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Doctored: The Disillusionment of an American Physician
Doctored is the shocking follow-up to Intern, Sandeep Jauhar’s widely praised chronicle of the harsh realities of a hospital residency. Now the director of the Heart Failure Program at a Long Island hospital, Jauhar uses his own story as a scalpel to lay open the American health-care system.
The patient is ill indeed. A perverse system forces doctors to prescribe unnecessary tests and participate in an elaborate system of cronyism just to cover costs and protect themselves from malpractice suits. Jauhar reports cases where a single patient might see fifteen specialists in one hospital stay, fail to receive a full picture of his actual condition, and leave with a bill for hundreds of thousands of dollars. Jauhar himself wrestles with his conscience as, struggling to make ends meet, he moonlights for a practitioner who charges exorbitant fees for tests of questionable value.
Doctored is a cry for reform; a fascinating look at what really goes on in examining rooms, ORs, and your own doctor’s mind; and, most of all, a deeply personal and unsparing act of introspection by a physician who wants to return meaning and moral grounding to a noble profession that has lost its way. It is certain to kick off controversy and heated debate at a time when the dysfunctionalities of our health-care system remain at the top of the nation’s agenda.
The patient is ill indeed. A perverse system forces doctors to prescribe unnecessary tests and participate in an elaborate system of cronyism just to cover costs and protect themselves from malpractice suits. Jauhar reports cases where a single patient might see fifteen specialists in one hospital stay, fail to receive a full picture of his actual condition, and leave with a bill for hundreds of thousands of dollars. Jauhar himself wrestles with his conscience as, struggling to make ends meet, he moonlights for a practitioner who charges exorbitant fees for tests of questionable value.
Doctored is a cry for reform; a fascinating look at what really goes on in examining rooms, ORs, and your own doctor’s mind; and, most of all, a deeply personal and unsparing act of introspection by a physician who wants to return meaning and moral grounding to a noble profession that has lost its way. It is certain to kick off controversy and heated debate at a time when the dysfunctionalities of our health-care system remain at the top of the nation’s agenda.
288 pages, Hardcover
First published August 19, 2014
105 people are currently reading
2570 people want to read
About the author
Sandeep Jauhar
11 books220 followersSandeep Jauhar has written several bestselling books, all published by Farrar, Straus, and Giroux.
"My Father’s Brain," his most recent book, is a memoir of his relationship with his father as he succumbed to dementia. In the book, Jauhar sets his father’s descent into Alzheimer’s alongside his own journey toward understanding his father’s disease. It was named by The New Yorker and Smithsonian magazine as one of the best books of 2023.
The book relates the complications that arise when family members must become caregivers. Though the conflicts are personal, they are also universal—conversations and conflicts that every family facing the mental erosion of an elder has. At the same time, the book explores everything from ancient conceptions of the mind to the most cutting-edge neurological―and bioethical―research. It delves into what happens in the brain as we age and our memory falters, how memory gives meaning to our lives, even as it changes with time, how dementia complicates our understanding of what it means to have a self — and what all this means for patients, their families, and society at large.
Jauhar's first book, "Intern: A Doctor's Initiation," was an international bestseller and was optioned by NBC for a dramatic television series.
His second book, "Doctored: The Disillusionment of an American Physician," was a New York Times bestseller and was named a New York Post Best Book of 2014.
"Heart: A History," his third book, was named a best book of 2018 by the Mail on Sunday, Science Friday, Zocalo Public Square, and the Los Angeles Public Library, and was the PBS NewsHour/New York Times book club pick for January 2019; it was also a finalist for the Wellcome Book Prize.
A practicing physician, Jauhar writes regularly for the opinion section of The New York Times. His TED Talk on the emotional heart was one of the ten most-watched TED Talks of 2019. To learn more about him and his work, visit his website at www.sandeepjauhar.com or follow him on social media.
"My Father’s Brain," his most recent book, is a memoir of his relationship with his father as he succumbed to dementia. In the book, Jauhar sets his father’s descent into Alzheimer’s alongside his own journey toward understanding his father’s disease. It was named by The New Yorker and Smithsonian magazine as one of the best books of 2023.
The book relates the complications that arise when family members must become caregivers. Though the conflicts are personal, they are also universal—conversations and conflicts that every family facing the mental erosion of an elder has. At the same time, the book explores everything from ancient conceptions of the mind to the most cutting-edge neurological―and bioethical―research. It delves into what happens in the brain as we age and our memory falters, how memory gives meaning to our lives, even as it changes with time, how dementia complicates our understanding of what it means to have a self — and what all this means for patients, their families, and society at large.
Jauhar's first book, "Intern: A Doctor's Initiation," was an international bestseller and was optioned by NBC for a dramatic television series.
His second book, "Doctored: The Disillusionment of an American Physician," was a New York Times bestseller and was named a New York Post Best Book of 2014.
"Heart: A History," his third book, was named a best book of 2018 by the Mail on Sunday, Science Friday, Zocalo Public Square, and the Los Angeles Public Library, and was the PBS NewsHour/New York Times book club pick for January 2019; it was also a finalist for the Wellcome Book Prize.
A practicing physician, Jauhar writes regularly for the opinion section of The New York Times. His TED Talk on the emotional heart was one of the ten most-watched TED Talks of 2019. To learn more about him and his work, visit his website at www.sandeepjauhar.com or follow him on social media.
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Displaying 1 - 30 of 209 reviews
December 5, 2016
I hate this book. I hate the author's attitude. It's whine whine whine, health care costs are so high but doctors don't earn enough. They are only paid half of what a lawyer earns, their costs are so high and whine whine whine the money isn't going to us who provide the health care. I stopped my children from going into medicine because it is so poorly paid. When I was an ER doc I had to work sometimes 100 hours a week and I was only paid $11 an hour once you take off all my expenses. Whine whine whine. Things are getting worse. Primary health care doctors who do all the work are really not getting enough money.
Now let's get on to another topic to do with being disillusioned as a doctor. Oh, there isn't one, it's all about the huge bureaucracy that is part of American health care and how they get all the money so the doctors don't.
I don't know if the author is just a one trick pony or there are more subjects to complain about up the road. But I've had enough.
Sandeep Jauhar MD PhD talks of the enormous debt from school, but he had years of school to attain his PhD in Physics before switching to medicine. He is currently director of the Heart Failure Program at Long Island Jewish Medical Center in New York . According to Becker's Hospital Review) in 2012, he would have been earning a minimum of $500K a year, probably much more as he's a director not just a physician. Poor man. Set up a Go Fund Me page or something.
I wasn't paid for my time, I'll never get that hour back and I paid the author for the book. Result: I am seriously disillusioned not about American medicine, but with the author himself.
Now let's get on to another topic to do with being disillusioned as a doctor. Oh, there isn't one, it's all about the huge bureaucracy that is part of American health care and how they get all the money so the doctors don't.
I don't know if the author is just a one trick pony or there are more subjects to complain about up the road. But I've had enough.
Sandeep Jauhar MD PhD talks of the enormous debt from school, but he had years of school to attain his PhD in Physics before switching to medicine. He is currently director of the Heart Failure Program at Long Island Jewish Medical Center in New York . According to Becker's Hospital Review) in 2012, he would have been earning a minimum of $500K a year, probably much more as he's a director not just a physician. Poor man. Set up a Go Fund Me page or something.
I wasn't paid for my time, I'll never get that hour back and I paid the author for the book. Result: I am seriously disillusioned not about American medicine, but with the author himself.
December 27, 2022
Reading books by the same author communicates in action, and it’s something not requiring explanation. Sandeep Jauhar is human, and we learn first-hand about private practice and how “lovey dovey” (is the norm) in “Doctored: The Disillusionment of an American Physician.” Caring for the patient requires some extreme interventions.
Many physicians' use the “Halloween Voice” or the word “Cancer” despite---no indication of its presence---to scare one into health. Does this really work? When did going “Halloween” ever work on anyone not classified as a caveman/woman? Referring to physicians as knaves/swords is hilarious as his self-deprecating rants that ooze “pus.”
“Success is judged not by the position you reach in life but by the obstacles you have overcome...Callahan got up and wrote: extend life, prevent suffering, yes...hasten death, no...”
---Sandeep Jauhar, MD
Dr. Jauhar strongly voices frustrations with our medical system. Doctor bashing takes the spotlight in this book. Jauhars’ angst is a common chronic diarrheal theme. Throughout we can picture a cartoon of this sensational Cardiologist’ face being illustrated and artist pens “Stooge” instead of Sandeep.
"Doctored: The Disillusionment of an American Physician” is a despotic listen on Audible. The intonations bring respiration to his family characters. Sadly, this famous Cardiologist gets fired for not bringing in enough money to the private practice that welcomed him after being vetted by family. Read, laugh and share.
Many physicians' use the “Halloween Voice” or the word “Cancer” despite---no indication of its presence---to scare one into health. Does this really work? When did going “Halloween” ever work on anyone not classified as a caveman/woman? Referring to physicians as knaves/swords is hilarious as his self-deprecating rants that ooze “pus.”
“Success is judged not by the position you reach in life but by the obstacles you have overcome...Callahan got up and wrote: extend life, prevent suffering, yes...hasten death, no...”
---Sandeep Jauhar, MD
Dr. Jauhar strongly voices frustrations with our medical system. Doctor bashing takes the spotlight in this book. Jauhars’ angst is a common chronic diarrheal theme. Throughout we can picture a cartoon of this sensational Cardiologist’ face being illustrated and artist pens “Stooge” instead of Sandeep.
"Doctored: The Disillusionment of an American Physician” is a despotic listen on Audible. The intonations bring respiration to his family characters. Sadly, this famous Cardiologist gets fired for not bringing in enough money to the private practice that welcomed him after being vetted by family. Read, laugh and share.
This entire review has been hidden because of spoilers.
August 31, 2014
I usually love medical memoirs and he certainly raises some important issues (overtesting, overcharging, extending the end of life past the point of sanity), but the author is, excuse me, a whiny little bitch. He and his wife (also a doctor!) simply cannot make ends meet, and a huge chunk of the book revolves around his efforts to make extra $$$ by pimping himself out to pharma companies, shady clinics, etc. He also laments the good old days, when patients treated doctors like gods. Now all they do is complain! Also, they're too fat and kind of disgusting and don't listen to him.
I figure these are common grievances among doctors, but after the first 100 pages I was in a medically induced coma, and by medically induced I mean Tanqueray.
I figure these are common grievances among doctors, but after the first 100 pages I was in a medically induced coma, and by medically induced I mean Tanqueray.
January 20, 2016
This book could not end soon enough. It was an easy read (250 pages total and it was easy to read 50-60 pages in one sitting), but pretty dry. His major complaints are that nowadays, working in a hospital results in too much pressure to give unnecessary tests to get insurance money and that doctors are seriously underpaid and under-respected.
He spends a lot of time discussing his various forays into "moonlighting," or getting a second part-time job to cover the expenses of his Manhattan apartment, two children, private school, and auto expenses. I rolled my eyes at this plenty of times. You don't have enough money? Step 1. Move out of the most expensive part of the most expensive city in the nation. His hospital was 22 miles outside of Manhattan.... no reason to stay there other than the desire to live there, which should've been negated by the outrageous cost. Step 2. Put your children in public school. I promise it won't ruin them. Step 3. Make your wife get a job. He said they were $2,000 short every month. Another doctor's income would easily surpass $2,000 a month!
Overall, the book would've been super interesting if it were written by a passionate, interested doctor. Instead, Sandeep Jauhar complained endlessly about problems that were completely self-created.
He spends a lot of time discussing his various forays into "moonlighting," or getting a second part-time job to cover the expenses of his Manhattan apartment, two children, private school, and auto expenses. I rolled my eyes at this plenty of times. You don't have enough money? Step 1. Move out of the most expensive part of the most expensive city in the nation. His hospital was 22 miles outside of Manhattan.... no reason to stay there other than the desire to live there, which should've been negated by the outrageous cost. Step 2. Put your children in public school. I promise it won't ruin them. Step 3. Make your wife get a job. He said they were $2,000 short every month. Another doctor's income would easily surpass $2,000 a month!
Overall, the book would've been super interesting if it were written by a passionate, interested doctor. Instead, Sandeep Jauhar complained endlessly about problems that were completely self-created.
December 8, 2014
This book helped me understand why U.S. health care is so mismanaged. It portrays a system where doctors have become cogs in a corporate culture of overtesting and other abuses. I appreciated the author's attempts to practice medicine with integrity, but it appears that is extremely difficult under the current system. Although the author makes no mention of this, it makes wish we had a single payer national system like Canada, England, France and other countries. They consistently have better health outcomes and spend less money. For more information on the benefits of a single payer system, see http://www.pnhp.org/facts/single-paye...
July 22, 2015
Don’t bother reading this. Instead, listen to this NPR interview (where I heard about the book) and call it a day. The book is mostly an exhaustive exercise in narcissism and whining, with Jauhar waxing poetic about financial ruin and family drama over and over again. I don’t want to dismiss his difficulties with a wave of the hand, but his tone in this book makes it hard for us to really care about them.
January 26, 2015
I was very eager to read DOCTORED and truly wanted to like it. However, the book has severe structural problems. It's possible to write a book about healthcare that is both educational and entertaining--a combination of general fact and personal narrative--and Atul Gawande's BEING MORTAL: MEDICINE AND WHAT MATTERS IN THE END is a great example of such a feat.
DOCTORED, however, ricochets back and forth between dry passages devoted to the current problems plaguing health care (which seem like material recycled from editorials already published by the author) and highly personal stories that ultimately leave a bad taste in the reader's mouth.
I appreciate honesty in memoir. However, the author needs to properly process those feelings and put them into perspective for the reader, otherwise such material will come off as self-serving and (in this case) whiny. I thought the author had a great opportunity to explore, with sensitivity, his own depression, his failed relationship with his demanding father, his jealousy of his favored older brother, and his difficulties with his fellow-doctor wife. Yet Dr. Jauhar's portrayal of himself--as well as his family members--is full of bitterness. It is difficult to sympathize with his financial problems, which easily could have been solved had he and his wife lived within their means or made lifestyle changes that all Americans--many physicians included--must make.
I also found the author's habit of referring to patients and fellow professionals by their ethnicity and/or race clumsy and off-putting. Maybe the author wanted to give the reader the sense that he worked in an urban environment surrounded by people from a wide variety of backgrounds. Fine. But there is no need to refer to someone repeatedly as "an Italian doctor" after you have given his clearly-Italian surname, no need to point out that this patient is black, that doctor is Jewish, this nurse is Filipina, etc., unless his/her race or ethnicity plays a role in the story.
I think the true disappointment of DOCTORED is that many people will pick it up and think all physicians act and think like this. Thankfully there are a host of other narratives written by MDs that aptly prove that this is not the case.
DOCTORED, however, ricochets back and forth between dry passages devoted to the current problems plaguing health care (which seem like material recycled from editorials already published by the author) and highly personal stories that ultimately leave a bad taste in the reader's mouth.
I appreciate honesty in memoir. However, the author needs to properly process those feelings and put them into perspective for the reader, otherwise such material will come off as self-serving and (in this case) whiny. I thought the author had a great opportunity to explore, with sensitivity, his own depression, his failed relationship with his demanding father, his jealousy of his favored older brother, and his difficulties with his fellow-doctor wife. Yet Dr. Jauhar's portrayal of himself--as well as his family members--is full of bitterness. It is difficult to sympathize with his financial problems, which easily could have been solved had he and his wife lived within their means or made lifestyle changes that all Americans--many physicians included--must make.
I also found the author's habit of referring to patients and fellow professionals by their ethnicity and/or race clumsy and off-putting. Maybe the author wanted to give the reader the sense that he worked in an urban environment surrounded by people from a wide variety of backgrounds. Fine. But there is no need to refer to someone repeatedly as "an Italian doctor" after you have given his clearly-Italian surname, no need to point out that this patient is black, that doctor is Jewish, this nurse is Filipina, etc., unless his/her race or ethnicity plays a role in the story.
I think the true disappointment of DOCTORED is that many people will pick it up and think all physicians act and think like this. Thankfully there are a host of other narratives written by MDs that aptly prove that this is not the case.
January 5, 2017
Swinging by the 092s at Pasadena Central, this leapt out. I've read several wonderful books about the grueling lives of doctors, and I picked this up.
Well written, honest, clear, analytical, he sees the dysfunction within himself and the medical field, and he comes to see resolutions.
I'm not sure I was aware of such pressure.
I have read many accounts of residents and interns, and also, I have heart issues. I found this book enlightening.
We are going through radical transformations on all levels of society, and Jauhar has the courage to dig deeply and honestly within his field. It has heartening to witness his level of compassion and care towards his patients.
Readers should find themselves quite absorbed in his stories!
Well written, honest, clear, analytical, he sees the dysfunction within himself and the medical field, and he comes to see resolutions.
I'm not sure I was aware of such pressure.
I have read many accounts of residents and interns, and also, I have heart issues. I found this book enlightening.
We are going through radical transformations on all levels of society, and Jauhar has the courage to dig deeply and honestly within his field. It has heartening to witness his level of compassion and care towards his patients.
Readers should find themselves quite absorbed in his stories!
March 14, 2024
This made me very, very glad I no longer work in healthcare. Most doctors I worked with were great but this reminded me of the ones who weren’t.
I enjoyed Jauhar’s first book Intern back in the day and thought it was high time to try his next book. Unfortunately, it wasn’t what I was hoping for. I’m not sure who the intended audience was: other doctors? Insurance company providers? Certainly not patients??
Doctors deserve to have safe places where they can commiserate about the ups and downs of their field. In that sense, I commend Dr. Jauhar for his vulnerability here. At the same time, I can’t help but wonder what his colleagues and patients made of it. He didn’t seem to actually enjoy his work, even aside from the frustrating aspects that accompany any career. His greater focus is on how he can make more money, without recognizing he and his wife chose to live in a more expensive neighborhood in an expensive city and pay for private school for their kid, all while his wife wasn’t working. If you work at a city hospital, there are going to be trade offs, including a lower salary compared to private practice doctors (which he’s adamant about not wanting to do). He tries moonlighting for a doctor and giving talks for a pharmaceutical company, both of which are ethically dubious.
I did not know what to make of the complaining and entitlement—particularly when I think about how little I made as a medical social worker compared to my doctor colleagues—which took away from the very real issues he was raising in terms of redundant insurance requirements and how doctors over-order tests or take advantage of the system. I wish there had more of a focus on the latter and that he would have proposed some solutions. Not everything applies anymore given how long ago this was published but our healthcare system still has much farther to go.
Content notes: patient death, cancer, substance abuse (patient), alcoholism (patient), ableism, depression, discussion of suicide rates, mental illness stigma (author’s father), past physical abuse by author’s father, medical malpractice and fraud, author is a cardiologist specializing in Congestive Heart Failure, racism, Islamaphobia, Romani slur (quote from poem), homophobia and homophobic slur (by patient), insomnia, anti-fat bias, diet culture, classism, pregnancy after fertility issues (author’s wife), pregnancy complications and C-section (author’s wife), animal experimentation and death, past death of author’s grandfathers (heart attack), author’s family immigrated from India to the US when he was 8, alcohol, inebriation, recreational drug use, gendered pejorative, gender essentialism, ableist language, compares US healthcare to a “gang bang”
I enjoyed Jauhar’s first book Intern back in the day and thought it was high time to try his next book. Unfortunately, it wasn’t what I was hoping for. I’m not sure who the intended audience was: other doctors? Insurance company providers? Certainly not patients??
Doctors deserve to have safe places where they can commiserate about the ups and downs of their field. In that sense, I commend Dr. Jauhar for his vulnerability here. At the same time, I can’t help but wonder what his colleagues and patients made of it. He didn’t seem to actually enjoy his work, even aside from the frustrating aspects that accompany any career. His greater focus is on how he can make more money, without recognizing he and his wife chose to live in a more expensive neighborhood in an expensive city and pay for private school for their kid, all while his wife wasn’t working. If you work at a city hospital, there are going to be trade offs, including a lower salary compared to private practice doctors (which he’s adamant about not wanting to do). He tries moonlighting for a doctor and giving talks for a pharmaceutical company, both of which are ethically dubious.
I did not know what to make of the complaining and entitlement—particularly when I think about how little I made as a medical social worker compared to my doctor colleagues—which took away from the very real issues he was raising in terms of redundant insurance requirements and how doctors over-order tests or take advantage of the system. I wish there had more of a focus on the latter and that he would have proposed some solutions. Not everything applies anymore given how long ago this was published but our healthcare system still has much farther to go.
Content notes: patient death, cancer, substance abuse (patient), alcoholism (patient), ableism, depression, discussion of suicide rates, mental illness stigma (author’s father), past physical abuse by author’s father, medical malpractice and fraud, author is a cardiologist specializing in Congestive Heart Failure, racism, Islamaphobia, Romani slur (quote from poem), homophobia and homophobic slur (by patient), insomnia, anti-fat bias, diet culture, classism, pregnancy after fertility issues (author’s wife), pregnancy complications and C-section (author’s wife), animal experimentation and death, past death of author’s grandfathers (heart attack), author’s family immigrated from India to the US when he was 8, alcohol, inebriation, recreational drug use, gendered pejorative, gender essentialism, ableist language, compares US healthcare to a “gang bang”
June 27, 2015
Well written, and he makes some good points. I tend to distrust the amounts of tests and procedures doctors want to do, and there's plenty of information here about how and why all the unnecessary stuff happens--profits and paychecks, of course.
The author has an odd affect. He's extremely self-involved, in a way that incorporates self-loathing. He lacks the social skills for schmoozing, and that costs him professionally and financially. He's not without compassion, but doesn't seem to understand how, when he cuts corners by being late, etc., it means that other people have to pick up the slack. In his previous book, I wondered if he understood that and wrote about it with feelings of shame. But if he was ashamed, it didn't help him to change his ways, as he was still doing it in this book. Plus, his articles for the New York Times and his two books are critical (at both institutional and personal levels) of his employers and colleagues. And he wonders why he gets into trouble.
My guess is that he's a good doctor, does the best he can for his patients, and is trying to improve the system. But he doesn't come across as likable, and is critical of himself, and this makes the book a less enjoyable read than it could have been.
The author has an odd affect. He's extremely self-involved, in a way that incorporates self-loathing. He lacks the social skills for schmoozing, and that costs him professionally and financially. He's not without compassion, but doesn't seem to understand how, when he cuts corners by being late, etc., it means that other people have to pick up the slack. In his previous book, I wondered if he understood that and wrote about it with feelings of shame. But if he was ashamed, it didn't help him to change his ways, as he was still doing it in this book. Plus, his articles for the New York Times and his two books are critical (at both institutional and personal levels) of his employers and colleagues. And he wonders why he gets into trouble.
My guess is that he's a good doctor, does the best he can for his patients, and is trying to improve the system. But he doesn't come across as likable, and is critical of himself, and this makes the book a less enjoyable read than it could have been.
December 24, 2020
I generally like memoirs about the medical profession. This book was the most interesting when the author is talking about his patients and cases that he has encountered. When he talks about his personal life it seems like it is a lot of complaining, but I suppose that is to be expected when the word 'disillusionment' is in the title. I hope in the years since this book was written that the author has found something that gives him happiness, but we all know the red tape associated with medicine has not gotten better so if he is still in the medical profession I doubt he has found his happiness.
August 27, 2014
This book was very interesting to me because the author is so honest. You really get inside the mind of a physician, and that leads to a unique insight into the mess of the health care system in this country. I think doctors are still viewed with great respect in the USA, but he does portray many of them as really money-grubbing. I guess any profession has those who practice with integrity and those who are less than high-minded. The book is well-written and thought-provoking. I marked a number of passages that made me pause. Here is one:
"...Among my colleagues I see an emotional emptiness created by the relentless consideration of money. Most of us went into medicine for intellectual stimulation or the desire to develop relationships with patients, not to maximize income. There is a palpable sense of grieving. The job for many has become just that---a job." (p. 170)
The author's characterizations of his patients, colleagues, and family members is very artfully done. You feel as though you have, yourself, somehow donned that white coat and are making the rounds---something which speaks to the skill of the writer. I really felt his anguish at the many directions in which he was pulled: adding more and more hours to his schedule in order to afford living in such an expensive city (New York City), all the while being dragged away from spending time with his young son, whom he obviously adores.
The next time I need a doctor, I will certainly be looking at that person in a new light after reading this book.
"...Among my colleagues I see an emotional emptiness created by the relentless consideration of money. Most of us went into medicine for intellectual stimulation or the desire to develop relationships with patients, not to maximize income. There is a palpable sense of grieving. The job for many has become just that---a job." (p. 170)
The author's characterizations of his patients, colleagues, and family members is very artfully done. You feel as though you have, yourself, somehow donned that white coat and are making the rounds---something which speaks to the skill of the writer. I really felt his anguish at the many directions in which he was pulled: adding more and more hours to his schedule in order to afford living in such an expensive city (New York City), all the while being dragged away from spending time with his young son, whom he obviously adores.
The next time I need a doctor, I will certainly be looking at that person in a new light after reading this book.
November 2, 2014
This was a decidedly underwhelming book, and though it purports to be both about the crisis in American medicine and a crisis in one doctor's life, it is much more about the latter than the former. Jauhar has a handful of interesting observations about the evolving fortunes of doctors over time, but primarily repeats points that have been widely cited in policy debates about the subject. Much of the book is devoted to his dispiriting experiences "moonlighting" to earn extra income. While he argues this is because the salaries of academic physicians are not high enough, the average reader probably will not sympathize with the fact that a physician living in Manhattan, seeking to own two cars and send his children to private school, doesn't earn enough to meet these objectives. Given that the problem does not seem very serious, it's hard to take his unhappiness at moonlighting very seriously either. Ultimately, it's not clear Jauhar has much to share that is of more general interest.
September 28, 2014
Parts of this man's story are sympathetic - but he comes across as a spoiled chiled who wants medical care to magically be free and available - denying that all medical goods and services are the product of someone's labor. He hates private practice precisely because doctor's in private practice have to consider costs and profit and money. the few private practice docs he describes do have some questionable to disposable traits -- but then the author generalizes from these men to ALL of private practice.
Someone who hates the fact that healthcare does not grow on trees and so misunderstands the role of profits and free enterprise is bound to be miserable and disillusioned when faced with the reality of life..
Someone who hates the fact that healthcare does not grow on trees and so misunderstands the role of profits and free enterprise is bound to be miserable and disillusioned when faced with the reality of life..
August 26, 2014
I really appreciate the honesty and vulnerability that this book is built on. As much as some things are disheartening, there is hope. And where there is hope, there is room for change.
July 6, 2018
This is an essay recounting the author’s experience of being a cardiologist in a New York City hospital. It is primarily negative, discussing various problems in the healthcare system.
1. The most important complaint is that insurance companies and government regulations interfere with the doctor’s professional practices. They force doctors to save cost through various measures, many of them ended up costing more and producing poorer results. They also cut doctors’ pay, forcing doctors to spend less time with the patients or find other ways to game the system.
2. Some doctors, especially those in private practices, do not put the patients’ interest first. They overprescribe tests and treatment for financial gains. They cater to the interests and desires of their referral network despite their professional judgments on the contrary.
3. Doctors face difficult decisions in life and death and in various tradeoffs, primarily the tradeoff between prolonging life and life quality. Such day to day decisions causes much stress to the doctors and their families.
The book tells a lot of negative stories. However, it does not seem to advocate a particular solution. The author complains about external factors (insurance, regulations, hospital management) interfering with doctor’s work. It seems that the author would desire a system where the doctors follow their good hearts and infinite wisdom. However, such an idea may not fit well with American’s value of check and balance.
Perhaps the primary lesson from the book is that the current check and balance system does not work well. We need to find a better one. Maybe we can learn from the peer review system in academics?
1. The most important complaint is that insurance companies and government regulations interfere with the doctor’s professional practices. They force doctors to save cost through various measures, many of them ended up costing more and producing poorer results. They also cut doctors’ pay, forcing doctors to spend less time with the patients or find other ways to game the system.
2. Some doctors, especially those in private practices, do not put the patients’ interest first. They overprescribe tests and treatment for financial gains. They cater to the interests and desires of their referral network despite their professional judgments on the contrary.
3. Doctors face difficult decisions in life and death and in various tradeoffs, primarily the tradeoff between prolonging life and life quality. Such day to day decisions causes much stress to the doctors and their families.
The book tells a lot of negative stories. However, it does not seem to advocate a particular solution. The author complains about external factors (insurance, regulations, hospital management) interfering with doctor’s work. It seems that the author would desire a system where the doctors follow their good hearts and infinite wisdom. However, such an idea may not fit well with American’s value of check and balance.
Perhaps the primary lesson from the book is that the current check and balance system does not work well. We need to find a better one. Maybe we can learn from the peer review system in academics?
August 31, 2017
This book was highly disappointing. I should have trusted the reviews first. I loved Intern and often recommend it as one my favorite non-fiction books. The author changed from Intern. He is more arrogant and less reflective. In Intern, he recognized he was learning and owned up to his mistakes. In Doctored, his true colors come true. He's upset because Doctors don't receive the revered status they once had. Dr. Jauhar should know that self-worth comes from within not from external factors. I'm sorry but it's hard to feel bad for someone who lives in Manhattan and then Sea Cliff. Instead of "playing the game" to provide for his family he acts all haughty until he finds some out like he did with the pharmaceutical company. I liked the positive relationship he had with his son. But, other then that this author did not come across well in his book. I rushed to finish it because it became dry and repetitive. It's the exact opposite of Intern which I found fascinating and exciting.
April 10, 2019
Six years after publishing his first book, INTERN: A Doctor's Initiation, Dr. Sanderp Jauhar has published this book about his disillusionment with the practice of medicine. It is a totally honest revelation of the inherent problems, failures and frustrations thst today's physicisns face on a daily basis.
Many of the revelations show the shocking waste of money by unnecessary tests, the necessary overcharging because of insurance company restrictions and the lack of time each doctor can spend examining and taking patient histories due to the pressures necessary to see the largest number of patients to make private practice even break even financially.
Dr. Jauhar holds little back in his critique of our present system of patient care and reading his book is a revelation.
Many of the revelations show the shocking waste of money by unnecessary tests, the necessary overcharging because of insurance company restrictions and the lack of time each doctor can spend examining and taking patient histories due to the pressures necessary to see the largest number of patients to make private practice even break even financially.
Dr. Jauhar holds little back in his critique of our present system of patient care and reading his book is a revelation.
August 13, 2017
I read some negative reviews before I read this book, so didn't expect to like it, but I actually thought it was an incredibly insightful, and at times disturbing, look at the current American medical system. Jauhar spares no one, including himself. People say he "whines" a lot about not making enough money. Well, if I had been in medical training for 7-8 years, and was a highly acclaimed specialist, and still couldn't pay my bills, I'd complain too. I'd say this book is a cautionary tale for anyone interested in taking the MD path, and 100% worthwhile to read for anyone interested in the American healthcare system.
December 8, 2019
Review of Doctored: The Disillusionment of an American Physician by Sandeep Jauhar, MD, PhD.
Being a Physician in America today is very different than it was in 1950’s, 1970’s or even 2000’s. The structure of healthcare has drastically changed. The physician’s role and the physician’s role within a healthcare system has evolved from know all and be all to part of a cohesive healthcare team.
Sandeep Jauhar MD, PhD, the director of the heart failure program and writer for the New York Times shares his frustrations as a practicing physician, the physician role in a healthcare system, and the healthcare system in its entirety, in his book “Doctored”, a descriptive look at the difficulties as a physician in today healthcare system. Dr. Jauhar first book “Intern: A Doctor's Initiation”, written 10 years after completing his internship, and shared his disillusion with the educational system and the treated of trainees entering the medical profession.
There are clear reasons for physicians today to be disillusioned. Physicians work for seven years to earn the title and degree of Doctor, while other professions can earn the title with as little 1500 hours of training.
The role of the physician has evolved. The physicians are no longer the “owners” of medical knowledge. They are now part of Interprofessional healthcare teams, where physicians may not have the authority to make healthcare decisions. NP and PA are further providing more medical services and are competing for same patient bases. Today’s patients are more knowledgeable, and more active in their treatment plans. They expect to be part of their healthcare team and make the final choices.
Healthcare Administration has grown exponential. New managers and administrators who have never held decision-making positions now work side-by-side with physicians. Insurance companies are restructuring payments systems and integrating into all aspects of patient care. All practices of healthcare and the business of healthcare are changing and will continue to change.
It is not surprising that physicians, the best trained, most complete, and most powerful of the healthcare professionals bemoan the continual changes. As king of the mountain it is hard to share the peak with others, who have not in the king’s eyes worked as hard to obtain the same footing.
In reading, Dr Jauhar’s book, his disillusion spans the physician role, how work affects his family life, and the choices he is forced to make. Dr Jauhar chooses to be an academic physician, a role that provides more satisfaction [for him] than as a straightforward patient care provider. This choice provides him the ability to bond with new physicians, though the book scarcely mentions any trainee interaction. It also is interesting that Dr. Jauhar has made choices that should provide a rewarding and team oriented existence,
The book is very much an individual presentation of one person’s feelings and experiences. For a broader view of how change is affecting the daily life in healthcare it needed stories or viewpoint from new physicians. In the acknowledgements at the end of the book, the chief resident who worked with Dr. Jauhur is thanked for providing the time for Dr. Jauhar to work on the individual book project, an old role that misses the power of many of the changes in healthcare, and I wondered about the viewpoint of the newbies entering medicine.
The focus is on the negative and does not provides a full picture. The problems of the healthcare system only become evident when his wife is the patient. The lack of autonomy she experiences opens his eyes to issues, but ones he does not look beyond his own experience to solve. To Dr. Juapar, changes are disorienting. He laments the change in required work hours, in the moonlighting jobs that focus on money and exist on the borderlines of medicine and business. At the same time he regrets new oversights in place that limits the activity he says is going on and should not be.
The book is worthwhile reading, about the bad in medicine. I would caution readers from outside the world of medicine that they are not getting the full view of healthcare and its systems. The book provides only a limited view of healthcare and lacks an appreciation for the change that is occurring and where physicians will fit in the new system being developed. It further lacks a history of Dr. Jauhar’s professional life, or of the systems beyond his practice. Medicine is more that what occurs in a hospital or heart failure program.
The book is clear on why change is needed and why change is painful. The systems referred to in the book are different now than they were five years ago, and will be even more different five years in the future. Change is and will be difficult for physicians and other health professionals.
Being a Physician in America today is very different than it was in 1950’s, 1970’s or even 2000’s. The structure of healthcare has drastically changed. The physician’s role and the physician’s role within a healthcare system has evolved from know all and be all to part of a cohesive healthcare team.
Sandeep Jauhar MD, PhD, the director of the heart failure program and writer for the New York Times shares his frustrations as a practicing physician, the physician role in a healthcare system, and the healthcare system in its entirety, in his book “Doctored”, a descriptive look at the difficulties as a physician in today healthcare system. Dr. Jauhar first book “Intern: A Doctor's Initiation”, written 10 years after completing his internship, and shared his disillusion with the educational system and the treated of trainees entering the medical profession.
There are clear reasons for physicians today to be disillusioned. Physicians work for seven years to earn the title and degree of Doctor, while other professions can earn the title with as little 1500 hours of training.
The role of the physician has evolved. The physicians are no longer the “owners” of medical knowledge. They are now part of Interprofessional healthcare teams, where physicians may not have the authority to make healthcare decisions. NP and PA are further providing more medical services and are competing for same patient bases. Today’s patients are more knowledgeable, and more active in their treatment plans. They expect to be part of their healthcare team and make the final choices.
Healthcare Administration has grown exponential. New managers and administrators who have never held decision-making positions now work side-by-side with physicians. Insurance companies are restructuring payments systems and integrating into all aspects of patient care. All practices of healthcare and the business of healthcare are changing and will continue to change.
It is not surprising that physicians, the best trained, most complete, and most powerful of the healthcare professionals bemoan the continual changes. As king of the mountain it is hard to share the peak with others, who have not in the king’s eyes worked as hard to obtain the same footing.
In reading, Dr Jauhar’s book, his disillusion spans the physician role, how work affects his family life, and the choices he is forced to make. Dr Jauhar chooses to be an academic physician, a role that provides more satisfaction [for him] than as a straightforward patient care provider. This choice provides him the ability to bond with new physicians, though the book scarcely mentions any trainee interaction. It also is interesting that Dr. Jauhar has made choices that should provide a rewarding and team oriented existence,
The book is very much an individual presentation of one person’s feelings and experiences. For a broader view of how change is affecting the daily life in healthcare it needed stories or viewpoint from new physicians. In the acknowledgements at the end of the book, the chief resident who worked with Dr. Jauhur is thanked for providing the time for Dr. Jauhar to work on the individual book project, an old role that misses the power of many of the changes in healthcare, and I wondered about the viewpoint of the newbies entering medicine.
The focus is on the negative and does not provides a full picture. The problems of the healthcare system only become evident when his wife is the patient. The lack of autonomy she experiences opens his eyes to issues, but ones he does not look beyond his own experience to solve. To Dr. Juapar, changes are disorienting. He laments the change in required work hours, in the moonlighting jobs that focus on money and exist on the borderlines of medicine and business. At the same time he regrets new oversights in place that limits the activity he says is going on and should not be.
The book is worthwhile reading, about the bad in medicine. I would caution readers from outside the world of medicine that they are not getting the full view of healthcare and its systems. The book provides only a limited view of healthcare and lacks an appreciation for the change that is occurring and where physicians will fit in the new system being developed. It further lacks a history of Dr. Jauhar’s professional life, or of the systems beyond his practice. Medicine is more that what occurs in a hospital or heart failure program.
The book is clear on why change is needed and why change is painful. The systems referred to in the book are different now than they were five years ago, and will be even more different five years in the future. Change is and will be difficult for physicians and other health professionals.
July 19, 2025
Cardiologist who hates what he does, hates his patients, shows up late to work, becomes a corrupted part time private practice doc, has a kid, complains that he doesn’t have money for said kid and UWS apartment, has another kid, tries to become more corrupt, moves to a big house in Long Island funded by his FIL. Writing is also trash. Read this if you want more reasons to hate him and the cardiology private practice model.
December 19, 2023
I usually like medical memoirs. There were parts that I enjoyed. But overall it felt trite and boring. Lots of petulant complaining. Which I could forgive as someone who also works in healthcare but the whole book was whiny and just really fell flat
May 14, 2015
I can imagine readers not in the medical field will have mixed reactions about this book. It might be hard to empathize with a physician who earns six figures a year constantly worrying about how to afford to live in NY City and comparatively judging his worth on trying to earn an income based on what he and his colleagues feel they need to sustain their lifestyles. And although on its surface it does seem somewhat petulant of a physician who feels entitled to earn more than what he is making and constantly bringing such a monetary focus into the book's narrative, paradoxically he earns a modicum of respect by bringing such earthy, less noble concerns about what it's like to practice medicine in an era of increasing cost control. His personal faults remind us that physicians are just like the patients they treat: sometimes noble, occasionally petty, and sometimes enlightened. And yet, this theme would miss the other important themes that Jauhar elucidates.
He is quick to cast aspersions on his fellow physicians who in an attempt to maintain their incomes, order tests that are not in the best interests of their patients. However, based on the highly fragmented, piecemeal way medical care is delivered in the US, you can empathize with his frustration as to why its so hard to provide comprehensive quality care for patients. He immediately won me over when he recognizes the importance of health literacy as it relates to health care outcomes. We constantly obsess over technology in the delivery of care that we gloss over assumptions that were published over a decade ago that estimate that better medical care only contributes to approximately 15% of the impact on population health outcomes. The higher contribution to health? Social determinants of health. Aspects such as behavior, education, social support systems, etc., are such incredible contributors to optimal health care outcomes that its incredible that we are so blinded by this fact and continue to focus on technology-- "smart" medicines that can determine what percentage of the time they are taken, genetic-based testing and treatment,etc. I am running a health literacy program as a physician in Columbus, Ohio and we are going into patients' homes an hour a week for 4 weeks to educate them about their illness, medications, how to problem solve, perform motivational interviewing and other interventions that enlist patients to take control over their health care. So far, after 10 months, we have seen a relative 50% decline in 30 day hospital readmissions. My anecdotes are similar to Jauhar's on the incredible people whom we are graced to care for (and he relays a poignant story about a home visit he conducts) and it's in this revelation that by doing the right thing he finally lets go of the dream of balancing his money concerns with a move to the suburbs and more importantly gives the reader a sense that in middle age he has learned to let some things go and focus more on things he can control. This hard won epiphany also reminds us physicians are not pawns in the health care delivery system. There are opportunities to innovate, have some semblance of autonomy over how we comport to our medical ideals, and most of all, validate the choice that thousands of individuals make each year when they enter the medical profession-- they will do well by doing well for others. I thank Jauhar for his insights and his genuinely well-written narrative about the practice of medicine in the 21st century.
He is quick to cast aspersions on his fellow physicians who in an attempt to maintain their incomes, order tests that are not in the best interests of their patients. However, based on the highly fragmented, piecemeal way medical care is delivered in the US, you can empathize with his frustration as to why its so hard to provide comprehensive quality care for patients. He immediately won me over when he recognizes the importance of health literacy as it relates to health care outcomes. We constantly obsess over technology in the delivery of care that we gloss over assumptions that were published over a decade ago that estimate that better medical care only contributes to approximately 15% of the impact on population health outcomes. The higher contribution to health? Social determinants of health. Aspects such as behavior, education, social support systems, etc., are such incredible contributors to optimal health care outcomes that its incredible that we are so blinded by this fact and continue to focus on technology-- "smart" medicines that can determine what percentage of the time they are taken, genetic-based testing and treatment,etc. I am running a health literacy program as a physician in Columbus, Ohio and we are going into patients' homes an hour a week for 4 weeks to educate them about their illness, medications, how to problem solve, perform motivational interviewing and other interventions that enlist patients to take control over their health care. So far, after 10 months, we have seen a relative 50% decline in 30 day hospital readmissions. My anecdotes are similar to Jauhar's on the incredible people whom we are graced to care for (and he relays a poignant story about a home visit he conducts) and it's in this revelation that by doing the right thing he finally lets go of the dream of balancing his money concerns with a move to the suburbs and more importantly gives the reader a sense that in middle age he has learned to let some things go and focus more on things he can control. This hard won epiphany also reminds us physicians are not pawns in the health care delivery system. There are opportunities to innovate, have some semblance of autonomy over how we comport to our medical ideals, and most of all, validate the choice that thousands of individuals make each year when they enter the medical profession-- they will do well by doing well for others. I thank Jauhar for his insights and his genuinely well-written narrative about the practice of medicine in the 21st century.
October 30, 2018
2.5 stars
There is a bit of good in this book. Jauhar attempts to point out what's ailing the current system of medical care. (For example, unnecessary testing/procedures because that's how doctors make their money, lack of communication between specialist doctors, the frantic pace that causes patients to be treated poorly/improperly, etc.) I can agree with most of what he included on that subject.
However, Jauhar also does a lot of whining about how doctors don't get paid enough. He states they are making half of what they used to before "managed care." Possibly true, but does that really mean they're not making enough? He laments how he and his wife are struggling just to get by... but then mentions that his wife, also a doctor, is not working. And his 3-year-old is in a private nursery school because the local public schools are oh-so-bad. And his 3-year-old is in soccer. And then they have another baby and their 2-bedroom apartment is just way too small for them and their 2 very young children. So they have to move to a 3-bedroom house that they can only afford with help from his father-in-law. Cable TV was listed as a necessary expense. Blah, blah, blah.
He's apparently never known what it's like to truly struggle financially, and it's always ingratiating to hear someone claim to be an "every man" when they cannot even comprehend what that encompasses.
In addition to this, his writing style annoyed me a little. It felt too "written." And he kept using the word cranium when talking about holding his son's head in his hands. I could understand using the word in an actual medical/scientific setting, but to describe a moment between father and son? Really?
There is mention of recreational drugs being used (by Jauhar and friends) and a fair amount of language.
I appreciate that he included some stories that didn't always reflect well on him but I also sometimes got the sense that he was unaware of just how poorly they reflected - that his apparent humility here and there was completely by accident.
And finally, despite its short length, it still was a bit repetitive and could have been shorter.
There is a bit of good in this book. Jauhar attempts to point out what's ailing the current system of medical care. (For example, unnecessary testing/procedures because that's how doctors make their money, lack of communication between specialist doctors, the frantic pace that causes patients to be treated poorly/improperly, etc.) I can agree with most of what he included on that subject.
However, Jauhar also does a lot of whining about how doctors don't get paid enough. He states they are making half of what they used to before "managed care." Possibly true, but does that really mean they're not making enough? He laments how he and his wife are struggling just to get by... but then mentions that his wife, also a doctor, is not working. And his 3-year-old is in a private nursery school because the local public schools are oh-so-bad. And his 3-year-old is in soccer. And then they have another baby and their 2-bedroom apartment is just way too small for them and their 2 very young children. So they have to move to a 3-bedroom house that they can only afford with help from his father-in-law. Cable TV was listed as a necessary expense. Blah, blah, blah.
He's apparently never known what it's like to truly struggle financially, and it's always ingratiating to hear someone claim to be an "every man" when they cannot even comprehend what that encompasses.
In addition to this, his writing style annoyed me a little. It felt too "written." And he kept using the word cranium when talking about holding his son's head in his hands. I could understand using the word in an actual medical/scientific setting, but to describe a moment between father and son? Really?
There is mention of recreational drugs being used (by Jauhar and friends) and a fair amount of language.
I appreciate that he included some stories that didn't always reflect well on him but I also sometimes got the sense that he was unaware of just how poorly they reflected - that his apparent humility here and there was completely by accident.
And finally, despite its short length, it still was a bit repetitive and could have been shorter.
June 12, 2017
A very enlightening, very personal story explaining the business and insurance conflicts that doctors (both primary care and specialists) must deal with every day. You can't help but come away with the understanding that fixing the US health system is going to be really difficult, and will take a long time, most likely going through several painful iterations
July 17, 2021
So much fascinating info in this book. The constant comments about the nurses' attractiveness though? Not at all awesome.
...and the comment "The bedside is not the place to wage battles for social justice" was atrocious. I can't think of anywhere that should be exempt from social justice.
...and the comment "The bedside is not the place to wage battles for social justice" was atrocious. I can't think of anywhere that should be exempt from social justice.
July 22, 2017
A wonderful, thought-provoking, and bravely honest book. Recommended.
December 26, 2022
I read Intern way back when and recall liking it but this was awful. I mean, I read the whole thing, but it went nowhere and he comes off as a total whiner. I won’t read any more but this guy.
April 11, 2017
This was the true story of a cardiologist who had to do some unethical things to make ends meet. I found it to be a discouraging tale. One hopes that the system is now reformed in NYC area and doctors are not forced to order unnecessary tests etc. to survive.
I have to point out that I have been under the care of Rochester cardiologist for 60 years and I have never met a cardiologist that is like the one in this book. My doctors have been careful not to give me unnecessary tests and seem genuinely happy in their work.
I have to point out that I have been under the care of Rochester cardiologist for 60 years and I have never met a cardiologist that is like the one in this book. My doctors have been careful not to give me unnecessary tests and seem genuinely happy in their work.
December 27, 2014
This review originally appeared on my blog at www.gimmethatbook.com.
This was another book I picked up at the library for myself, and I was excited to see the author of Intern: A Doctor’s Initiation had written another book. This one is of a bit darker tone, as he talks about his struggle to keep focused and happy saving lives and battling insurance companies. The main focus of this book is money and cronyism: how much it costs for medical care, how much the doctors are getting paid, ways to circumvent insurance companies’ unwillingness to pay, and quid pro quo buddy systems where referrals are the goal.
Once again, as in other books written by doctors, this was pretty depressing. On page 11 Jauhar talks about how doctors are disillusioned:
In 2001, 58% of about 2000 physicians questioned said their enthusiasm for medicine had gone down in the previous five years, and 87% said their overall morale had declined during that time. More recent surveys have shown that 30 to 40% of practicing physicians would not choose to enter the medical profession if they were deciding on a career again, and an even higher percentage would not encourage their children to pursue a medical career.
There are many reasons for this disillusionment besides managed care. An unintended consequence of progress is that physicians increasingly say they have inadequate time to spend with patients. Medical advances have transformed once terminal diseases – cancer, AIDS, congestive heart failure – into complex chronic conditions that must be managed long term.
So. We have people living longer, restrictions placed on doctors by HMOs, pressure to make ends meet at home, and doctors being forced to produce referrals in order to maintain the old boy network. That could definitely make anyone disillusioned. What’s scary about this situation is that people’s lives are at stake here. All anyone wants is to be able to trust their physician, that he will do no harm.
Jauhar tells his story, warts and all: he is frustrated at not being able to practice his own medicine, without having to network. His marriage is straining due to lack of money. He seems to be suffering from depression that is untreated. Personally, I would not want to be in the hands of a doctor that was being pressured on so many fronts. But Jauhar perserveres, tries to practice good medicine, and attempts to play the game. He marvels at the circumstance of a man, admitted to the hospital because of shortness of breath. During his 30 day, $200,000 stay, he was seen by SEVENTEEN doctors and underwent TWELVE procedures. He was discharged with only “minimal improvement in his shortness of breath” and “follow ups…with SEVEN specialists“.
As the book proceeds further, Jauhar discusses taking away the financial incentive to over test patients, and make suggestions on how to fix our beleagured healthcare system. His arguments are sound, and probably could only happen in a perfect world. I urge you to read this book, only if it will help arm you against unscrupulous surgeons and the overreach of the billing department.
The only problem I have with the book is that I wasn’t sure if Jauhar wanted to make it a story about him, or a general story about our healthcare. He will start off a chapter with a patient’s story, then end up talking about how it affected him and how frustrated he was, then insert a dialogue he had with his young son. Then the next chapter will start off with personal thoughts and stories about how he was mentally checked out of his marriage, and suddenly mention a patient. There was also a long part about him trying to moonlight, but not billing enough, not seeing enough patients, and not playing the game–but instead of trying to fix things, he seems to go into a vapor lock (that could be the depression) and let things just swirl around him and get worse. He seemed to be very wishy washy here, and let his brother and father galvanize him into action by calling in favors and getting him money making opportunities. Nothing he did made him happy, and that whole middle section of the book was very depressing and drawn out. Eventually things get better at home for the author…..but our healthcare system stays broken.
This was a very illuminating read, and a good follow up to INTERN– we see how Jauhar grows as a doctor and becomes more self aware. DOCTORED is a great book for anyone who thinks all doctors are millionaires. Want your own copy? You can pick it up here.
This was another book I picked up at the library for myself, and I was excited to see the author of Intern: A Doctor’s Initiation had written another book. This one is of a bit darker tone, as he talks about his struggle to keep focused and happy saving lives and battling insurance companies. The main focus of this book is money and cronyism: how much it costs for medical care, how much the doctors are getting paid, ways to circumvent insurance companies’ unwillingness to pay, and quid pro quo buddy systems where referrals are the goal.
Once again, as in other books written by doctors, this was pretty depressing. On page 11 Jauhar talks about how doctors are disillusioned:
In 2001, 58% of about 2000 physicians questioned said their enthusiasm for medicine had gone down in the previous five years, and 87% said their overall morale had declined during that time. More recent surveys have shown that 30 to 40% of practicing physicians would not choose to enter the medical profession if they were deciding on a career again, and an even higher percentage would not encourage their children to pursue a medical career.
There are many reasons for this disillusionment besides managed care. An unintended consequence of progress is that physicians increasingly say they have inadequate time to spend with patients. Medical advances have transformed once terminal diseases – cancer, AIDS, congestive heart failure – into complex chronic conditions that must be managed long term.
So. We have people living longer, restrictions placed on doctors by HMOs, pressure to make ends meet at home, and doctors being forced to produce referrals in order to maintain the old boy network. That could definitely make anyone disillusioned. What’s scary about this situation is that people’s lives are at stake here. All anyone wants is to be able to trust their physician, that he will do no harm.
Jauhar tells his story, warts and all: he is frustrated at not being able to practice his own medicine, without having to network. His marriage is straining due to lack of money. He seems to be suffering from depression that is untreated. Personally, I would not want to be in the hands of a doctor that was being pressured on so many fronts. But Jauhar perserveres, tries to practice good medicine, and attempts to play the game. He marvels at the circumstance of a man, admitted to the hospital because of shortness of breath. During his 30 day, $200,000 stay, he was seen by SEVENTEEN doctors and underwent TWELVE procedures. He was discharged with only “minimal improvement in his shortness of breath” and “follow ups…with SEVEN specialists“.
As the book proceeds further, Jauhar discusses taking away the financial incentive to over test patients, and make suggestions on how to fix our beleagured healthcare system. His arguments are sound, and probably could only happen in a perfect world. I urge you to read this book, only if it will help arm you against unscrupulous surgeons and the overreach of the billing department.
The only problem I have with the book is that I wasn’t sure if Jauhar wanted to make it a story about him, or a general story about our healthcare. He will start off a chapter with a patient’s story, then end up talking about how it affected him and how frustrated he was, then insert a dialogue he had with his young son. Then the next chapter will start off with personal thoughts and stories about how he was mentally checked out of his marriage, and suddenly mention a patient. There was also a long part about him trying to moonlight, but not billing enough, not seeing enough patients, and not playing the game–but instead of trying to fix things, he seems to go into a vapor lock (that could be the depression) and let things just swirl around him and get worse. He seemed to be very wishy washy here, and let his brother and father galvanize him into action by calling in favors and getting him money making opportunities. Nothing he did made him happy, and that whole middle section of the book was very depressing and drawn out. Eventually things get better at home for the author…..but our healthcare system stays broken.
This was a very illuminating read, and a good follow up to INTERN– we see how Jauhar grows as a doctor and becomes more self aware. DOCTORED is a great book for anyone who thinks all doctors are millionaires. Want your own copy? You can pick it up here.
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