Sunday, November 16, 2014

Three books by doctors on greed, empathy and end-of-life care - The Washington Post

Doctors are under the microscope. They're scrutinized for their role in our high health-care costs and graded on the quality of their care. Because of cuts in what insurance pays them, their incomes have not kept pace with inflation, creating pressure for practitioners to see more patients. Medical students, burdened by gigantic school debts, are migrating toward the highest-earning specialties and away from lower-paid primary-care fields, where doctors are in short supply.

Educators worry that physicians' stressful training — focused on technology, information and time management — might stunt their ability to gauge patients' emotions and inhibit them from discussing difficult subjects, such as a patient's wishes at the end of life. Most of the beginning medical school students whom I teach are altruistic and caring, but they wonder whether medical school and residency will grind the empathy out of them.

In three remarkable new books, physician-authors illuminate aspects of medicine that members of the profession are often reluctant to talk about: the deeply flawed care of the old and the dying, how greed influences doctors' clinical decisions, and a trainee's searing encounters with patients who are beyond his medical help.

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