How We Do Harm: A Doctor Breaks Ranks About Being Sick In America

I haven't posted in awhile, but I promise real updates are forthcoming! For now, a review.

I read a book a few months ago and forgot to post a review of it! Dr. Otis Webb Brawley "is the chief medical and scientific officer of The American Cancer Society, an oncologist with a dazzling clinical, research, and policy career."

Here's part of the book description from Amazon: "Brawley tells of doctors who select treatment based on payment they will receive, rather than on demonstrated scientific results; hospitals and pharmaceutical companies that seek out patients to treat even if they are not actually ill (but as long as their insurance will pay); a public primed to swallow the latest pill, no matter the cost; and rising healthcare costs for unnecessary—and often unproven—treatments that we all pay for. Brawley calls for rational healthcare, healthcare drawn from results-based, scientifically justifiable treatments, and not just the peddling of hot new drugs."


It's full of individual patient stories and snapshots that help Dr. Brawley make his points, which makes it easy to read.

Favorite quotes: 

In regards to a woman who was told that, in addition to other treatments, a bone marrow transplant would eradicate her cancer but then found out later it was semi-experimental and did more harm than good:

"The problem is, we don't use our expensive drugs and technologies appropriately. Instead of using these interventions to benefit patients, we use them to maximize revenues, and often harm patients. If we could learn to practice medicine rationally, the money we would save would help us provide the most basic care for those who are now shut out of the system. Health care for the rich would benefit as well, because in medicine gluttony equals harm."

In regards to money as a medical motivator:

"Too often, helping the patient isn't the point. Economic incentives can dictate that the patient be ground up as expensively as possible with the goal of maximizing the cut of every practitioner who gets involved. When we, doctors, are at our best, we set aside our self-interest and put the patient's interest first. When we aren't at our best, the public pays more in fees, insurance premiums, taxes--and poor outcomes."