Where Medicine Went Wrong Book in PDF, ePub and Kindle version is available to download in english. Read online anytime anywhere directly from your device. Click on the download button below to get a free pdf file of Where Medicine Went Wrong book. This book definitely worth reading, it is an incredibly well-written.
Where Medicine Went Wrong explores how the idea of an average value has been misapplied to medical phenomena, distorted understanding and lead to flawed medical decisions. Through new insights into the science of complexity, traditional physiology is replaced with fractal physiology, in which variability is more indicative of health than is an average. The capricious nature of physiological systems is made conceptually manageable by smoothing over fluctuations and thinking in terms of averages. But these variations in such aspects as heart rate, breathing and walking are much more susceptible to the early influence of disease than are averages.It may be useful to quote from the late Stephen Jay Gould's book Full House on the errant nature of averages: ?? our culture encodes a strong bias either to neglect or ignore variation. We tend to focus instead on measures of central tendency, and as a result we make some terrible mistakes, often with considerable practical import.? Dr West has quantified this observation and make it useful for the diagnosis of disease.
Institute of Medicine,Committee on Quality of Health Care in America
Author : Institute of Medicine,Committee on Quality of Health Care in America Publisher : National Academies Press Page : 312 pages File Size : 46,5 Mb Release : 2000-03-01 Category : Medical ISBN : 9780309068376
To Err Is Human by Institute of Medicine,Committee on Quality of Health Care in America Pdf
Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine
The Origins of Bioethics argues that what we remember from the history of medicine and how we remember it are consequential for the identities of doctors, researchers, and patients in the present day. Remembering when medicine went wrong calls people to account for the injustices inflicted on vulnerable communities across the twentieth century in the name of medicine, but the very groups empowered to create memorials to these events often have a vested interest in minimizing their culpability for them. Sometimes these groups bury this past and forget events when medical research harmed those it was supposed to help. The call to bioethical memory then conflicts with a desire for “minimal remembrance” on the part of institutions and governments. The Origins of Bioethics charts this tension between bioethical memory and minimal remembrance across three cases—the Tuskegee Syphilis Study, the Willowbrook Hepatitis Study, and the Cincinnati Whole Body Radiation Study—that highlight the shift from robust bioethical memory to minimal remembrance to forgetting.
This edited collection of articles addresses aspects of medical care in which human error is associated with unanticipated adverse outcomes. For the purposes of this book, human error encompasses mismanagement of medical care due to: * inadequacies or ambiguity in the design of a medical device or institutional setting for the delivery of medical care; * inappropriate responses to antagonistic environmental conditions such as crowding and excessive clutter in institutional settings, extremes in weather, or lack of power and water in a home or field setting; * cognitive errors of omission and commission precipitated by inadequate information and/or situational factors -- stress, fatigue, excessive cognitive workload. The first to address the subject of human error in medicine, this book considers the topic from a problem oriented, systems perspective; that is, human error is considered not as the source of the problem, but as a flag indicating that a problem exists. The focus is on the identification of the factors within the system in which an error occurs that contribute to the problem of human error. As those factors are identified, efforts to alleviate them can be instituted and reduce the likelihood of error in medical care. Human error occurs in all aspects of human activity and can have particularly grave consequences when it occurs in medicine. Nearly everyone at some point in life will be the recipient of medical care and has the possibility of experiencing the consequences of medical error. The consideration of human error in medicine is important because of the number of people that are affected, the problems incurred by such error, and the societal impact of such problems. The cost of those consequences to the individuals involved in medical error, both in the health care providers' concern and the patients' emotional and physical pain, the cost of care to alleviate the consequences of the error, and the cost to society in dollars and in lost personal contributions, mandates consideration of ways to reduce the likelihood of human error in medicine. The chapters were written by leaders in a variety of fields, including psychology, medicine, engineering, cognitive science, human factors, gerontology, and nursing. Their experience was gained through actual hands-on provision of medical care and/or research into factors contributing to error in such care. Because of the experience of the chapter authors, their systematic consideration of the issues in this book affords the reader an insightful, applied approach to human error in medicine -- an approach fortified by academic discipline.
Argues that doctors are deliberately misinformed by profit-seeking pharmaceutical companies that casually withhold information about drug efficacy and side effects, explaining the process of pharmaceutical data manipulation and its global consequences. By the best-selling author of Bad Science.
In 1998, Nicholas Gonzalez, M.D. received National Cancer Institute approval for a clinical trial to evaluate his nutritional-enzyme approach in the treatment of patients with pancreatic cancer. Though Dr. Gonzalez hoped the venture would initiate an era of cooperation between conventional scientists and serious alternative researchers, problems plagued the study from its beginning. The design discouraged patient participation; conventional oncologists discouraged patients from joining and at times pressured those already admitted for nutritional therapy to change to more conventional treatment. Then in 2000 the NCI insisted that all patient selection decisions be turned over to the Principal Investigator, who as it turned out helped develop the chemotherapy protocol used as the control treatment.Repeatedly, the Principal Investigator approved patients for the nutritional treatment who did not meet the entry requirements, or who were too ill or uncommitted to follow the self-administered regimen. An evaluation by government scientists in early 2005 confirmed that so many patients had failed to follow the prescribed nutritional therapy that the data had little meaning. Despite such problems, without Dr. Gonzalez¿ knowledge the Principal Investigator published an article implying the study was properly run, patients complied fully and that the nutritional therapy had no effect.In response, Dr. Gonzalez, a former journalist, has written What Went Wrong, to bring the truth of this project to light, and show how bias, indifference, and at times incompetence undermined a promising research effort that, if properly run, might have ushered in a new direction in cancer treatment.
#1 NEW YORK TIMES BESTSELLER • PULITZER PRIZE FINALIST • This inspiring, exquisitely observed memoir finds hope and beauty in the face of insurmountable odds as an idealistic young neurosurgeon attempts to answer the question What makes a life worth living? NAMED ONE OF PASTE’S BEST MEMOIRS OF THE DECADE • NAMED ONE OF THE BEST BOOKS OF THE YEAR BY The New York Times Book Review • People • NPR • The Washington Post • Slate • Harper’s Bazaar • Time Out New York • Publishers Weekly • BookPage Finalist for the PEN Center USA Literary Award in Creative Nonfiction and the Books for a Better Life Award in Inspirational Memoir At the age of thirty-six, on the verge of completing a decade’s worth of training as a neurosurgeon, Paul Kalanithi was diagnosed with stage IV lung cancer. One day he was a doctor treating the dying, and the next he was a patient struggling to live. And just like that, the future he and his wife had imagined evaporated. When Breath Becomes Air chronicles Kalanithi’s transformation from a naïve medical student “possessed,” as he wrote, “by the question of what, given that all organisms die, makes a virtuous and meaningful life” into a neurosurgeon at Stanford working in the brain, the most critical place for human identity, and finally into a patient and new father confronting his own mortality. What makes life worth living in the face of death? What do you do when the future, no longer a ladder toward your goals in life, flattens out into a perpetual present? What does it mean to have a child, to nurture a new life as another fades away? These are some of the questions Kalanithi wrestles with in this profoundly moving, exquisitely observed memoir. Paul Kalanithi died in March 2015, while working on this book, yet his words live on as a guide and a gift to us all. “I began to realize that coming face to face with my own mortality, in a sense, had changed nothing and everything,” he wrote. “Seven words from Samuel Beckett began to repeat in my head: ‘I can’t go on. I’ll go on.’” When Breath Becomes Air is an unforgettable, life-affirming reflection on the challenge of facing death and on the relationship between doctor and patient, from a brilliant writer who became both.
Medical mistakes are more pervasive than we think. How can we improve outcomes? An acclaimed MD’s rich stories and research explore patient safety. Patients enter the medical system with faith that they will receive the best care possible, so when things go wrong, it’s a profound and painful breach. Medical science has made enormous strides in decreasing mortality and suffering, but there’s no doubt that treatment can also cause harm, a significant portion of which is preventable. In When We Do Harm, practicing physician and acclaimed author Danielle Ofri places the issues of medical error and patient safety front and center in our national healthcare conversation. Drawing on current research, professional experience, and extensive interviews with nurses, physicians, administrators, researchers, patients, and families, Dr. Ofri explores the diagnostic, systemic, and cognitive causes of medical error. She advocates for strategic use of concrete safety interventions such as checklists and improvements to the electronic medical record, but focuses on the full-scale cultural and cognitive shifts required to make a meaningful dent in medical error. Woven throughout the book are the powerfully human stories that Dr. Ofri is renowned for. The errors she dissects range from the hardly noticeable missteps to the harrowing medical cataclysms. While our healthcare system is—and always will be—imperfect, Dr. Ofri argues that it is possible to minimize preventable harms, and that this should be the galvanizing issue of current medical discourse.
Editor of the award-winning site Feministing.com, Maya Dusenbery brings together scientific and sociological research, interviews with doctors and researchers, and personal stories from women across the country to provide the first comprehensive, accessible look at how sexism in medicine harms women today. In Doing Harm, Dusenbery explores the deep, systemic problems that underlie women’s experiences of feeling dismissed by the medical system. Women have been discharged from the emergency room mid-heart attack with a prescription for anti-anxiety meds, while others with autoimmune diseases have been labeled “chronic complainers” for years before being properly diagnosed. Women with endometriosis have been told they are just overreacting to “normal” menstrual cramps, while still others have “contested” illnesses like chronic fatigue syndrome and fibromyalgia that, dogged by psychosomatic suspicions, have yet to be fully accepted as “real” diseases by the whole of the profession. An eye-opening read for patients and health care providers alike, Doing Harm shows how women suffer because the medical community knows relatively less about their diseases and bodies and too often doesn’t trust their reports of their symptoms. The research community has neglected conditions that disproportionately affect women and paid little attention to biological differences between the sexes in everything from drug metabolism to the disease factors—even the symptoms of a heart attack. Meanwhile, a long history of viewing women as especially prone to “hysteria” reverberates to the present day, leaving women battling against a stereotype that they’re hypochondriacs whose ailments are likely to be “all in their heads.” Offering a clear-eyed explanation of the root causes of this insidious and entrenched bias and laying out its sometimes catastrophic consequences, Doing Harm is a rallying wake-up call that will change the way we look at health care for women.
On average, a physician will interrupt a patient describing her symptoms within eighteen seconds. In that short time, many doctors decide on the likely diagnosis and best treatment. Often, decisions made this way are correct, but at crucial moments they can also be wrong—with catastrophic consequences. In this myth-shattering book, Jerome Groopman pinpoints the forces and thought processes behind the decisions doctors make. Groopman explores why doctors err and shows when and how they can—with our help—avoid snap judgments, embrace uncertainty, communicate effectively, and deploy other skills that can profoundly impact our health. This book is the first to describe in detail the warning signs of erroneous medical thinking and reveal how new technologies may actually hinder accurate diagnoses. How Doctors Think offers direct, intelligent questions patients can ask their doctors to help them get back on track. Groopman draws on a wealth of research, extensive interviews with some of the country’s best doctors, and his own experiences as a doctor and as a patient. He has learned many of the lessons in this book the hard way, from his own mistakes and from errors his doctors made in treating his own debilitating medical problems. How Doctors Think reveals a profound new view of twenty-first-century medical practice, giving doctors and patients the vital information they need to make better judgments together.
Our health care is staggeringly expensive, yet one in six Americans has no health insurance. We have some of the most skilled physicians in the world, yet one hundred thousand patients die each year from medical errors. In this gripping, eye-opening book, award-winning journalist Shannon Brownlee takes readers inside the hospital to dismantle some of our most venerated myths about American medicine. Brownlee dissects what she calls "the medical-industrial complex" and lays bare the backward economic incentives embedded in our system, revealing a stunning portrait of the care we now receive. Nevertheless, Overtreated ultimately conveys a message of hope by reframing the debate over health care reform. It offers a way to control costs and cover the uninsured, while simultaneously improving the quality of American medicine. Shannon Brownlee's humane, intelligent, and penetrating analysis empowers readers to avoid the perils of overtreatment, as well as pointing the way to better health care for everyone.
"Christopher Wanjek uses a take-no-prisoners approach in debunkingthe outrageous nonsense being heaped on a gullible public in thename of science and medicine. Wanjek writes with clarity, humor,and humanity, and simultaneously informs and entertains." -Dr. Michael Shermer, Publisher, Skeptic magazine; monthlycolumnist, Scientific American; author of Why People Believe WeirdThings Prehistoric humans believed cedar ashes and incantations could curea head injury. Ancient Egyptians believed the heart was the centerof thought, the liver produced blood, and the brain cooled thebody. The ancient Greek physician Hippocrates was a big fan ofbloodletting. Today, we are still plagued by countless medicalmyths and misconceptions. Bad Medicine sets the record straight bydebunking widely held yet incorrect notions of how the body works,from cold cures to vaccination fears. Clear, accessible, and highly entertaining, Bad Medicine dispelssuch medical convictions as: * You only use 10% of your brain: CAT, PET, and MRI scans all provethat there are no inactive regions of the brain . . . not evenduring sleep. * Sitting too close to the TV causes nearsightedness: Your motherwas wrong. Most likely, an already nearsighted child sits close tosee better. * Eating junk food will make your face break out: Acne is caused bydead skin cells, hormones, and bacteria, not from a pizza witheverything on it. * If you don't dress warmly, you'll catch a cold: Cold viruses arethe true and only cause of colds. Protect yourself and the ones you love from bad medicine-the brainyou save may be your own.
Testing Treatments by Imogen Evans,Hazel Thornton,Iain Chalmers,Paul Glasziou Pdf
This work provides a thought-provoking account of how medical treatments can be tested with unbiased or 'fair' trials and explains how patients can work with doctors to achieve this vital goal. It spans the gamut of therapy from mastectomy to thalidomide and explores a vast range of case studies.
An acclaimed medical expert and patient advocate offers an eye-opening look at many common and widely used medical interventions that have been shown to be far more harmful than helpful. Yet, surprisingly, despite clear evidence to the contrary, most doctors continue to recommend them. Modern medicine has significantly advanced in the last few decades as more informed practices, thorough research, and incredible breakthroughs have made it possible to successfully treat and even eradicate many serious ailments. Illnesses that once were a death sentence, such as HIV and certain forms of cancer, can now be managed, allowing those affected to live longer, healthier lives. Because of these advances, we now live 30 years longer than we did 100 years ago. But while we have learned much in the preceding decades that has changed our outlook and practices, we still rely on medical interventions that are vastly out of date and can adversely affect our health. We all know that finishing the course of antibiotics prevents the recurrence of illness, that sunscreens block harmful UV rays that cause skin cancer, and that all cancer-screening programs save lives. But do scientific studies really back this up? In this game-changing book, Dr. Paul A. Offit debunks fifteen common medical interventions that have long been considered gospel despite mounting evidence of their adverse effects, from vitamins, sunscreen, fever-reducing medicines, and eyedrops for pink eye to more serious procedures like heart stents and knee surgery. Analyzing how these practices came to be, the biology of what makes them so ineffective and harmful, and the medical culture that continues to promote them, Overkill informs patients to help them advocate for their health. By educating ourselves, we can ask better questions about some of the drugs and surgeries that are all too readily available—and all too heavily promoted.
