★★★★★ 5
"More" is not "better"
Format: Kindle
I had the privilege of working with Otis during part of his training at the National Cancer Institute at a time that policies on PSA and mammography screening were being newly scrutinized with respect to risk/benefit. The notion that screening might actually do more harm than good was seen as absolute heresy and I fondly remember the wonder and amazement in Otis' eyes as he unraveled to me just how this counter-intuitive idea could be so. Twenty years later, the truths I learned from Otis back then are still not widely appreciated among patients, indeed even doctors more sadly. I eagerly snatched this book up not only because I knew Otis and expected a riveting review of healthcare but because my experience in pharmaceutical development has led me to participate unintentionally in some of the perverse systems of conflicts of interest that characterize our healthcare system. I am at a personal watershed and this book is a strong antidote for what ails me, i.e. I feel emboldened to take my career in the direction of a solution rather than continue to contribute to the problem. Written for the general audience, We Do Harm breaks the ranks of legions of doctors who are invested in perpetuating a broken but remunerative healthcare system by introducing specific and by no means isolated instances where patients have been harmed. This book is at once disparaging of blind trust of one's physician and optimistic in that some stars like Otis and microcosms like Grady Memorial can and do avoid patient-disadvantaged conflicts of interest. This book provides evidence and motivation for every person in every role they engage in in the healthcare system: patient, consumer, provider, insurer, politician. No one can escape the relevance and import of the key message of this book that "more" is not always "better." Until such time, if ever, that our healthcare system operates under transparency, this is a must read for all. That means you! Now! It can't wait! I am a believer that healthcare quality will come from the bottom up and not the top down and this book exemplifies this spirit; read it and be empowered to ask the hard questions as to who is motivated to provide what care and at what personal gain.
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Reviewed in the United States on January 14, 2013
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