Severed Trust Why American Medicine Hasn T Been Fixed

"The inside story of organized medicine's sell-out to commerce and politics--and a hopeful vision for change--from the former editor of JAMA."--Jacket.

This important book proposes revising the current informed consent protocol for predictive genetic testing to reflect the trend toward patient-centered medicine. Emphasizing the predictive aspect of testing, the author analyzes the state of informed consent procedure in terms of three components: comprehension of risk assessment, disclosure to select appropriate treatment, and voluntariness. The book's revised model revisits these cornerstones, restructuring the consent process to allow for expanded comprehension time, enhanced patient safety, greater patient involvement and autonomy, and reduced chance of coercion by family or others. A comparison of the current and revised versions and case studies showing the new model in real-world applications add extra usefulness to this resource. Included in the coverage: The science behind PGT. Understanding genetic risks and probability. The history of informed consent. Revised model of informed consent: comprehension, disclosure, voluntariness, patient safety. Applications of the model in DTC and pleiotropic genetic testing. Implementation of the revised model, and assessing its effectiveness. A milestone in the bioethics literature, Informed Consent in Predictive Genetic Testing will be of considerable interest to genetic counselors, medical and bioethicists, and public health professionals.

This is a comprehensive survey of the causes and consequences of declining trust in healthcare, and provides suggestions for its restoration. The authors identify the elements of trust in the environment of modern healthcare, and analyse the sources of mistrust in key areas of medicine.

This book describes an overlooked solution to a long-standing problem in health care. The problem is an informational supply chain that is unnecessarily dependent on the minds of doctors for assembling patient data and medical knowledge in clinical decision making. That supply chain function is more than the human mind can deliver. Yet, dependence on the mind is built into the traditional role of doctors, who are educated and licensed to rely heavily on personal knowledge and judgment. The culture of medicine has long been in denial of this problem, even now that health information technology is increasingly used, and even as artificial intelligence (AI) tools are emerging. AI will play an important role, but it is not a solution. The solution instead begins with traditional software techniques designed to integrate novel functionality for clinical decision support and electronic health record (EHR) tools. That functionality implements high standards of care for managing health information. This book describes that functionality in some detail. This description is intended in part to be a starting point for developers in the open source software community, who have an opportunity to begin developing an integrated, cloud-based version of the tools described, working with interested clinicians, patients, and others. The tools grew out of work beginning more than six decades ago, when this book’s lead author (deceased) originated problem lists and structured notes in medical records. The electronic tools he later developed led him to reconceive education and licensure for doctors and other health professionals, which are also part of the solution this book describes.

An incisive look into the problematic relationships among medicine, politics, and business in America and their effects on the nation's health "A comprehensive, revealing and surprising account of the history of American medicine."--David Blumenthal, M.D., coauthor of The Heart of Power: Health and Politics in the Oval Office and president of the Commonwealth Fund "This book is both an important contribution to the history of the American medical profession (and its impact on society as a whole), and a reminder of the malleable, historically contingent nature of its identity and ethos."--Scott H. Podolsky, M.D., author of The Antibiotic Era Meticulously tracing the dramatic conflicts both inside organized medicine and between the medical profession and the larger society over quality, equality, and economy in health care, Peter A. Swenson illuminates the history of American medical politics from the late nineteenth century to the present. This book chronicles the role of medical reformers in the progressive movement around the beginning of the twentieth century and the American Medical Association's dramatic turn to conservatism later. Addressing topics such as public health, medical education, pharmaceutical regulation, and health-care access, Swenson paints a disturbing picture of the entanglements of medicine, politics, and profit seeking that explain why the United States remains the only economically advanced democracy without universal health care. Swenson does, however, see a potentially brighter future as a vanguard of physicians push once again for progressive reforms and the adoption of inclusive, effective, and affordable practices.

"There are many books on the U.S. healthcare system, but few have the longevity of this one. It is easy to read and straightforward in its approach to difficult subjects such as the rise of the Tea Party and how that movement has impacted healthcare. This update is certainly needed as the landscape has changed dramatically since the previous edition was published in 2007."--Doody's Medical Reviews This best-selling textbook remains the most concise and balanced introduction to the United States health care system. Providing an accessible overview of the basic components of the system, this latest edition is also entirely updated to address the health care reform bill of 2010 and subsequent changes to health care services, delivery, and financing. Like its predecessors, Jonasí Introduction to the U.S. Health Care System includes an overview of health care personnel, hospitals and other institutions, the federal government, financing and payment mechanisms, and managed care. It has been updated to offer insights into the 2010 health care reform bill and its resulting political and medical fallout, and a new chapter on health care system trends and consequences has been added. All students of health care administration and policy, as well as practicing health care professionals seeking a clear and concise overview of our health care system, will benefit from this resource. Key Features of the Updated Edition: Remains the most concise and balanced introduction to the U.S. health care system Entirely updated to address the 2010 health care reform bill and subsequent changes to health care services, delivery, and financing Includes new chapter on health care system trends and consequences Ideal for use in undergraduate courses on the U.S. health care system, in graduate survey courses, and in courses introducing the subject to medical students Comes with instructor materials, including PowerPoints, an instructor manual, and a test bank

Note to Readers: Publisher does not guarantee quality or access to any included digital components if book is purchased through a third-party seller. This revised ninth edition of the best-selling introductory text to the U.S. health care system is fully updated to reflect changes to health care services, delivery, and financing resulting from new policies affecting the Affordable Care Act (ACA). Valued for its concise and balanced survey of the U.S. health care system, this book describes how the American health care system currently functions, the major factors that led to its present day structure, and a forecasting of how the industry is likely to change over the course of the next few years. This practical text highlights an array of influences shaping the future of health care, such as the use of big data and analytics, new policies and trends tied to pharmaceuticals and medical devices, and innovations to mental health and substance abuse. With an emphasis on policy development, the authors underscore the fluidity of the system and examine the debates and conflicts that have shaped health care changes and influenced American values and belief systems. This accessible text defines the most essential elements of the health care system, including its components, organization, services, and financing. An ideal text for undergraduate courses, graduate survey courses, and courses introducing the subject to medical students, it describes the ongoing evolution of the system, taking into consideration future directions given proposed changes to the ACA and other health laws by Congress, the Trump administration, and the political landscape in general. Organized to facilitate an understanding of concepts at work, Jonas’ Introduction to the U.S. Health Care System equips public health and health administration students as well as medical, nursing, and allied health professionals with a deeper understanding of the field in which they will practice, so they can position themselves to navigate upcoming changes that affect health care quality, value, and access. New to the Ninth Edition: Updated to address changes to health care services, delivery, and financing in the United States An expanded section on future trends in health care A full description of the health care reform politics under the Obama and Trump administrations and those being promoted in political campaigns New chapter on medicines, devices, and health care technology Increased coverage of mental health and substance abuse, long-term care, and other institutionalized populations Digital ancillaries include access to the eBook, an annual update on U.S. health policy, and new student exercises utilizing publicly available data Key Features: The most concise and balanced introduction to the U.S. health care system Provides a framework for examining how each structure and stakeholder within the health system interacts and how changes to policy would affect them Numerous cartoons, graphs, and tables break up the text and serve as meaningful context with pertinent data Each chapter utilizes learning objectives and discussion questions to guide student reading Includes a full suite of Instructor ancillaries including an Instructor’s Manual, PowerPoints, Test Bank, and other exercises

Completely expanded and updated to account for the latest changes in the U.S. health care system, this best-selling text remains the most concise and balanced introduction to the domestic health care system. Like its predecessors, it provides an accessible overview of the basic components of the system: healthcare personnel, hospitals and other institutions, the federal government, financing and payment mechanisms, and managed care. Finally, it provides an insightful look at the prospects for health care reform. Steven Jonas, a revered expert in public health, has enlisted his colleagues, Drs. Raymond and Karen Goldsteen, to add their expertise in public health and health policy and management to this outstanding volume. All students of health care administration and policy, as well as practicing healthcare professionals who simply want a relatively brief overview of the system, will find it useful.