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7 of 7 people found the following review helpful:
3.0 out of 5 stars
A Doctor's Story of Managed Care, March 29, 2011
This review is from: The Color of Atmosphere: One Doctor's Journey In and Out of Medicine (Paperback)
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This book shows what managed care has wrought; how it turned a dedicated doctor into a disillusioned "health care provider" and her patients into "health care consumers" who demand and expect child care advice, not the expertise of a highly trained physician.
This is an engrossing story of struggle, idealism and disillusionment; of how a girl who grew up in an emotionally brutal, alcoholic home, overcame all odds and became a physician. The story follows her through triumphs and struggles of medical school, internship and residency and her grueling days and nights as a pediatrician and then finally, after having overcome all these obstacles, her defeat at the hands of managed care.
The author describes in exquisite detail the hours, day and nights, she put in, the number of patients she was forced to see in a day due to low reimbursement payments, the dictated amount of time she could spend with them, the constant threat of malpractice suits and the unending attention to insurance premiums, co-pay deductibles and out-of-pocket payments, and the increasingly unrealistic expectations of health insurance companies. She came to realize that... "Health insurance reimbursement...not pediatric training programs determine what a pediatrician is expected to do."
The Color of Atmosphere is enriched with the author's descriptions of family members; her unloving, alcoholic, bitter-tongued mother, indifferent father, her beloved Aunt Dorothy and the emotionally defeated siblings who left home early and from whom she became estranged. This narrative alone makes for a compelling story.
Maggie Kozel shows us a first hand, behind the scenes, up close account of what it means to be a doctor today. She ends the book with her discovery, after speaking with her colleagues that there is "An epidemic of sad, disillusioned, depressed doctors out there."
This story, a doctor's experience with managed care will make you think. It may also make you cry, but this is one story and one author you'll probably never forget. It may be in your best interest not to.
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9 of 10 people found the following review helpful:
5.0 out of 5 stars
Modern-Day Arrowsmith, January 30, 2011
This review is from: The Color of Atmosphere: One Doctor's Journey In and Out of Medicine (Paperback)
In The Color of Atmosphere, Dr. Kozel gives us the modern-day equivalent of Sinclair Lewis's Martin Arrowsmith. Now, as in the 1920's, the dedicated idealistic medical student journeys through the various territories of American medicine, and gradually discovers how bleak that landscape is. Where Dr. Arrowsmith finally finds fulfillment and joy in medical research, Dr. Kozel stays true to her original dedication to children by becoming a chemistry teacher. The journey is heartbreaking, but ultimately uplifting and hopeful.
The remarkable difference between the two books is that The Color of Atmosphere is not fiction. The excitement of discovery, the joy of helping an ill child, the shock at the venality of colleagues, parents, lawyers, and insurance companies; all are real and immediate. There are no fictional stereotypes, only live and complex characters.
This is the book that all healthcare administrators, politicians, and consumers should read. The problems explored, and some of the solutions offered, must be confronted and discussed before the care of children, and American healthcare in general, can be improved. American medicine needs more Maggie Kozels.
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8 of 9 people found the following review helpful:
4.0 out of 5 stars
A Doctor's Memoir, January 23, 2011
This review is from: The Color of Atmosphere: One Doctor's Journey In and Out of Medicine (Paperback)
Thanks to the publisher, via NetGalley, I had the opportunity to read Maggie Kozel's memoir of her time as a medical student and pediatrician. Born in a dysfunctional family, the daughter of alcoholic parents, Maggie decided while a student in a Catholic high school that she wanted to be a doctor. We followed her through medical school, residency, the Navy, work in a community charity clinic, private practice and, finally, out of practice and into teaching.
While mostly a memoir, this book is also a not-to-subtle call for the United States to adopt the medical model used by the US military in the early 1980's. In short, every patient (and at that time this model was used to treat family members and retirees as well as active-duty service people) had an assigned medical clinic or hospital. When you got sick, you went there and were treated. Work was delegated down to non-physician providers when possible. No money changed hands. She could order the treatments she thought best without worrying about being paid or about malpractice. Patients didn't have to worry about paying for it.
Kozel complains about parents who wanted antibiotics for colds or who didn't listen to her when she suggested that "Johnny" needed more playtime and less screen time. She complains about doctors who avoid tough cases because of the time commitment and the risk of malpractice suits. Mostly she complains about the insurance reimbursement system which, in her opinion, rewards the wrong thing. An example she gives is well-baby checks. In the military hospital, kids the same age were scheduled for checks on the same day. First, the nurse talked to a room full of parents going over milestones, discipline issues, and other stuff that gets discussed with everyone at those visits. Then a corpsman would weigh and measure the kids. The doctor would check them over and answer any remaining questions--or send them to someone who would, and would refer the parents to anyone else they needed to see. In civilian practice, she was the one who had to do all the work because the insurance company wouldn't pay extra for the nurse to do it--hiring a nurse to do those sessions would cut into their income.
While I found the ending of the book to be a bit self-absorbed, I enjoyed seeing the life of a modern pediatrician through her eyes. Grade: B
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