Healthcare Reform


As a medical librarian, most of the books that cross my desk are clinical textbooks and references. But occasionally there is one I want to read. My boss ordered this one and I read it before he returned from his conference. It’s one I recommend highly for any patient or doctor concerned with healthcare reform in the United States.

Demand Better! Revive Our Broken Healthcare System is written by two doctors who have been involved with improving our current system, Drs. Sanjaya Kumar and David B. Nash.

Drs. Kumar and Nash show the discrepancies in our current system. For example, clinical guidelines available for many standard diagnoses, especially in heart care. Yet many doctors do not know them or reference them before treating a patient. They go with what they’ve done in the past whether it’s the best care or not.

It has been shown that an angioplasty procedure doesn’t make much difference overall diagnosis and care of a heart attack patient. But the invasive procedure is still often done – often because the procedure adds money to the doctor’s or hospital’s pocket. The patient will be in the same condition within three years whether the procedure was done or not. Why should a patient allow himself to have tubes surgically inserted if there’s no benefit? Because the doctor says so.

As a patient, check into treatments available from reputable sources like MedLinePlus or Health on the Net Foundation. Take the information with you when you go to the doctor. Question anything you are unsure about.

As a doctor, as busy as you may be, make yourself aware of your clinical guidelines. You may save your patient pain and grief. Be ready to work out other solutions. It may cost a little now, but will pay off in the future. Happy patients refer their friends to doctors who treat them well.

The use of clinical guidelines is only one area Drs. Kumar and Nash discuss. They also discuss medical errors, communication between medical practitioners in all fields (nursing, lab techs, physical therapists, etc). They show good and bad examples in the current health payment system. Medical student education changes are addressed.

They offer solutions to many of these problems. They also highlight practices, hospitals, doctors, etc., who have started with these solutions and the results that have been shown so far.

What surprised me is how quickly things have gone from bad to worse. When I started in the medical field back in the early 80’s, healthcare needed revision to improve. Then in the 90’s we pushed healthcare reform. Then again in the 2000’s. Yet it’s worse now than it was when it comes to costs, problems, and errors.

Demand Better! is an eye opener and a Must Read.