The Book of the Week is “Doctored” by Sandeep Jauhar, published in 2014. This is an eloquently written autobiographical slice of life from a cardiologist in Long Island, NY, within the last decade.
Dr. Jauhar suggests that America’s broken health care system is the fault of all parties involved– the government, the doctors, the insurance companies and the patients. He writes that his specialty, heart failure, actually generates losses for the hospital at which he is employed. The money is in the installation and monitoring of stents and pacemakers, not prolonged hospital stays of patients. He resists going into private practice because he would be a “…grunt, overtesting, kissing ass for referrals, fighting insurers to get paid” not to mention being forced to pay the out-of-pocket, astronomical cost of medical malpractice insurance. Medical school doesn’t show students the real-world worries of practicing medicine in the United States. One of countless worries of doctors is of lawsuits brought by litigious patients, notwithstanding the malpractice insurance.
Doctors have to deal with a slew of issues peripheral to treating patients; among them, that doctors these days have trouble making a living due to the facts that reimbursement of Medicare and insurance companies to doctors are at an all-time low, and doctors have the burden of student loans while possibly trying to move into their own home and raise a family. This puts pressure on them to engage in the behaviors of private practice mentioned above.
The pay of even an “attending physician” (employee) such as Dr. Jauhar, fluctuates with the amount of revenue he generates for his employer. He writes, “Insurers can make doctors jump through hoops to get paid… tell patients which doctors they can see… restrict medications. But they still cannot…” control the referrals doctors make to other doctors.
Read the book to learn about the (sleazy) strategies used by the medical community to protect itself against (stingy and at times, unreasonable) insurance companies, the author’s moral dilemmas on his own situation told through real-patient anecdotes, and the author’s family life.
Side Note: Despite the flaws in the way health care is provided in the United States– as John and Hank Green (YouTube Nerdfighters) directly or indirectly remind viewers in every video they make lately– people born in the United States have won the world birth lottery, and thus have access to the best life-saving and life-prolonging technology, procedures and treatments, due ironically to the profit motive.