Book: One Doctor by Brendan Reilly, MD

Close Calls, Cold Cases, and the Mysteries of Medicine

Dr. Reilly writes of how medicine is practiced today in the United States. There is much wrong with our health care delivery and he explains the problems. One of the most important concerns for him is how nearly every patient now dow not have a "family doctor." So, as he or she progresses through the onset of symptoms, diagnostic testing, illnesses, hospitalizations, specialists, surgeries, aging, cancer treatments, medications, preventive medicine education, recoveries, recurrences and ultimately death, dozens of medical practitioners and service providers are involved but seldom do any of them have a unifying and cohesive knowledge of the individual they are treating each with his or her unique familial, emotional, psychosocial and physical components. Even with electronic medical records (which are not always available and do not always include all the pertinent information about a patient), a relative stranger, no matter how brilliant or dedicated, can miss important details about a patient. 

Dr. Reilly illustrates all of this, drawing on his own experiences, and he does it well. 

For anyone interested in the ramifications of the Affordable Care Act, or where our country falls on the healthcare spectrum, or what we can expect as patients, or why we should be informed, and what our moral obligations are to those without resources (although Dr. Reilly does not get into that arena as much),  I recommend this book. There are over 50 pages of Notes supporting what he writes and which further explicate the terms and statistics he uses. 

Just one example of his writing:

"Did Ms. Dubois's son who insisted that his mother receive CPR, understand these things? So much depends on whether doctors explicitly debunk CPR creep when they discuss resuscitation with patients or their surrogate decision-makers. One geriatrician, who cared for elderly patents in a long-term care facility like the one where Ms. Dubois lived, wrote that 36 of his 40 patients (whose average age was 87) told him that they wanted CPR. This confused him until he found that they did not understand the low likelihood of benefit and the potential downside of CPR. After he had discussed the realities with his patients, 39 of the 40 opposed resuscitation."

Informative and well-written.