"Mullan gets it right! His 'big doctors' are the unsung heroes of American medicine. Their stories —and they are great stories—tell us where we have to go to build a medical system that will work for everybody. And I mean everybody - the CEO, the family on welfare, you, and me."—Studs Terkel, author of Working, The Good War, and Coming of Age "Big Doctoring is a unique undertaking. We hear people in the frontlines of medicine tell us their story, and tell it in their own voices. In these pages, which are a joy to read, we find proof that medicine is, and always will be, both art and science."—Abraham Verghese, M.D., author of The Tennis Partner "Big Doctoring is an extraordinarily compelling effort by a dedicated and idealistic physician -- who offers us, through the voices of his informants, a clearly written narrative that tells of a profession's contemporary challenges and difficulties. Here is documentary work of the most instructive and telling kind -- a nation's healers become witnesses and teachers for us readers."—Robert Coles, M.D. "At a time when both doctors and patients in record numbers abhor the shadowy mass of gloomy economics and gruesome bureaucracy that has overtaken American medicine, Mullan shows us a path out of the darkness. And his is a desperately needed map, as physicins and nurses are now quitting in droves, tens of millions of Americans are losing their health insurance, and millions more, though insured, are forbidden treatments and primary care that could save their lives. Bravo!"—Laurie Garrett, author of The Coming Plague and Betrayal of Trust

The general practitioner was once America's doctor. The GP delivered babies, removed gallbladders, and sat by the bedsides of the dying. But as the twentieth century progressed, the pattern of medical care in the United States changed dramatically. By the 1960s, the GP was almost extinct. The later part of the twentieth century, however, saw a rebirth of the idea of the GP in the form of primary care practitioners. In this engrossing collection of oral histories and provocative essays about the past and future of generalism in health care, Fitzhugh Mullan—a pediatrician, writer, and historian—argues that primary care is a fascinating, important, and still endangered calling. In conveying the personal voices of primary care practitioners, Mullan sheds light on the political and economic contradictions that confront American medicine. Mullan interviewed dozens of primary care practitioners—family physicians, internists, pediatricians, nurse practitioners, and physician assistants—asking them about their lives and their work. He explains how, during the last forty years, the primary care movement has emerged built on the principles of "big doctoring"--coordinated, comprehensive care over time. This book is essential reading for understanding core issues of the current health care dilemma. As our country struggles with managed care, market reforms, and cost containment strategies in medicine, Big Doctoring in America provides an engrossing and illuminating look at those in the trenches of the profession.

A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 "This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems. In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast? Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.

A doctor tells his own behind-the-scenes story of the making of a medical man and the disintegration of an American myth

There is little debate that health care in the United States is in need of reform. But where should those improvements begin? With insurers? Drug makers? The doctors themselves? In Big Med, David Dranove and Lawton Robert Burns argue that we’re overlooking the most ubiquitous cause of our costly and underperforming system: megaproviders, the expansive health care organizations that have become the face of American medicine. Your local hospital is likely part of one. Your doctors, too. And the megaproviders are bad news for your health and your wallet. Drawing on decades of combined expertise in health care consolidation, Dranove and Burns trace Big Med’s emergence in the 1990s, followed by its swift rise amid false promises of scale economies and organizational collaboration. In the decades since, megaproviders have gobbled up market share and turned independent physicians into salaried employees of big bureaucracies, while delivering on none of their early promises. For patients this means higher costs and lesser care. Meanwhile, physicians report increasingly low morale, making it all but impossible for most systems to implement meaningful reforms. In Big Med, Dranove and Burns combine their respective skills in economics and management to provide a nuanced explanation of how the provision of health care has been corrupted and submerged under consolidation. They offer practical recommendations for improving competition policies that would reform megaproviders to actually achieve the efficiencies and quality improvements they have long promised. This is an essential read for understanding the current state of the health care system in America—and the steps urgently needed to create an environment of better care for all of us.

For more than a century, the American medical profession insisted that doctors be rigorously trained in medical science and dedicated to professional ethics. Patients revered their doctors as representatives of a sacred vocation. Do we still trust doctors with the same conviction? In Trusting Doctors, Jonathan Imber attributes the development of patients' faith in doctors to the inspiration and influence of Protestant and Catholic clergymen during the nineteenth and early twentieth centuries. He explains that as the influence of clergymen waned, and as reliance on medical technology increased, patients' trust in doctors steadily declined. Trusting Doctors discusses the emphasis that Protestant clergymen placed on the physician's vocation; the focus that Catholic moralists put on specific dilemmas faced in daily medical practice; and the loss of unchallenged authority experienced by doctors after World War II, when practitioners became valued for their technical competence rather than their personal integrity. Imber shows how the clergy gradually lost their impact in defining the physician's moral character, and how vocal critics of medicine contributed to a decline in patient confidence. The author argues that as modern medicine becomes defined by specialization, rapid medical advance, profit-driven industry, and ever more anxious patients, the future for a renewed trust in doctors will be confronted by even greater challenges. Trusting Doctors provides valuable insights into the religious underpinnings of the doctor-patient relationship and raises critical questions about the ultimate place of the medical profession in American life and culture.

Using the examples of Vioxx, Celebrex, cholesterol-lowering statin drugs, and anti-depressants, Overdo$ed America shows that at the heart of the current crisis in American medicine lies the commercialization of medical knowledge itself. Drawing on his background in statistics, epidemiology, and health policy, John Abramson, M.D., an award-winning family doctor on the clinical faculty at Harvard Medical School, reveals the ways in which the drug companies have misrepresented statistical evidence, misled doctors, and compromised our health. The good news is that the best scientific evidence shows that reclaiming responsibility for your own health is often far more effective than taking the latest blockbuster drug. You -- and your doctor -- will be stunned by this unflinching exposé of American medicine.