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Book details
  • Genre:MEDICAL
  • SubGenre:Clinical Medicine
  • Language:English
  • Pages:200
  • eBook ISBN:9798350947328

Healing the Wounds

How Medicine Lost Its Way and What To Do About It

by Jeffrey Kleiman

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Overview
Healing the Wounds is a deep dive on what is wrong with healthcare in America. It is based on 40 years of experience as a primary care physician (in Family Practice). It weaves together stories of actual patients and colleagues. There is so much promise of what Medicine has to offer. The discoveries in the last 100 years are astounding. Life span has doubled. The deadly diseases of childhood are gone. We can now look at the genome and alter the course of deadly cancers. When President Eisenhower had a heart attack in 1955, he was confined to bed for 3 months. When President Clinton complained of chest pain in 2004, he rapidly had two stents put in and was back to work within days. Yet for all of this progress, doctors are more burned out and depressed than ever. Fewer young doctors are selecting to practice primary care. Being a doctor is immensely satisfying. You get to work in one of the most challenging and intellectually satisfying fields, care for sick and injured patients on some of their hardest days, positively affect people everyday, and have tremendous job security. And yet, patients are unhappy, hospitals are barely surviving, and soaring costs may tumble the whole system and drag society with it. The book compares what is going on in other countries. Are they better off? What can we learn? Is there hope? The book offers concrete solutions to both the structural and emotional turmoil. As the father of modern medicine, Willima Osler, said in 1900: "The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head."
Description
"To the typical physician, my metastatic cancer is a routine incident in his (her) rounds, while for me it's the crisis of my life. I would feel better if I had a doctor who at least perceived this incongruity." wrote author Antole Broyard. Medicine in the United States is widely regarded as the best in the world. Hardly a day passes without a major scientific breakthrough. Many formerly fatal diseases are now curable. People are healthier and live longer than ever. Still, patient dissatisfaction with doctors has rarely been more acute. Although physicians are increasingly able to cure disease and prolong life, the American public is suspicious, distrustful of, even antagonistic to the profession. Doctors universally acknowledge a crisis in healthcare. With the focus on colossal medical expenditures, amounting to trillions annually, most of the numerous solutions involve containing runaway costs. This book, Healing the Wounds, reaches a different conclusion about what is ailing our healthcare system. Medicine's profound crisis is only partially related to ballooning costs, for the problem is far deeper than economics. The basic reason is that medicine has lost its way, if not its soul. An unwritten covenant between doctor and patient made over several millennia is being broken. At midcentury a doctor's image outshone nearly every other profession. Yet it appears that with each new medical miracle, the image of physicians shrinks and grows more tarnished. No significant transformation results from a single or simple cause. Reflecting on forty-one years of medical practice, I see that something vital appears to be vanishing. A three thousand year tradition, which bonded doctor and patient in a special affinity of trust, is being traded for a new type of relationship. Healing is replaced with treating, caring is supplanted by managing, the art of listening is taken over by technologic procedures. Doctors no longer minister to a distinctive person but concern themselves with fragmented malfunctioning biological parts. The distressed human being is frequently absent from the transaction. The introduction of increasingly sophisticated technology is certainly one reason. Compared with the sharp images provided by CAT scans, MRIs, endoscopy, and angiography, a patient's history is flabby, confused, subjective, and seemingly irrelevant. Furthermore, it takes a good deal of time to elicit a full history. According to some doctors, technology has become a sufficient substitute for talking with patients. And, what about the lost art of the physical exam? The old-fashioned touching, looking and listening — the once prized, almost magical skills of the doctor who missed nothing and could swiftly diagnose a peculiar walk, sluggish thyroid or leaky heart valve using just keen eyes, practiced hands and a stethoscope and reflex hammer. Society places a much higher premium on technology than on examining, listening or counseling. Time spent in the operating room or performing an invasive procedure is rewarded tenfold more than conversing with patients or family. In addition to obviating discourse, current medical practice focuses on the acute and emergent and is largely indifferent to preventing disease and promoting health. The rot will continue until doctors reconnect with their tradition as healers. "Healing the Wounds" attacks the issues from multiple perspectives. Patient experience and stories are the core starting points. The book explores physician burnout and frustration. It compares different world wide healthcare systems. Finally it suggests solutions for a better future for all.
About the author
Dr. Jeffrey Kleiman is a board certified Family Practitioner of 41 years. He was born and raised in Baltimore, Maryland. Dr. Kleiman ran a medical ethics group for ten years and was head of his hospital's Medical Ethics Committee for five years. His hobbies include songwriting, martial arts, playwriting, taking broad based courses and continuous reading. He always felt honored to be a physician, thinking it the best profession in the world. He does extensive volunteer hospice work. He lives in Cape Elizabeth Maine along with his wife, children and grandchildren.