The Doctor Is Out
This book argues that primary care medicine in the United States is in crisis. Drawing on personal experience from the perspective of a solo practitioner of primary care, the book reflects on unfavorable trends in the field that are amenable to repair. It cites examples such as polypharmacy (doctors' propensity to overprescribe) and “poly-doctoring” (the excessive and expensive referral to multiple specialists), as well as the malaise of a malpractice suit facing health care professionals. It also discusses problems in the U.S. health care system, such as lack of access to health care, the staggering price tag of modern technologic medicine, and the growing number of old people. The book blames the sad state of primary care medicine on economists' tenets of maximized efficiency, profit, and productivity. It suggests that American patients deserve ready access to a compassionate, comprehensive, and sustained relationship with their primary care physicians, which this book argues is the backbone of good health care.
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