Deep disorder pervades medical practice. Disguised in euphemisms like "clinical judgment" and "evidence-based medicine," disorder exists because medical practice lacks a true system of care. The missing system has two core elements: standards of care for managing clinical information, and electronic information tools designed to implement those standards. Electronic information tools are now widely discussed, but the necessary standards of care are still widely ignored. Because these two elements are external to the physician's mind, they address a root cause of disorder: dependence on the internal capacities of autonomous physicians-their personal knowledge, intellect, habits and judgment. In this dependence on the limited, idiosyncratic capacities of individuals, medical practice lags centuries behind the domains of science and commerce. Breaking that dependence is the subject of this book.Going back 400 years to the philosophy of Francis Bacon, and examining parallel ideas from 20th Century thinkers, this book illuminates the origin of medicine's disorder. The analysis is more than theoretical. It grew out of decades of development and clinical experience in finding a new approach to medical practice. Designed to create order and transparency, this new approach involves not only standards and tools but also institutional changes essential to building a true system of care. In the current non-system, physicians bear impossible burdens of performance, other practitioners are barred from sharing those burdens, patients do not participate effectively in their own care, the U.S. spends $2.5 trillion annually without clinical accounting standards, third parties manipulate the situation for their own advantage, and none of the stakeholders are accountable for their own behaviors.This book offers a clear blueprint for building a better system of care, a system that patients, practitioners and third parties could trust. A better system could make health care a source of hope for our economic future, rather than its greatest threat.

Doctors in Denial examines the relationship between the Canadian medical profession and the pharmaceutical industry, and explains how doctors have become dependents of the drug companies instead of champions of patients' health. Big Pharma plays a role in every aspect of doctors' work. These giant, wealthy multinationals influence how medical students are trained and receive information, how research is done in hospitals and universities, what is published in leading medical journals, what drugs are approved, and what patients expect when they go into their doctors' offices. But almost all doctors deny the influence and control the drug companies exert. In this book Dr. Lexchin urges the medical profession to make the changes needed to give priority to protecting and promoting patients' health and benefitting society, rather than enabling Big Pharma to dominate health care while raking in billions in profits from citizens and governments.

Environmental Health I Health Care Policy I History Of Medicine --

A first-hand account by one of the doctors who exposed the truth at National Women's Hospital. Jones sets the record straight with his personal story: a story of the unnecessary suffering of countless women, a story of professional arrogance and misplaced loyalties, and a story of doctors in denial of the truth.

Over recent decades, the decline of trust, mounting of fears, and increasing denial of science appear as a marked shift of societal attitudes towards many institutions and professionals. This book analyses these developments and looks at their role in medicine and healthcare, both in terms of the patient-physician relationship and for delivering high-quality healthcare, in order to establish why we need trust and what can be done to restore it. The book begins by offering a conceptual analysis and definition of trust, using a ‘pattern definition’ based upon typical features and common usage of the term, as well as the related concepts of hope, fear, and belief. It charts evidence for the decline of public trust in various professions, and then looks at the causes, as well as the accompanying growth of fear and the rejection of science. The study addresses possible options for restoring trust in medicine and healthcare, be it in individual physicians, in hospitals, or in managed care institutions. Written jointly by a medical doctor and an academic specialising in biomedical ethics, the book will be of interest to those working in the areas of biomedical ethics and law, medicine and healthcare, public health, philosophy, sociology, politics, and psychology.