From Publishers Weekly
With 35 years' experience as a physician, Lockshin remembers the days before Medicare, Medicaid and HMOs. Working particularly with lupus patients, he has accrued vast knowledge of chronic illness, insurance and hospital administration. Here, in the voice of a caring doctor whose primary concern is always the welfare of his patients, Lockshin provides moving human case histories that illustrate current issues and dilemmas in American medicine. His prognosis is bleak, as he details how the personal welfare of individuals and their families is often ignored by a system obsessed with numbers and, ultimately, "comfortable profits." Lockshin finds that, in particular, the elderly, the poor and those with chronic illnesses are not well served by the number-crunching approach of insurance companies and hospital administrations. He observes that limiting the number and kinds of tests and procedures, the length of hospital stays and access to specialists keeps costs down in the short term, but drastically reduces the quality of care and often ends up costing more later. In this enlightening and frightening book, Lockshin carefully considers all sides to his arguments and, finally, offers hope that beneficial compromise is still possible.
Copyright 1998 Reed Business Information, Inc.
Copyright 1998 Reed Business Information, Inc.
From Booklist
The subtitle tells much more about this book than the title. For doctors do not treat aggregates of patients, they treat individual humans. Lockshin argues that governments, insurance companies, hospitals, and HMOs should listen to individuals rather than the impersonal figures aggregates produce. Many of Lockshin's patients have lupus, arthritis, or scleroderma. Since those diseases affect different patients in different ways, Lockshin's emphasis on the individual makes sense; each person's sense of health priorities, he says, should be carefully considered when choosing a treatment program. Lockshin draws a clearcut distinction between medicine and science: the former deals primarily with individuals, the latter with theories and groups. Since HMOs have come into the picture, many doctors are being forced to think of each potential patient in terms of whether this treating of this person is going to be an occasion of profit or of loss, and he asks, "Are you sure that you know for whom your doctor works?" William Beatty
