The Patient Paradox

Explaining the truth behind the screening statistics and investigating the evidence behind the hype, Margaret McCartney, an award-winning writer and doctor, argues that this patient paradox - too much testing of well people and not enough care for the sick - worsens health inequalities and drains professionalism.

"Although physicians make use of science, this book argues that medicine is not itself a science, but rather an interpretive practice that relies heavily on clinical reasoning." "In How Doctors Think, Kathryn Montgomery contends that assuming medicine is strictly a science can have adverse effects. She suggests these can be significantly reduced by recognizing the vital role of clinical judgment."--BOOK JACKET.

Foreword by Harvey V. Fineberg, President of the Institute of Medicine For decades, experts have puzzled over why the US spends more on health care but suffers poorer outcomes than other industrialized nations. Now Elizabeth H. Bradley and Lauren A. Taylor marshal extensive research, including a comparative study of health care data from thirty countries, and get to the root of this paradox: We've left out of our tally the most impactful expenditures countries make to improve the health of their populations-investments in social services. In The American Health Care Paradox, Bradley and Taylor illuminate how narrow definitions of "health care," archaic divisions in the distribution of health and social services, and our allergy to government programs combine to create needless suffering in individual lives, even as health care spending continues to soar. They show us how and why the US health care "system" developed as it did; examine the constraints on, and possibilities for, reform; and profile inspiring new initiatives from around the world. Offering a unique and clarifying perspective on the problems the Affordable Care Act won't solve, this book also points a new way forward.

Numerous case examples illustrate fundamental topics such as cost containment, health insurance, primary care, and physician and hospital payment. In addition, this book does a superior job linking policy issues to the practice of medicine. The second edition features a brand new chapter on payment in managed care.

“Oliver Sacks meets Stephen King”* in this propulsive, haunting journey into the life of the most studied human research subject of all time, the amnesic known as Patient H.M. For readers of The Immortal Life of Henrietta Lacks comes a story that has much to teach us about our relentless pursuit of knowledge. Winner of the PEN/E.O. Wilson Literary Science Writing Award • Los Angeles Times Book Prize Winner NAMED ONE OF THE BEST BOOKS OF THE YEAR BY The Washington Post • New York Post • NPR • The Economist • New York • Wired • Kirkus Reviews • BookPage In 1953, a twenty-seven-year-old factory worker named Henry Molaison—who suffered from severe epilepsy—received a radical new version of the then-common lobotomy, targeting the most mysterious structures in the brain. The operation failed to eliminate Henry’s seizures, but it did have an unintended effect: Henry was left profoundly amnesic, unable to create long-term memories. Over the next sixty years, Patient H.M., as Henry was known, became the most studied individual in the history of neuroscience, a human guinea pig who would teach us much of what we know about memory today. Patient H.M. is, at times, a deeply personal journey. Dittrich’s grandfather was the brilliant, morally complex surgeon who operated on Molaison—and thousands of other patients. The author’s investigation into the dark roots of modern memory science ultimately forces him to confront unsettling secrets in his own family history, and to reveal the tragedy that fueled his grandfather’s relentless experimentation—experimentation that would revolutionize our understanding of ourselves. Dittrich uses the case of Patient H.M. as a starting point for a kaleidoscopic journey, one that moves from the first recorded brain surgeries in ancient Egypt to the cutting-edge laboratories of MIT. He takes readers inside the old asylums and operating theaters where psychosurgeons, as they called themselves, conducted their human experiments, and behind the scenes of a bitter custody battle over the ownership of the most important brain in the world. Patient H.M. combines the best of biography, memoir, and science journalism to create a haunting, endlessly fascinating story, one that reveals the wondrous and devastating things that can happen when hubris, ambition, and human imperfection collide. “An exciting, artful blend of family and medical history.”—The New York Times *Kirkus Reviews (starred review)

According to the Latina health paradox, Mexican immigrant women have less complicated pregnancies and more favorable birth outcomes than many other groups, in spite of socioeconomic disadvantage. Alyshia Gálvez provides an ethnographic examination of this paradox. What are the ways that Mexican immigrant women care for themselves during their pregnancies? How do they decide to leave behind some of the practices they bring with them on their pathways of migration in favor of biomedical approaches to pregnancy and childbirth? This book takes us from inside the halls of a busy metropolitan hospital’s public prenatal clinic to the Oaxaca and Puebla states in Mexico to look at the ways Mexican women manage their pregnancies. The mystery of the paradox lies perhaps not in the recipes Mexican-born women have for good perinatal health, but in the prenatal encounter in the United States. Patient Citizens, Immigrant Mothers is a migration story and a look at the ways that immigrants are received by our medical institutions and by our society

The NHS is 'the closest thing the UK has to a national religion'. No wonder: it has worked secular miracles. Before the NHS, sick children could not see a doctor before a sixpence was handed over. People died of whooping cough and tuberculosis, illnesses we now scarcely see. When the NHS was founded, almost 70 years ago, people in the UK lived less than 50 years on average - a lifespan which has almost doubled. No matter how poor we are, our health care is included with British citizenship. But the NHS has also been accused of high death rates, lazy and uncaring staff, dirty hospitals and unbridgeable funding gaps. Every politician claims to know how to save the NHS. Margaret McCartney argues differently. She believes that the NHS is world class: but politicians have to stop micromanaging based on faith in their own political beliefs and instead base decisions on evidence. Patients and professionals working together to deliver an evidence-based NHS is the only future - if we want our NHS to survive.