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"I am an AIDS doctor. When I began that work in 1992, we knew what caused AIDS, how it spread, and how to avoid getting it, but we didn't know how to treat it or how to prevent our patients' seemingly inevitable progression toward death. The stigma that surrounded AIDS patients from the very beginning of the epidemic in the early 1980s continued to be harsh and isolating. People looked askance at me: What was it like to work in that kind of environment...
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Andy Lazris, MD, is a practicing primary care physician who experiences the effects of Medicare policy on a daily basis. As a result, he believes that the way we care for our elderly has taken a wrong turn and that Medicare is complicit in creating the very problems it seeks to solve. Aging is not a disease to be cured; it is a life stage to be lived. Lazris argues that aggressive treatments cannot change that fact but only get in the way and decrease...
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For many of the 1.6 million U.S. service members who have served in Iraq and Afghanistan since 2001, the trip home is only the beginning of a longer journey. Many undergo an awkward period of readjustment to civilian life after long deployments. Some veterans may find themselves drinking too much, unable to sleep or waking from unspeakable dreams, lashing out at friends and loved ones. Over time, some will struggle so profoundly that they eventually...
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Although the United States spends 16 percent of its gross domestic product on health care, more than 46 million people have no insurance coverage, while one in four Americans report difficulty paying for medical care. Indeed, the U.S. health care system, despite being the most expensive health care system in the world, ranked thirty-seventh in a comprehensive World Health Organization report. With health care spending only expected to increase, Americans...
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In 2009, an influential panel of medical experts ignited a controversy when they recommended that most women should not begin routine mammograms to screen for breast cancer until the age of fifty, reversing guidelines they had issued just seven years before when they recommended forty as the optimal age to start getting mammograms. While some praised the new recommendation as sensible given the smaller benefit women under fifty derive from mammography,...
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To get the resources and respect they need, nurses have long had to be advocates for themselves and their profession, not just for their patients. For a decade, From Silence to Voice has provided nurses with the tools they need to explain the breath and complexity of nursing work. Bernice Buresh and Suzanne Gordon have helped nurses around the world speak up and convey to the public that nursing is more than dedication and caring-it demands specialized...
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The reassuring bromides of "chicken soup for the soul" provide little solace for nurses-and the people they serve-in real-life hospitals, nursing homes, schools of nursing, and other settings. In the minefield of modern health care, there are myriad obstacles to quality patient care-including work overload, inadequate funds for nursing education and research, and poor communication between and within the professions, to name only a few. The seventy...
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Even the most capable individuals are challenged when confronted with the complexity of the modern hospital experience. The Informed Patient is a guide and a workbook, divided into topical, focused sections with step-by-step instructions, insights, and tips to illustrate what patients and their families can expect during a hospital stay. Anyone who will experience a hospital stay-or friends or family who may be in charge of a patient's care-will find...
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According to the Bureau of Labor Statistics, there were approximately 1.7 million home health aides and personal and home care aides in the United States as of 2008. These home care aides are rapidly becoming the backbone of America's system of long-term care, and their numbers continue to grow. Often referred to as frontline care providers or direct care workers, home care aides-disproportionately women of color-bathe, feed, and offer companionship...
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The U.S. healthcare system is now spending many millions of dollars to improve "patient safety" and "inter-professional practice." Nevertheless, an estimated 100,000 patients still succumb to preventable medical errors or infections every year. How can health care providers reduce the terrible financial and human toll of medical errors and injuries that harm rather than heal? Beyond the Checklist argues that lives could be saved and patient care enhanced...
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We are on the verge of the nation's worst nursing shortage in history. Dedicated nurses are leaving hospitals in droves, and there are not enough new recruits to the profession to meet demand. Even hospitals that were once very highly regarded for the quality of their nursing care, such as Boston's Beth Israel Deaconess Medical Center, now struggle to fill vacant positions. What happened? Dana Beth Weinberg argues that hospital restructuring in the...
13) Beyond Medicine: Why European Social Democracies Enjoy Better Health Outcomes Than the United States
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In Beyond Medicine, Paul V. Dutton provides a penetrating historical analysis of why countless studies show that Americans are far less healthy than their European counterparts.
Dutton argues that Europeans are healthier than Americans because beginning in the late nineteenth century European nations began construction of health systems that focused not only on medical care but the broad social determinants of health: where and how we live, work,...
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Antivaxxers are crazy. That is the perception we all gain from the media, the internet, celebrities, and beyond, writes Bernice Hausman in Anti/Vax, but we need to open our eyes and ears so that we can all have a better conversation about vaccine skepticism and its implications.
Hausman argues that the heated debate about vaccinations and whether to get them or not is most often fueled by accusations and vilifications rather than careful attention...
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In this revealing look at home care, Cynthia J. Cranford illustrates how elderly and disabled people and the immigrant women workers who assist them in daily activities develop meaningful relationships even when their different ages, abilities, races, nationalities, and socio-economic backgrounds generate tension in the intimate encounter that is home help. As Cranford shows, workers experience devaluation within racialized and gendered class hierarchies,...
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Primary care medicine, as we know and remember it, is in crisis. While policymakers, government administrators, and the health insurance industry pay lip service to the personal relationship between physician and patient, dissatisfaction and disaffection run rampant among primary care doctors, and medical students steer clear in order to pursue more lucrative specialties. Patients feel helpless, well aware that they are losing a valued close connection...
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Medical competence is a hot topic surrounded by much controversy about how to define competency, how to teach it, and how to measure it. While some debate the pros and cons of competence-based medical education and others explain how to achieve various competencies, the authors of the seven chapters in The Question of Competence offer something very different. They critique the very notion of competence itself and attend to how it has shaped what...
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Teamwork is essential to improving the quality of patient care and reducing medical errors and injuries. But how does teamwork really function? And what are the barriers that sometimes prevent smart, well-intentioned people from building and sustaining effective teams? Collaborative Caring takes an unusual approach to the topic of teamwork. Editors Suzanne Gordon, David L. Feldman, MD, and Michael Leonard, MD, have gathered fifty engaging first-person...
19) Kidney to Share
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In Kidney to Share, Martha Gershun tells the story of her decision to donate a kidney to a stranger. She takes readers through the complex process by which such donors are vetted to ensure that they are physically and psychologically fit to take the risk of a major operation. John D. Lantos, a physician and bioethicist, places Gershun's story in the larger context of the history of kidney transplantation and the ethical controversies that surround...
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Where Night Is Day is a nonfiction narrative grounded in the day-by-day, hour-by-hour rhythms of an ICU in a teaching hospital in the heart of New Mexico. It takes place over a thirteen-week period, the time of the average rotation of residents through the ICU. It begins in September and ends at Christmas. It is the story of patients and families, suddenly faced with critical illness, who find themselves in the ICU. It describes how they navigate...
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