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Dissecting American Health Care

Commentaries on Health, Policy, and Politics

Clarion Review (5 Stars)

It is no easy task to “dissect” American health care, but Douglas Kamerow’s collection of essays does a fine job of it. Kamerow, a physician and former Assistant Surgeon General, has collected forty-seven essays he wrote between 2007 and 2011 on health-related topics. He divides the topics into five broad areas: Assessing and Improving Health Care; Preventive Medicine; Politics, Health, and Health Care; Health Care Reform; and Personal Stories and Ethical Issues.

All of the essays are related to health care, but Kamerow actually covers a broad spectrum of subject matter, which makes for interesting reading. The author addresses issues both common and controversial.

In one essay about retail health clinics, such as the CVS MinuteClinic, Kamerow refers to a national poll suggesting that “patients love them.” While a physician could easily see a retail clinic as competition, Kamerow suggests that instead “they are providing a useful service, from which conventional practitioners could learn a thing or two. In that sense they provide additional impetus for medicine to reinvent itself to become more patient-centered and responsive.” Discussing preventive care, Kamerow writes, “Here’s the dirty little secret: most prevention doesn’t save money, any more than treatment saves money. The question to ask is not whether preventive medicine saves money, but whether your money is buying good value in health.” Kamerow also addresses the free drug samples given to physicians by pharmaceutical sales representatives and admits, “They influence doctors’ prescribing patterns and the types of refills requested by patients.”

As indicated in the excerpts above, Kamerow is not afraid to share his honest opinion. Thankfully, he abandons “physician speak” and instead writes in simple, comprehensible language that is both appealing and engaging. The essays are also very short and easy to read. Admittedly, the author was constrained by format—the pieces were originally written for three-minute National Public Radio commentaries or one-page entries in a medical journal. Brevity serves Kamerow well, and he uses it to full advantage.

Kamerow includes a number of commentaries on governmental health care reform in his collection, though it is unlikely the text will influence opinions on this issue as it is not the main focus of his work. Still, a reader will undoubtedly be better informed about the complexities of health care after reading these essays, and may also feel that he or she has gained rare personal insight from a leading physician.

Barry Silverstein