Patients and doctors alike are keenly aware that the medical world is in the midst of great change. We live in an era of continuous healthcare reforms, many of which focus on high volume, efficiency, and cost-effectiveness. This compelling, thoughtful book is the response of a practicing psychiatrist who explains how population-based reforms have diminished the relationship between doctors and patients, to the detriment of both. As an antidote to failed reforms and an alternative to stubbornly held traditions, Dr. Abraham M. Nussbaum suggests ways that doctors and patients can learn what it means to be ill and to seek medical assistance.
Using a variety of riveting stories from his own and others’ experiences, the author develops a series of metaphors to explore a doctor’s role in different healthcare reform scenarios: scientist, technician, author, gardener, teacher, servant, and witness. Each role influences what a physician sees when examining a person as a patient. Dr. Nussbaum cautions that true healthcare reform can happen only when those who practice medicine can see, and be seen by, their patients as fellow creatures. His memoir makes a hopeful appeal for change, and his insights reveal the direction that change must take.
Abraham M. Nussbaum, M.D., directs the adult inpatient psychiatry unit at Denver Health, where he also trains medical students and residents. He is assistant professor, Department of Psychiatry, University of Colorado School of Medicine, and author of the best-selling The Pocket Guide to the DSM-5 Diagnostic Exam. He lives in Denver, CO.
Table of Contents
Introduction: Parts and Money 1
1 Seeing Wisely 10
2 Occult Findings 26
3 The Book and the Coat 38
4 Full Responsibility 52
5 Duty Hours 67
6 Efficient and Effective 84
7 Checklists and Dance Lessons 99
8 Famous Factory Meatloaf 114
9 Sickbeds and Garden Beds 131
10 Committed 146
11 Impatient Attending 162
12 Muscle Ups 176
13 Doctors Without Silver 191
14 Red Cards 207
15 Witnesses 223
16 Hope 239
Epilogue: Luster 258
What do you hope readers will take away from the experience of reading The Finest Traditions of My Calling? I hope readers will learn that healthcare reform is not just a question of who should have access to care and who should pay for it, but also of our desire for a favorable outcome when a physician meets a person as a patient. Reformers believe the problem with medicine is that it does not consistently and safely deliver the best treatments. And the solution is to transform the delivery of medical care using processes pioneered in high-risk industries like aviation, mining, and automobile manufacturing: run hospitals like factories, optimized for efficiency and effectiveness. But factories make things, not people.
How might your book help change the practice of medicine? I hope to shift the conversation from the reform of healthcare systems to the renewal of medical practice. We need to envision hospitals and clinics not as factories but as cultural spaces such as schools and gardens, restaurants, and gyms, all of which require human relationships for their operation.
What are examples of the roles physicians and patients assume when they interact? Physicians are like scientists who want to know how the body works; technicians who control it; authors who tell its story; gardeners who carefully tend it; teachers who help patients achieve what they could not on their own; and servants who give of themselves for the sake of their patients.
On March 21st, 1960, police opened fire on members of the Pan Africanist Congress (PAC)
protesting peacefully in the Vaal Triangle township of Sharpeville against apartheid's iniquitous pass laws. Sixty-nine people died. The shots fired that day in an obscure ...
The most authoritative book to date on the life and work of Eero Saarinen, one
of the most influential architects of the 20th century From the swooping concrete vaults of the TWA Terminal at JFK Airport to the 630-foot-tall Gateway ...
Teeming with chatrooms, online discussion groups, and blogs, the Internet offers previously unimagined opportunities for
personal expression and communication. But there’s a dark side to the story. A trail of information fragments about us is forever preserved on the Internet, ...
For members of the social elite in eighteenth-century England, extended travel for pleasure came to
be considered part of an ideal education as well as an important symbol of social status. Italy, and especially Romea fashionable, exciting, and comfortable citybecame ...
In A.D. 49, Paul traveled to Thessalonica, a major city in northern Greece, to preach
the gospel. A small group of manual laborers responded positively to his message, resulting in the formation of a church. After spending less than three ...
A long-overdue publication that restores Wilfred to the art-historical canon Lumia presents a long-overdue reevaluation of
the groundbreaking artist Thomas Wilfred (1889–1968), whose unprecedented works prefigured light art in America. As early as 1919, many years before the advent of consumer ...
A first-person account of a revolutionary scientific discovery that is now helping to unravel the
mysteries of brain diseases In 1997, Stanley B. Prusiner received a Nobel Prize, the world's most prestigious award for achievement in physiology or medicine. That he ...
In 1675, Antony van Leeuwenhoek, an unlearned haberdasher from Delft, placed a drop of rainwater
under his microscope and detected thousands of tiny animals in it. Leeuwenhoek proceeded to examine the microscopic activity of his spittle, teeth plaque, and feces, ...