlantic Monthly, Carl Elliott ventures into the uncharted dark side of medicine, shining a light on the series of social and legislative changes that have sacrificed old-style doctoring to the values of consumer capitalism. Along the way, he introduces us to the often shifty characters who work the production line in Big Pharma: from the professional guinea pigs who test-pilot new drugs and the ghostwriters who pen “scientific” articles for drug manufacturers to the PR specialists who manufacture “news” bulletins. We meet the drug reps who will do practically anything to make quota in an ever-expanding arms race of pharmaceutical gift-giving; the “thought leaders” who travel the world to enlighten the medical community about the wonders of the latest release; even, finally, the ethicists who oversee all that commercialized medicine has to offer from their pharma-funded perches.   Taking the pulse of the medical community today, Elliott discovers the culture of deception that has become so institutionalized many people do not even see it as a problem. Head-turning stories and a rogue’s gallery of colorful characters become his springboard for exploring larger ethical issues surrounding money. Are there certain things that should not be bought and sold? In what ways do the ethics of business clash with the ethics of medical care? And what is wrong with medical consumerism anyway? Elliott asks all these questions and more as he examines the underbelly of medicine.

    Designed for graduate and advanced undergraduate students, it includes the contributions of leading thinkers, educators, and practitioners who provide an in-depth and objective appraisal of why and how we organize health care the way we do; the enormous impact of health-related behaviors on the structure, function, and cost of the health care delivery system; and other emerging and recurrent issues in health policy, health care management, and public health. To update this book with the rapid changes that have occurred in health care through November 2013, a separate chapter, the Affordable Care Act (ACA) Supplement, is available to students and instructors as a downloadable PDF.This text is divided into five sections, in order to provide some coherence to this broad terrain. Part I, The Current U.S. Health Care System, addresses major characteristics and issues, including reform, financing, and comparative health care systems. This section now includes multiple new charts and tables providing concrete health care data. Part II, Population Health, focuses on health behavior, including health care models, public health policy and practice, risk factors, facilitating healthy lifestyle practices, and access to care. Part III, Medical Care Delivery, addresses integrated health models, delivering high-quality health care, health care costs and value, and comparative effectiveness. Part IV, Support for Medical Care Delivery, concerns governance and management issues, including accountability, the health workforce, and information technology. Part V, The Future of Health Care Delivery in the United States, includes a new 5-year trend forecast.Key Features: Includes major provisions of the Patient Protection and Affordable Health Care Act of 2010Each chapter includes these special features: key concepts; extensive mapping resources; key words; learning objectives; discussion questions; and case studiesCovers the newest models of care, such as Accountable Care Organizations and Integrated Delivery SystemsExamines new ways of conceptualizing and assessing health care, including comparative effectiveness researchFeatures contributions by leading scholars and key figures within the U.S. health care system, including John Billings, JD; Carolyn M. Clancy, MD; C. Tracy Orleans, PhD; and Michael S. Sparer, PhD, JDContains new coverage of health reform, developing countries, population health, public health and catastrophic events, and a broadened discussion of the health care workforceAffordable Care Act (ACA) Supplement available to students and instructors as a downloadable PDF. Available to Instructors: Instructor's Guide (updated to reflect content from ACA supplement)PowerPoint PresentationsImage BankTest Bank (updated to reflect content from ACA supplement)"

    Longer training, ever more advanced technologies—neither seems to prevent grievous errors. But in a hopeful turn, acclaimed surgeon and writer Atul Gawande finds a remedy in the humblest and simplest of techniques: the checklist. First introduced decades ago by the U.S. Air Force, checklists have enabled pilots to fly aircraft of mind-boggling sophistication. Now innovative checklists are being adopted in hospitals around the world, helping doctors and nurses respond to everything from flu epidemics to avalanches. Even in the immensely complex world of surgery, a simple ninety-second variant has cut the rate of fatalities by more than a third.In riveting stories, Gawande takes us from Austria, where an emergency checklist saved a drowning victim who had spent half an hour underwater, to Michigan, where a cleanliness checklist in intensive care units virtually eliminated a type of deadly hospital infection. He explains how checklists actually work to prompt striking and immediate improvements. And he follows the checklist revolution into fields well beyond medicine, from disaster response to investment banking, skyscraper construction, and businesses of all kinds.An intellectual adventure in which lives are lost and saved and one simple idea makes a tremendous difference, The Checklist Manifesto is essential reading for anyone working to get things right.