Guarded Prognosis: A Doctor and His Patients Talk about Chronic Disease and How to Cope with It

Michael Lockshin, Author, Michael Lockshin, Joint Author
Michael Lockshin, Author, Michael Lockshin, Joint Author Hill & Wang $24 (260p) ISBN 978-0-8090-5345-2
Reviewed on: 12/29/1997
Release date: 01/01/1998
With 35 years' experience as a physician, Lockshin remembers the days before Medicare, Medicaid and HMOs. Working particularly with lupus patients, he has accrued vast knowledge of chronic illness, insurance and hospital administration. Here, in the voice of a caring doctor whose primary concern is always the welfare of his patients, Lockshin provides moving human case histories that illustrate current issues and dilemmas in American medicine. His prognosis is bleak, as he details how the personal welfare of individuals and their families is often ignored by a system obsessed with numbers and, ultimately, ""comfortable profits."" Lockshin finds that, in particular, the elderly, the poor and those with chronic illnesses are not well served by the number-crunching approach of insurance companies and hospital administrations. He observes that limiting the number and kinds of tests and procedures, the length of hospital stays and access to specialists keeps costs down in the short term, but drastically reduces the quality of care and often ends up costing more later. In this enlightening and frightening book, Lockshin carefully considers all sides to his arguments and, finally, offers hope that beneficial compromise is still possible. (Sept.)
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