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How We Do Harm: A Doctor Breaks Ranks About…

How We Do Harm: A Doctor Breaks Ranks About Being Sick in America (edition 2012)

by Otis Webb Brawley, Paul Goldberg

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1066113,849 (4.35)7
Title:How We Do Harm: A Doctor Breaks Ranks About Being Sick in America
Authors:Otis Webb Brawley
Other authors:Paul Goldberg
Info:St. Martin's Griffin (2012), Hardcover
Collections:Your library

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How We Do Harm: A Doctor Breaks Ranks About Being Sick in America by Otis Webb Brawley



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This book is one of a long string of books that caution against uncritically following your doctor's advice. Many factors contribute to U.S. citizens being overtreated and underserved: over-aggressive cancer treatment is just one of them. I'd go on about this, but for me it's a soap box issue. There'a a new book on my to-read list "The New Prescription: How to Get the Best Health Care in a Broken System" - perhaps it will be of more guidance to a broader spectrum than Dr. Brawley's book. ( )
  Jeannine504 | Jan 23, 2016 |
The author, an oncologist, describes how many factors drive patient care that aren't based on evidence found through clinical trials. We all know that poor people often get substandard care because of a lack of insurance, but oftentimes wealthy people get too much care that is harmful because of their own insistence. And sometimes doctors rely on intuition rather than evidence. A sobering book. ( )
  creynolds | Jun 24, 2014 |
This is an extremely important book which I urge everyone in the world to read. Otis Brawley is a caring doctor, an oncologist, who understands the health care system inside and out, and can see what is wrong and how to make it better. The individual stories he tells about people who have been harmed by "too much care" are heartbreaking. Please people, read this book, and you will be much better prepared to take your own health care into your own hands. ( )
  Scrabblenut | Jan 14, 2014 |
I only read a handful of non-fiction a year because it can take me so long to get through it. My interests wanes or it just becomes tedious. This was not the case for this book. It keep my interest with real cases that demonstrate how the system is failing. I read it almost as fast as a fiction paperback once I started, about 3 days.

Otis Browley's writing has wit and heart. Along with that he points to real statistics and tells it like it is. Some of these things I already knew, like the kick backs doctors get for prescribing certain drugs and using their own facilities. Browley points out how it is done and how it is pushed by profit and greed but sometimes by well meaning groups.

While reading, you get to know the people Browley writes about, and you feel for them. There are descriptions that some people may feel squeamish about eg. a woman whose breast is so rotted by cancer it literally falls off, a man whose prostate radiation creates a hole between the rectum and bladder and causes infection from stool in the urine. but you get the gist early on and if you have a problem with the first story, about a poor black woman coming in for breast cancer, you should probably not read the book. There is much more story than the small graphic parts. All of the stories are engaging and really show how harm is done. That is the name of this book.

Most of the harm that Browley points to is backtracked to profits and greed in the system. Some harm is that doctors don't police their own; Instead it is a club that many continue on in their careers even after blatant abuse. He shows many very interesting cases that you can imagine happening to someone you know. Perhaps it has happened to someone you know.

I enjoyed how well he pointed out the problems in the broken system we have, at the same time as getting real stories told with emotion and at times humor. I wish I had the book with me as I would quote just one of the many witty things he says. Alas it was due at the library.

Anybody who is not too squeamish and is concerned about health, healthcare, an older relative, a sick friend, healthcare costs, the deficit in America, should read this book. We spend 52% more per person than the next country down on the list, and it is about the same for per capita of the GDP. The list is of OECD member countries but if you look at the 190 WHO member countries, it has very similar figures. Yet, we are 50th in life expectancy and around 45th in infant mortality. Healthcare is the biggest problem for a balanced budget but it is not due to paying for older people and their RXs on Medicare but paying too much for poor service, overpriced drugs and frequently unnecessary procedures and medications. We need control of costs and create some true over-site in the system. Browley points this out in a way that doesn't make your eyes cross nor make you feel like you are being preached to.

Otis Browley is a doctor and one of color. He points this out and how it has affected him and how it affects his patients. This in itself is a reason to read this book. He is personable in his writing and you feel like you know him after reading just a while. He doesn't use his title of Dr. but instead introduces himself as Otis Browley a doctor. While writing this review I kept his title from his name as he does in the book but truly Dr Otis Browley deserves the title. ( )
  tivonut | Jul 25, 2013 |
A truly excellent book dissecting the problems with the American medical system. Everybody knows that uninsured and underinsured people don't get care they need; Brawley focuses more on insured, informed people getting care they absolutely don't need, from men whose lives were ruined by overtreatment for prostate cancer that may have been harmless to women whose deaths may have been hastened by treatment that was supposed to improve their quality of life but might have caused their tumors to grow instead. In all these cases, Brawley points out, evidence existed to indicate that these treatments were a bad idea, or at least not necessarily a good one - but doctors made money off them, and patients demanded more action rather than less, and we all end up paying for it: most of us with higher insurance premiums and cost of care, and patients frequently with their lives.

Brawley is a scientist above all; he wants doctors to rely on evidence, not instinct or habit or the unconscious pressure of a $40,000 reimbursement, when making decisions for care. He seems a little optimistic for me; my instinct is to say that this book is a bad idea in the environment that produced the whole "death panels" argument against socialized health care, because he is saying that sometimes patients shouldn't get the care that they demand, because patients don't know what's best for them and their doctors should, and should be able to say no to irrational demands. I agree with him, but I think he might overestimate how easy it will be to change these patients' minds, especially when these patients are the people making the laws. ( )
  jen.e.moore | Mar 30, 2013 |
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Amazon.com Product Description (ISBN 0312672977, Hardcover)

How We Do Harm exposes the underbelly of healthcare today—the overtreatment of the rich, the under treatment of the poor, the financial conflicts of interest that determine the care that physicians’ provide, insurance companies that don’t demand the best (or even the least expensive) care, and pharmaceutical companies concerned with selling drugs, regardless of whether they improve health or do harm.

Dr. Otis Brawley is the chief medical and scientific officer of The American Cancer Society, an oncologist with a dazzling clinical, research, and policy career. How We Do Harm pulls back the curtain on how medicine is really practiced in America. 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.

Brawley’s personal history – from a childhood in the gang-ridden streets of black Detroit, to the green hallways of Grady Memorial Hospital, the largest public hospital in the U.S., to the boardrooms of The American Cancer Society—results in a passionate view of medicine and the politics of illness in America - and a deep understanding of healthcare today. How We Do Harm is his well-reasoned manifesto for change.

(retrieved from Amazon Thu, 12 Mar 2015 18:00:42 -0400)

Dr. Brawley exposes the underbelly of healthcare today--the under-treatment of the poor, the over-treatment of the rich, the financial conflicts of interests physicians face, insurance that doesn't demand the best (or even cheapest) care, and a pharmaceutical behemoth concerned with selling drugs, not providing health.… (more)

(summary from another edition)

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