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This was another book I picked up at the library for myself, and I was excited to see the author of [easyazon_link asin=”0374531595″ locale=”US” new_window=”default” nofollow=”default” tag=”gimmethatbook-20″ add_to_cart=”yes” cloaking=”default” localization=”yes” popups=”default”]Intern: A Doctor’s Initiation[/easyazon_link] had written another book. This one is of a bit darker tone, as he talks about his struggle to keep focused and happy saving lives and battling insurance companies. The main focus of this book is money and cronyism: how much it costs for medical care, how much the doctors are getting paid, ways to circumvent insurance companies’ unwillingness to pay, and quid pro quo buddy systems where referrals are the goal.

Once again, as in other books written by doctors, this was pretty depressing. On page 11 Jauhar talks about how doctors are disillusioned:

In 2001, 58% of about 2000 physicians questioned said their enthusiasm for medicine had gone down in the previous five years, and 87% said their overall morale had declined during that time. More recent surveys  have shown that 30 to 40% of practicing physicians would not choose to enter the medical profession if they were deciding on a career again, and an even higher percentage would not encourage their children to pursue a medical career.

There are many reasons for this disillusionment besides managed care. An unintended consequence of progress is that physicians increasingly say they have inadequate time to spend with patients. Medical advances have transformed once terminal diseases – cancer, AIDS, congestive heart failure – into complex chronic conditions that must be managed long term.

So.  We have people living longer, restrictions placed on doctors by HMOs, pressure to make ends meet at home,  and doctors being forced to produce referrals in order to maintain the old boy network. That could definitely make anyone disillusioned. What’s scary about this situation is that people’s lives are at stake here. All anyone wants is to be able to trust their physician, that he will do no harm.

Jauhar tells his story, warts and all: he is frustrated at not being able to practice his own medicine, without having to network. His marriage is straining due to lack of money. He seems to be suffering from depression that is untreated. Personally, I would not want to be in the hands of a doctor that was being pressured on so many fronts. But Jauhar perserveres, tries to practice good medicine, and attempts to play the game. He marvels at the circumstance of a man, admitted to the hospital because of shortness of breath. During his 30 day, $200,000 stay, he was seen by SEVENTEEN doctors and underwent TWELVE procedures. He was discharged with only “minimal improvement in his shortness of breath” and “follow ups…with SEVEN specialists“.

As the book proceeds further, Jauhar discusses taking away the financial incentive to over test patients, and make suggestions on how to fix our beleagured healthcare system. His arguments are sound, and probably could only happen in a perfect world. I urge you to read this book, only if it will help arm you against unscrupulous surgeons and the overreach of the billing department.

The only problem I have with the book is that I wasn’t sure if Jauhar wanted to make it a story about him, or a general story about our healthcare. He will start off a chapter with a patient’s story, then end up talking about how it affected him and how frustrated he was,  then insert a dialogue he had with his young son. Then the next chapter will start off with personal thoughts and stories about how he was mentally checked out of his marriage, and suddenly mention a patient. There was also a  long part about him trying to moonlight, but not billing enough, not seeing enough patients, and not playing the game–but instead of trying to fix things, he seems to go into a vapor lock (that could be the depression) and let things just swirl around him and get worse.  He seemed to be very wishy washy here, and let his brother and father galvanize him into action by calling in favors and getting him money making opportunities. Nothing he did made him happy, and that whole middle section of the book was very depressing and drawn out. Eventually things get better at home for the author…..but our healthcare system stays broken.

This was a very illuminating read, and a good follow up to INTERN– we see how Jauhar grows as a doctor and becomes more self aware.  DOCTORED is a great book for anyone who thinks all doctors are millionaires. Want your own copy? You can pick it up [easyazon_link asin=”0374141398″ locale=”US” new_window=”default” nofollow=”default” tag=”gimmethatbook-20″ add_to_cart=”yes” cloaking=”default” localization=”yes” popups=”yes”]here.[/easyazon_link]