Doctored: The Disillusionment of an American Physician by Sandeep Jauhar. This wonderful memoir tells of the common experience of American cardiologists and other American physicians who find themselves providing expensive care that isn’t care at all. Dr. Jauhar describes how a perverse payment system drives doctors to routinely order dangerous unnecessary tests rather than doing a thorough history and physical exam. “I felt really dirty about it,” Jauhar says of his feeling compelled to perform dangerous tests ordered by other physicians when patients really just needed a good evaluation by a general physician.
He also tells how physicians commonly experience something like PTSD as a result of their continual confrontation of death and dying. He recognizes that physicians need support and training to learn how to support others at the end of life. And he suggests that physicians should not be paid and incentivized to do procedures. Rather, they should be paid as much to counsel patients on the potential harms of potentially unnecessary procedures and to tell them people the truth about what is best for their health.
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