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Doody's Review ServiceReviewer: David L. Nahrwold, MD (Northwestern University Feinberg School of Medicine)
Description: The basis of humanism in medicine is communication between patient and physician, but the basis of improvements in longevity and health status is technology. The author, an Australian surgeon, explores this dilemma by examining how physicians make medical decisions and how they communicate with their patients. To this end, he discusses the scientific method, probability, patient autonomy, ethics, informed consent, professionalism, and medical linguistics. He uses the revealing reactions of physicians to their own illnesses to create a compelling case for change and a template for modifying the physician-patient relationship.
Purpose: The author dissects the physician-patient relationship to expose its components for scrutiny by the profession, hoping to bring about change. He encourages education, changes in medical curriculum and clinical paradigms, and a conscious change from a medical model which is biopositivist to one which is biohumane. He provides convincing evidence that the profession can remedy the communication problem between doctors and their patients. Thus, the author has achieved his objectives.
Audience: The book is of interest to all healthcare workers and those who set health policy. The audience needing it the most, young physicians and students, may find it difficult to understand, owing not to its complexity but to their lack of experience with life and patients. This compels the more senior reader to push for the changes the author recommends. The publishing industry seems loath to tell readers much about authors. One can only surmise that Little is an extraordinary physician, ethicist, and scholar. The book itself establishes his credentials as a writer.
Features: The chapters are short, so the reader can digest and contemplate !he material before tackling the next chapter on a later day. The references are current and interesting, but not exhaustive. The price makes the book a bargain. A helpful glossary of terms, mostly from the social sciences, and a model humane medicine teaching exercise add to its value.
Assessment: This is a serious examination of the fundamental problems that plague the doctor-patient relationship. Physician leaders and public policymakers will serve the citizenry and the medical profession better by studying this important work.