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Doody's Review ServiceReviewer: Carole Ann Kenner, PhD, RN, FAAN (The College of New Jersey)
Description: This book discusses points of tension in the U.S. healthcare system and places the burden on readers to critically think about the paradoxes consumers face.
Purpose: The purpose is to discuss differences between what is presented by healthcare providers and what consumers may actually need. The lack of accountability in healthcare delivery is a recurring theme to evoke critical discussions or thoughtful analysis by readers.
Audience: The intended audience includes health providers and consumers. However, the content is too high level and technical for most consumers.
Features: The book includes excellent topics, starting with the disease framework of healthcare, moving to specific areas of mental health, chronic illness, then into screening for cancer, blood pressure, cholesterol, diabetes, and obesity. The final section discusses shared decision-making and practice guidelines. The author suggests that practice guideline development has been supported in many instances by pharmaceutical companies. The definitions used in these guidelines have not always been strongly evidence-based or consistent. These are important points to consider and determine if the author's assessment is accurate. The book had little information on the Institute of Medicine's reports regarding quality that have influenced healthcare delivery, which is a shortcoming.
Assessment: There are many health policy books that address ineffectiveness of healthcare delivery. No other book really questions the underpinnings of our health outcomes/parameter definitions or whether the guidelines are serving a corporate rather than individual purpose.