The Citizen Patient: Reforming Health Care for the Sake of the Patient, Not the System

by Nortin M. Hadler M.D.

Overview

Conflicts of interest, misrepresentation of clinical trials, hospital price-fixing, and massive expenditures for procedures of dubious efficacy — these and other critical flaws leave little doubt that the current U.S. health-care system is in need of an overhaul. In this essential guide, preeminent physician Nortin Hadler urges American health-care consumers to take time to understand the existing system and to visualize what the outcome of successful reform might look like. Central to this vision is a shared understanding of the primacy of the relationship between doctor and patient. Hadler shows us that a new approach is necessary if we hope to improve the health of the populace. Rational health care, he argues, is far less expensive than the irrationality of the status quo.

Taking a critical view of how medical treatment, health-care finance, and attitudes about health, medicine, and disease play out in broad social and political settings, Hadler applies his wealth of experience and insight to these pressing issues, answering important questions for Citizen Patients and policy makers alike.

Product Details

ISBN-13:	9781469654669
Publisher:	The University of North Carolina Press
Publication date:	08/01/2019
Series:	H. Eugene and Lillian Youngs Lehman
Edition description:	Reprint
Pages:	264
Product dimensions:	6.10(w) x 9.10(h) x 0.70(d)

About the Author

Nortin M. Hadler, M.D., M.A.C.P., M.A.C.R., F.A.C.O.E.M., is professor of medicine and microbiology/immunology at the University of North Carolina at Chapel Hill and attending rheumatologist at UNC Hospitals. He is author of Rethinking Aging: Growing Old and Living Well in an Overtreated Society, among other books.

Table of Contents

Acknowledgments xi

Introduction 1

1 Shills, When Profit Trumps Benefit 5

2 Price Fixing 41

3 Truth and Consequences, Marketing With Tortured and Massaged Data 71

4 If We Build It, They Will Come, The Procedures and Devices Gambit 91

5 Another Good Idea Still in Waiting, Health Promotion, Disease Prevention 119

6 The Social Construction of Health 144

7 Extricating Health Care from the Perversities of Its Delivery System 178

8 A Clinic for the Twenty-First Century 203

Conclusion QUO VADIS 222

Index 223

What People are Saying About This

From the Publisher

“A tour de force. Compelling and extremely well-informed. Hadler offers important new insights.” — Mark Hall, professor of law and public health, Wake Forest University

“The true promise of modern medicine will only be achieved when every person is prepared to participate as an informed patient and an intelligent citizen. This book does more to achieve that goal than any I have read.” — Daniel D. Federman, M.D., Dean Emeritus for Clinical Education, Harvard Medical School

“Blending best science, sound ethics, compassionate clinical care, and economic realism, Hadler exhorts patients to take control of their own health and health system to save the United States from fiscal disaster.” — George D. Lundberg, M.D., former editor in chief (1982–1999), Journal of the American Medical Association

“The insights and visions that Hadler presents merit serious study not only by the general public but also by all doctors who share his deep-seated commitment to genuinely patient-centered and properly science-informed health care.” — O. S. Miettinen, Department of Epidemiology, Biostatistics, and Occupational Health and Department of Medicine, McGill University

Editorial Reviews

Hadler offers a thoroughly researched argument that the American health-care system is largely profit driven and entails costs unmatched by those of other industrialized nations. . . . Hadler also offers attainable solutions.” — Library Journal

“An eye-opener for those not privy to what goes on inside the once-hallowed halls of hospitals and health-care systems. It’s also chock-full of information for citizens who want to take charge of their health for their own sake. Hadler’s suggestions aren’t radical; rather, they’re rational: evidence-based medicine, stringent medical device licensing guidelines, and restoration of the physician-client partnership, among others.” — ForeWord Reviews

“This is a fascinating and timely look at American health care and the healthcare business in the United States.” — Nursing Standard

“This well-written, timely book will interest health sciences students, health care practitioners and policy makers, and laypersons. Recommended. Lower-division undergraduates and above; general readers.” — CHOICE

“Dr. Hadler’s knowledge of conflicts endemic in U.S. health care is unparalleled. . . . A home run when. . . . [Hadler’s] examples are so clear and his integrity impeccable such that even his critics have to admire his pluck.” — New York Journal of Books

“This book takes the reader inside the pharmaceutical and health insurance industries, across borders, and, finally, where the healing actually takes place: inside the doctor’s office.” — Carolina Alumni Review

From the Publisher

In this work, Hadler (medicine, Univ. of North Carolina, Chapel Hill; Stabbed in the Back) offers a thoroughly researched argument that the American health-care system is largely profit driven and entails costs unmatched by those of other industrialized nations. The author uses his analytical skills and experience in the medical profession to reveal how stakeholders rely on consumer fear and gullibility to ensure steady profits from possibly unnecessary, even detrimental, products and procedures. Hadler also offers attainable solutions. Members of the general public who demand transparent medical information and responsible medical spending should be encouraged by what they find in this account. VERDICT Containing copious scientific analysis and cross references, this book will appeal to detail-oriented consumer health advocates and political advisers. Shannon Brownlee speaks to a broader audience in Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer.—Chad Clark, Lamar State Coll. Lib., Port Arthur, TX

Library Journal