Dr. Leana Wen - When Doctors Dont Listen

Drs. Wen and Kosowsky have insightfully crafted a revelation about the workings of modern medicine. It addresses with a finely nuanced balance the basis for our dysfunctional cookbook style of medicine. The analysis is not a critical pontification by outsiders, but a pained view by deeply informed insiders. The book pleads powerfully for the disenfranchised patient. It must be read both because most of us sooner or later are bound to seek health care and because the authors provide an important viewpoint for the intensifying nationwide health care debate.

Bernard Lown, M.D., Professor Emeritus, Harvard School of Public Health; Senior Physician Emeritus Brigham & Womens Hospital; Nobel Peace Laureate 1985

A powerful appeal for individualized medical evaluation based on an active partnership between doctors and patients. The rational, mutual approach to diagnosis advocated by Drs. Wen and Kosowsky is the antidote for mindless and wasteful routines that all too often replace careful listening and focused assessment of each patient.

Harvey V. Fineberg, M.D., Ph.D., president, Institute of Medicine

Wen and Kosowsky have revisited the never-ending debate around the art and science of medicine hoping to strike the right balance in the practice of emergency health care. Their hands-on discussion of the limits of algorithmic medicine is precise and timely. Their proposal for diagnostic partnership is a major contribution of this courageous book in which common sense plays the leading role.

Julio Frenk, M.D., Ph.D., dean of the Harvard School of Public Health

Drs. Wen and Kosowsky propose an innovative approach to fixing U.S. healthcare that begins with the patient. Read this book and now youas a patientcan be the change our country has been waiting for.

Elliot S. Fisher, M.D., M.P.H., director of Population Health and Policy, The Dartmouth Institute

Using real patient examples, Drs. Wen and Kosowsky paint a disturbing portrait of medicine gone awry and provide a simple series of prescriptions to empower patients to get their health care back on track.

Ron M. Walls, M.D., professor and chair, Department of Emergency Medicine, Brigham & Womens Hospital, Harvard Medical School

A wake-up call to move beyond cookbook American medicine to a new medical practice that brings the humanity back into the core of the art of healing.

Lincoln C. Chen, M.D., director, Global Equity Center at Harvard Kennedy School of Government

In this era of overweening medical technology, doctors and their patients are a great risk of losing touch with the centrality of patient-centered care. When Doctors Dont Listen not only offers a compelling argument for revitalizing this touchstone of good medicine, but also provides a comprehensive guide for how doctors and patients can improve the quality of healthcare by doing so.

Jordan J. Cohen, M.D., professor of medicine and public health, George Washington University; president emeritus, Association of American Medical Colleges

This is an important contribution to helping both physicians and patients more effectively manage their encounters.

Robert Graham, M.D., professor of family and community medicine, University of Cincinnati

This book is a must-read for informing the dialogue about healthcare reform and transforming medical education. The authors passion for the individual behind the illness is contagious. Their argument for bringing back the value of clinical judgment is brilliantly written, and is amply supported with case studies. In many ways this is a book about the humanism of the physician as much as it is about patients as human beings.

Afaf I. Meleis, Ph.D., DrPS (hon), FAAN, Margaret Bond Simon Dean of Nursing, University of Pennsylvania School of Nursing

Drs. Leana Wen and Joshua Kosowsky make the case that the resultant algorithms-gone-wild syndrome seen in many medical settings today actually drives imprecise and wasteful testing, muddled diagnoses, and patient confusion. They argue that these clinical behaviors are at the heart of our morbidly obese medical care system and that thoughtful physicians relying on patient narratives and diagnostic common sense will create a leaner medical care system and better patient outcomes. Theirs is a contrarian and compelling case with the well-being of millions of patients and $250 billion a year riding on it.

Fitzhugh Mullan, M.D., Murdock Head Professor of Medicine and Health Policy, George Washington University

What a brilliant conceptthis outstanding book provides an innovative and interesting approach to understanding how physicians interact with patients This excellent book contains a literal treasure trove of information which will be beneficial and educational for patient and physician alike.

W. Brian Gibler, M.D. FACEP, FACC, president and CEO, University Hospital; senior vice president, UC Health; professor of emergency medicine, University of Cincinnati College of Medicine

A commonsense and deeply sincere prescription to help patients advocate for their own health.

Sandeep Jauhar, M.D., author of Intern: A Doctors Initiation.

Doctors take an oath to do no harm. Yet more than ever, modern medicine makes healthy people sick. Emergency physicians Leana Wen and Josh Kosowsky make a passionate argument for patients to get involved and informed about their care. A fast, smart read to help you take charge of your health.

Audrey Young Crissman, M.D., author of What My Patients Taught Me: A Medical Students Journey

The author and publisher have provided this e-book to you for your personal use only. You may not make this e-book publicly available in any way. Copyright infringement is against the law. If you believe the copy of this e-book you are reading infringes on the authors copyright, please notify the publisher at: us.macmillanusa.com/piracy.

This book is dedicated to Leanas mother, Sandy Ying Zhang (19542010), whose long struggle with cancer was an inspiration for the book, and to all of our patients, for teaching us, guiding us, and allowing us to practice the art and science of medicine.

Acknolwedgments

There are many people who were instrumental in turning this book from idea into reality. We would like to thank our agent, Jessica Papin, for believing in us from the start. Jessica, your confidence in us never waivered, and we could not have done this project without your sage advice and your expert guidance. Similarly, we are indebted to our editor, Rob Kirkpatrick, his assistant Nicole Sohl, our publicist Joan Higgins, and the rest of the excellent team at Thomas Dunne Books/St. Martins Press. Their influence can be seen, literally, on every page.

As this is a book about the practice of medicine, we must also thank those clinical and research mentors who have guided us throughout the years. These remarkable individuals include: Dr. James Adams, Dr. John Atkinson, Dr. David Brown, Dr. Carlos Camargo, Dr. Hal Churchill, Dr. Raymond Garcia, Dr. Brian Gibler, Dr. Leslie Kahl, Dr. Bernard Lown, Dr. Fitzhugh Mullan, Dr. Donald Paulson, Dr. William Peck, Dr. Ron Walls, and Paul R. Wright.

We also thank the many expert clinicians, health-policy experts, and health writers who have helped us with this book: Dr. Stephen Bergman, Dr. Howard Blumstein, Ms. Shannon Brownlee, Dr. Doug Char, Dr. Lincoln Chen, Dr. Jordan Cohen, Dr. Audrey Young Crissman, Dr. James Ducharme, Dr. Harvey Fineberg, Dr. Elliot Fischer, Dr. Julio Frenk, Dr. Sandeep Jauhar, Dr. Robert Graham, Dr. Jerome Hoffman, Dr. Robert McNamara, Dr. Afaf Meleis, Dr. Siddhartha Mukerjee, Dr. Fitzhugh Mullan, Dr. Jesse Pines, Dr. Ali Raja, Dr. Mark Reiter, Dr. Lisa Sanders, Dr. Darshak Sanghavi, Dr. Ian Stiell, Dr. Ben Sun, Dr. Ron Walls, Dr. Mark Weinstock, and Dr. Larry Weiss.