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37 of 44 people found the following review helpful
5.0 out of 5 stars Real Medicine
You absolutely must read this book before your next health checkup or hospital visit. It is a huge understatement to say that Dr. Jauhar's book is eye-opening, intelligent, straight-forward, enlightening and shocking. Doctored: The Disillusionment of an American Physician, is a major cautionary tale of were we actually are in 21st century American medicine. It is a very...
Published 29 days ago by Amazon Customer

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22 of 23 people found the following review helpful
2.0 out of 5 stars Been There, however...
I, too, am a practicing cardiologist so I have "walked in Dr. Jauhar's shoes" and for many years longer (30). While many of his points about the practice of medicine, including the behaviors of some private practitioners, are well-taken and well-documented, he makes no attempt to offer suggestions or solutions. As other reviewers have noted, the book seems to be more...
Published 7 days ago by Steven Samuel


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22 of 23 people found the following review helpful
2.0 out of 5 stars Been There, however..., September 10, 2014
By 
This review is from: Doctored: The Disillusionment of an American Physician (Hardcover)
I, too, am a practicing cardiologist so I have "walked in Dr. Jauhar's shoes" and for many years longer (30). While many of his points about the practice of medicine, including the behaviors of some private practitioners, are well-taken and well-documented, he makes no attempt to offer suggestions or solutions. As other reviewers have noted, the book seems to be more about his personal financial and family states, and how the world hasn't taken care of him. Most cardiologists work harder than he does (in his clinical academic practice)--They have to see many more patients in a day to make ends meet, and they don't have Cardiology Fellows covering their hospital patients at night. And while the rewards of taking care of patients can be great, don't expect the patients or their referring doctors to beat a path to your door just because you think you're a great doctor. He seems to think it is his "due".

For me, this book picked up where his first book left off, continuing to bemoan his fate and the difficulty of his professional life. What seems clear is that Dr. Jauhar went into Medicine to please his parents, and to try to keep up with his older brother, not because he really wanted to. It seems like he lacks "the calling" and nothing short of accolades and more money will make him happy.

There are many better books on the market currently offering better analysis of the problems facing physicians and the health care sector, and offering thoughts toward solutions.
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37 of 44 people found the following review helpful
5.0 out of 5 stars Real Medicine, August 19, 2014
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You absolutely must read this book before your next health checkup or hospital visit. It is a huge understatement to say that Dr. Jauhar's book is eye-opening, intelligent, straight-forward, enlightening and shocking. Doctored: The Disillusionment of an American Physician, is a major cautionary tale of were we actually are in 21st century American medicine. It is a very personal, professional and highly revealing look at our US health and medical industry that simultaneously leaves you with a nauseous and hopeful feeling. He also details in clear-speak how we can and must still do far better -- though in reality, genuine improvements may not happen before our grand kids have kids. Even if our Affordable Care Act is a good first step, after reading just the first chapter of Dr. Sandeep Jauhar's latest book, I now realize the ACA is probably just a mere baby step compared to where we still have to go. I wouldn't read Doctored if I was already laying in a hospital bed, fearing it might stress me more. Dr. Jauhar is clearly speaking from experience and the trenches. Everyone I know and love over and under 50 will be asked to read Doctored.
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25 of 30 people found the following review helpful
5.0 out of 5 stars A Physician Deals With The Complex And Rapidly Changing Practice of Medicine, August 19, 2014
Jauhar is the author of Intern: A Doctor's Initiation, a classic memoir about residency in a big-city hospital. In his latest memoir, Doctored, Jauhar is now an attending cardiologist. He quickly learns that the actual practice of medicine in today's society is nothing like he (or we) imagined that it was, should be, and could be. The issues of practicing medicine in today's rapidly evolving climate are neither simple nor have obvious answers.

Physician income issues are prominent in this book. Doctors are paid less than they were paid ten years ago, causing many to even moonlight to make ends meet. The incredible advances in medical technology, which save countless more lives today than 50 years ago, also are a part of the rapid increase in health care expenditure. The reliance that today's physicians have on testing has caused many of them to lose the art of being a physician, the laying of hands to diagnose.

Throughout this book Jauhar wrestles with the various complicated issues that today's doctors face in the practice of medicine like those above. With the massive overhauling of the health care system today, his book comes at a very appropriate time. Medicine is changing, whether physicians like it or not. As a practicing physician, I highly recommend this book for medical students and physicians, in addition to anyone interested in today's medicine and medical memoirs.

Two other recent medical memoirs to check out are Dr. Danielle Ofri's fantastic Singular Intimacies: Becoming a Doctor at Bellevue and Dr. Sampson Davis' affecting Living and Dying in Brick City: Stories from the Front Lines of an Inner-City E.R.. They will also open your eyes to the psyche of today's doctors.
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7 of 7 people found the following review helpful
3.0 out of 5 stars Well written but there are better medical memoirs out there........, August 27, 2014
This review is from: Doctored: The Disillusionment of an American Physician (Hardcover)
I felt that this was a well written book, but there was nothing in it that most of us do not know about our all ready failing health care system. There are many physicians who practice medicine in our current system who have not lost sight of their ideals and values, and realize the privilege and gift it is to care for patients. I can't believe a physician with the 5 star credentials that Jauhar has and whose heart is truly in academic medicine would resort to working with people like "Dr Chaudri" to make ends meet. Too much whining and complaining made up a good deal of this book - alot of baggage and issues that seem to stem from his Indian background.

I agree Jauhar is a fine writer. But what I wonder about him is - if he has so many issues with the current health care system and with medicine - why doesn't he actually get involved and do something more than just write articles for the NYT or get payed for his last 2 books? Why not do something to change the system actively (ie Gawande) than just write whiney books and article from the comfort of your home and give us food for thought every few years or months. What makes him so different than any other Indian American physician with the nice salary, lovely house in Long Island, the beautiful physician wife and 2 cute kids in an expensive suburb of NYC? Did I forget the prestigious academic position at a teaching hospital where fellows do most of the work anyway? And socializing with physicians in palatial houses on the Island to make sure you keep a robust referral base. Really?

I agree with others that there are aspects of this book that should be taken with a grain of salt.
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13 of 16 people found the following review helpful
3.0 out of 5 stars A more focused approach would have made for a better book., September 2, 2014
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As a physician, I'm not entirely sure what Dr. Jauhar's point is. I doubt that it comes as any surprise to anyone that there are greedy doctors just as there are greedy lawyers, greedy teachers, greedy dentists, whatever. What's more, Dr. Jauhar's vision seems rather parochial: you can either be a pristine academic or practice medicine in strip malls in New Jersey and New York. Really? I believe there are other options.
However, many of his insights, such as the problems associated with the dearth of primary care physicians, especially general internists, certainly are worthy of applause. He puts his finger on many of the frustrations of medical practice in our increasingly corporate society, but his insights seem a bit scattershot. A more focused approach would have made for a better book.
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1 of 1 people found the following review helpful
4.0 out of 5 stars Well-written, timely, and sad commentary of the state of medicine in 2014, September 14, 2014
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SageRad (Clayton, MO USA) - See all my reviews
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I have been a consistent reader of Dr. Jauhar's NYT columns and eagerly awaited the publication of this updated memoir and commentary on the state of US medicine in 2014. As a fellow physician, much of what the author has experienced rings true. I was, however, shocked at the way the cardiology colleagues in private practice set up shops to milk as many procedures from their marks, uh, I mean, their patients, as possible. Perhaps I am naive, but I have not encountered anything like that in my 19 year career. If this is all true, Dr. Jauhar should be able to earn multiples of his salary as a whistleblower.

In general, much of the author's experience parallels that of all doctors of our generation. You start a career wanting to help people and have a great professional career. As the years have gone by, the treadmill seems to get a little faster every year, the administrative hassles grow, and the paycheck gets a little smaller. Obviously, the doctor is the loser in this game, but the patient is also the loser. He or she gets a physician who is stressed out, hassled from every direction, frustrated, and has less time than ever to dwell on the encounter. Regrettably, I do not see the situation changing anytime soon, and I also see, on the horizon, a large egress from the profession of mid and late career docs, the ones who cared, worked early and late, and understood and possessed the best attributes of the culture of medicine of a bygone era.

Things will get worse, maybe much worse, before they get better.

Back to the book, I did not find many of the autobiographical aspects of the book to be very useful, especially when they did not pertain to the subject at hand. Many of us have families we wish we had more time with, marriages that are stretched and often strangled by the lifestyle, and successful and happy siblings or in-laws that make us reconsider our paths. At any rate, I read these parts quickly and/or skipped these sections entirely.

The author is a very talented writer, and I look forward to reading more of his work in the future. I hope that this book becomes a rallying point for physicians who care to work to make the system better.
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1 of 1 people found the following review helpful
4.0 out of 5 stars Now I Understand the Hospital Referral System., September 14, 2014
By 
Daniel Dundon (Jacksonville, Fl) - See all my reviews
Reading Dr. Jauhar's book "Doctored: The Disillusionment of an American Physician" is both revealing and troubling.
It's revealing because I now understand the system of referrals especially in hospitals. When my wife was in ICU for an infection she picked up in the hospital, I saw an endless stream of "specialists" come into her room. At first I would ask each physician who he or she was and why they were visiting my wife. I believed at the time, they had been called in by the admitting physician to lend their expertise for her treatment. However, Dr. Jauhar paints a somewhat different picture of doctors who are in the "referral game" and merely visit as many patients as possible to increase their income. In my wife's case, I finally gave up even trying to track the faces coming into the room after the admitting physician came in one day and confessed he didn't even know all of the physicians. Apparently referral physicians can ask other physicians to consult. As Dr. Jauhar points out it is virtually impossible to coordinate such a system of care when the principal physician on the case doesn't even know who is being brought in on a referral.
After my wife died, I had this uneasy feeling that all was not right in the hospital referral system. Dr. Jauhar confirmed this feeling and for this I am thankful. He like so many other doctors went into medicine for all of the right reasons but quickly are disillusioned by the mechanics of making a living and surviving our bizarre medical system.
I wish I could tell you reading his book will make you feel good about the future of medicine in the United States, but I can't. Don't read it if you don't want to be depressed.
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18 of 26 people found the following review helpful
3.0 out of 5 stars that all (or even many) are like that. I will also say that any physician ..., August 21, 2014
This review is from: Doctored: The Disillusionment of an American Physician (Hardcover)
I think people need to take what Dr. Jauhar has written with a grain of salt. I'm tired of everyone thinking that just because there are some unscrupulous physicians out there just for a money grab, that all (or even many) are like that. I will also say that any physician who says that they are having trouble "making ends meet" is full of b.s. Even the lowest paid physician is in the top 5% of earners - most are in the top 2%, so quit your whining!

Both my wife and I are physicians, and we work for medical centers where we are salaried. I make the same amount every year no matter how many tests I do or don't order. If you're physician is like this, there's little incentive for them to run up costs. Furthermore, my medical center is the capitated Medicare provider for most of our patients - we get paid a certain amount per person per year, so even the hospital has good reason to not order unnecessary MRIs, etc.

Eventually we will move to this model (which the ACA is a small step towards, but the "free market" types opposed) - a group of providers (physicians, hospitals, labs, etc.) will agree to care for a set group of people for a set cost per year, with some extra compensation for good outcomes (to prevent things being pushed in the other direction - necessary tests or procedures not being done). Until that time, physicians like Dr. Jauhar or the people he describes who keep patients in the hospital intentionally to make more money should have their licenses revoked.
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3 of 4 people found the following review helpful
5.0 out of 5 stars Heart failure - disease of the body and disease of modern medicine in the USA, August 24, 2014
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I heard the author on Public Radio as I was driving. I knew I had to read the book. Many of the facts about modern medicine can be found elsewhere, but not in this very interesting, narrative configuration. Heart failure as a term carries medical implications as well as description of health care/ sickness services in the USA. The author writes a first-person decription of his dreams and reality with midlife the focal point. While professional, marital, family, and personal health require his undivided attention, Dr. Jauhar stretches his own limits to meet financial obligations. Here's what I do not understand - Only at the 93% kindle marker does Mrs./Dr. Sonia Jauhar get a medical position for pay. If there is to be a "second-shift", why couldn't the couple share in the obligations of income, child care, professional development, and personal wellness? Maybe it was easier for Dr. Sandeep Jauhar to write about the dilemmas of modern medicine if he were the sole moonlighter and provider for the family. He concludes with gracious appreciation for family, especially his wife. This book makes me think about what kind of patient I want to be if I need emergency hospitalization.
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18 of 27 people found the following review helpful
1.0 out of 5 stars most doctors are not like this, August 24, 2014
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Having read his first book, Intern, which was spot on with my experiences I was looking forward to this book. Much of the book is focused on his financial problems and the moonlighting that makes him order unnecessary tests for financial gain. Furthermore, he states multiple times that those in private practice are more likely to do this than those in salaried or academic positions.

A layperson who reads this book might assume that most if not all doctors engage in this behavior. As someone in private practice who started his own ophthalmology solo practice last year, I can assure you that this is entirely false; I do not order unnecessary tests, perform unnecessary surgery or refer for the sale of referring. Perhaps I am naive but I find many (but not all) physicians behave the same way as I do.

The parts of the book I enjoyed the most were when he mentions how emphasis on quality measures, such as mortality rate for cardiac surgery and antibiotics for pneumonia, could result in worse outcomes rather than improve quality, as well as his difficulty in obtaining insurance auths for admissions. If the whole book had been on topics like this, as well as perhaps intrusion on care (PQRS, EHR meaningful use, nurse practicioner administrators, patients with unrealistic expectations, narrow networks for insurance plans) it would have educated the public more about the hoops physicians jump through.

Rather than discussing this, he focuses on his financial problems. I find it kind of ironic that he also writes about a vacation in the Bahamas, cable TV, and shopping at Whole Foods. When I was a junior attending I could not afford any of these luxuries; I shopped at the regular grocery store, took driving vacations, and watched on my ipad. In my experience, many physicians particularly fresh out of training feel that they are entitled to the "doctor" lifestyle. Also in my experience these are the doctors that become the most disillusioned. Perhaps Dr. Jauhar should learn more to live on a budget than order tests for financial gain.
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Doctored: The Disillusionment of an American Physician
Doctored: The Disillusionment of an American Physician by Sandeep Jauhar (Hardcover - August 19, 2014)
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