Medical Quality Management: Theory and Practice Book

One of the problems I often have with non-fiction is that it has a tendency to wander, get bogged down in minutiae, and/or come across sounding like a textbook. David Newman is an excellent writer who manages to get his points across in an engaging manner. "Hippocrates' Shadow" is a quick, informative read that doesn't get bogged down in a lot of techno-babble. I would give it four stars because I think people really should read it, but my personal rating is three stars because I had already come to many of the conclusions that Newman did based on my own encounters with the medical system. I think people need to know the information this book contains, but I also think it doesn't go far enough. Here is what I think is missing or shortchanged:

1. The current insurance system in the U.S. has made it practically impossible for modern doctors to practice medicine they way doctors did in the past. (Newman spends about 3 pages in the last chapter talking about how the system is broken, but doesn't go into much detail.) Today, a doctor spends somewhere from 5-10 minutes with each patient. That's just not enough time to get to the bottom of the patient's complaint, much less get to know more about the patient and their lives. Heck, they don't even have time to review patients' charts before entering the examining room.

2. Newman talks about how doctors like tests. What he misses is that there are many times that tests that could be beneficial are not given because they need to keep costs down for the insurance companies.

3. Newman doesn't talk about the patient's role in health care, or when he does it's negative. He does mention that a patient could ask for a test or a treatment, but in the context he uses it, the patient is mis-informed. In my experience, a patient HAS to now the possible diagnoses and treatments for his/her condition. He or she may be wrong, but they have to be well-informed before going into the doctor's office so they can discuss the situation intelligently. When doctors (even specialists) only spend 5-10 minutes with each patient, things are going to be missed. Newman misses that modern medicine needs to be a partnership between doctors and patients. Doctors a human and subject to the same limits of knowledge and experience as any other humans.

4. Newman doesn't offer any suggestions for the reader to help overcome the problems he sees with modern medicine. He makes everything sound really hopeless. He doesn't offer examples of doctors doing things right. It just seems like everything about medicine is broken and there's nothing that can be done about it. While it's true that the system is broken, I have found that being an informed patient makes a world of difference. Knowing that doctors don't know everything and are fallible helps the patient take proactive steps in their medical care. Knowing that doctors are human allows the patient to change doctors without guilt when they don't connect on a human level with that doctor.

I thought "Hippocrates' Shadow" was very good in what it did cover. However, it was incomplete and should have covered a bit more.