From Publishers Weekly
Over 30 years ago, Gross (a professional gadfly whose earlier critiques have borne down on The Government Racket and The Tax Racket) took on the medical profession with The Doctors. While the field has changed drastically, he once again finds the American physician most at fault. Not that he lets the other sectors of the medical profession off the hook: Gross finds errors and misdeeds among hospitals, HMOs, dentists, private insurers, medical equipment distributors, testing laboratories, the home care industry and nursing homes. In each chapter, he details the health providers' errors, using anecdotes and statistical information gleaned from studies in the field. He cites horrifying cases of hospital error and charges that such iatrogenic (caused by the hospital itself) deaths are often unreported and covered up. While many of his accusations ring true, others seem less plausible, such as his argument that affirmative action has led to the lowering of medical school standards. He advocates decentralization of health care into hospital-centered communities, although why such a concept would bypass all the defects of the present chaos is not clear. Whether it's learning that some 80,000 deaths are either directly or indirectly attributable to infections acquired in hospitals or that med school grads identified only 20% of common heart abnormalities ordinarily detectable with a stethoscope, there's something ghoulishly fascinating about Gross's recitation of incompetence, dishonesty and greed in the medical profession.
Copyright 1998 Reed Business Information, Inc.
Although he repeats much about the perfidy of the present practice of medicine as a business that has lately been aired, alarm-sounder Gross adds important new material. He shows how HMOs encourage--indeed pay--doctors to not give care. For-profit HMOs are especially dangerous, he says, because the bottom line for their administrations is stockholders' dividends and CEOs' high incomes rather than caring for patients. "In truth," Gross writes, "the HMO is not a medical plan at all, but strictly an insurance gimmick." Minnesota has abolished this type of business, and other states should do so as soon as possible, he says. Gross also deals at length with home care frauds and points out questionable elements in medical education and training, especially the current misplaced emphasis on primary physicians when more specialists are needed. On the positive side, he does, however, grant that unnecessary coronary bypass operations have decreased. Finally, he suggests steps to improve medical education, patient care, and the accessibility of medical care.
William Beatty