Robert Pearl - Uncaring

No one is better qualified to write about what ails healthcare than Robert Pearl. Uncaring ought to trigger a rethinking of the professional culture of American medicine.

Malcolm Gladwell, author of five New York Times bestsellers

In Uncaring, Dr. Robert Pearl provides an X-ray examination of the medical profession and how it has both promoted and adversely affected American healthcare. Its deep, insightful, and can be considered the modern version of what Francis Peabody wrote almost a century ago: The secret of the care of the patient is in caring for the patient. We need to get that back.

Eric Topol, MD, professor at Scripps Research and author of Deep Medicine

In this hard-hitting, immensely valuable book, Robert Pearl pulls back the veil from the face of the culture of medicine. He reveals the truths, both good and bad, about what drives physicians and the system of care. As an accomplished surgeon, admired executive, sophisticated policy analyst, and master storyteller, he does that with both expertise and compassion, as few others could. His recommendationstough, clear, and rightfor what needs to change provide a roadmap for all who seek better health and care.

Donald M. Berwick, MD, president emeritus and senior fellow at the Institute for Healthcare Improvement

How do so many young doctors who enter medicine filled with idealism and the desire to do good end up decades later as cynical professionals, caring about money, prestige, successeverything but the patient? Dr. Robert Pearl, in this riveting examination of the physician culture, diagnoses the pathologies in the system that too often strips the caring out of healthcare.

Elisabeth Rosenthal, editor in chief of Kaiser Health News, and author of An American Sickness

Dr. Robert Pearl has peeled back the curtain and revealed major challenges facing the culture of medicine. His insights are a must-read for anyone who wants to improve our healthcare system, and in so doing, provide better care and save lives.

Leana Wen, MD, public health professor at George Washington University, and author of When Doctors Dont Listen

Uncaring is a brilliant and incisive dive into physician culture, both its seamy underbelly and the moments that inspire. Pearls vast experience as a physician steeped in the culture, and as leader of one of the largest healthcare systems in America, allows him to write with authority, yet in a personal and engaging way, and at the end to offer solutions. The result is a wonderful and compelling read.

Abraham Verghese, MD, professor of medicine, Stanford University, and author of Cutting for Stone

Culture squashes innovation. And this may just be a defining truth for the practice of medicine today. Pearl takes a probing look at Americas medical practice and reveals the sacrosanct clinical hierarchy, entrenched clinical biases, financial drivers, and physician burnout. Hes pressing on the tender and sensitive spots. And while conventional medicine might suggest that this wont hurt a bit, it will. As Pearl suggests, denial isnt the path to recovery. Uncaring provides an honest history and physical of medicine today, with a bold vision to define and protect the very best of care.

John Nosta, technology innovationist, Google Health Advisory Board, and World Health Organization technology expert

Dr. Robert Pearls Uncaring is a deeply readable, empathic, and insightful exploration of the status of twenty-first-century American physicianstheir heroism, their altruism, their limitations, and the shared culture that too often makes them less than they could and must be to heal our healthcare system. Healthcare leaders, policymakers, and physicians can all benefit from understanding the lessons Uncaring teaches.

David Blumenthal, MD, MPP, president of the Commonwealth Fund

The history and culture of medicine has set the stage for the way our current system of care is organized and delivered. In these unprecedented times, this book offers insights into the way our system of care is both working and failing the people that it serves. Pearl spells out the case that to really understand how the healthcare system works you must really understand how physicians work. Through storytelling and personal reflections of a career in medical leadership with distinction, Pearl shares how physicians view their patients and themselves. This rare under the covers view of medicine offers insights into tough issues that plague our system but also offers a path forward for improving healthcare. This personal and fascinating read shows doctors as humans and offers hope for those wanting to see empathy and compassion remain an essential part of the way we deliver care in the future. I highly recommend this book to all who seek a better understanding of healthcare and want to make a difference in improving the way it works.

The Honorable David J. Shulkin, MD, ninth secretary, US Department of Veterans Affairs

Dr. Robert Pearls Uncaring explains the unique challenges of the healthcare system in providing quality care in an equitable manner. He distills the issues down to the salient points, providing a roadmap to make the necessary changes. Now is our time to act! Dr. Pearl provides the way.

John Whyte, MD, MPH, chief medical officer, WebMD

Uncaring lifts the veil on the deeply conditioned culture that drives American physicians and our multi-trillion-dollar healthcare system. To solve our biggest challenges, we cant ignore this elephant in the room, and Dr. Robert Pearl never flinches once. Sunlight is the best disinfectant, and Uncaring illuminates the shadows that many doctors themselves are reluctant to see.

Zubin Damania, MD, host of The ZDoggMD Show, the internets most popular live medical show and podcast

Dr. Robert Pearl is uniquely qualified to take us inside physician culture and provide key insights on the medical mind. Physicians are the key resource in our healthcare system. Uncaring is a sweeping must-read exploration of physician culture, bringing together poignant stories, deep research, and vast professional experience to help us all understand how physician culture shapes healthcare. Patients, physicians, and policymakers will all benefit from this invaluable and highly engaging book that teaches us what works and what needs to change in the future.

Ian Morrison, PhD, author and healthcare futurist

Dr. Pearl writes with authority, having served as CEO of two successful Kaiser Permanente medical groups, one on each coast, leading 12,000 physicians. He traces the evolution of physician culture, which has come into conflict with modern demands for accountability in cost and quality. This has led to frustration and physician burnout. He explains how, A healthcare organization that is integrated, prepaid, and tech savvy can bring out the best in physiciansenabling better collaboration, cooperation, prevention creating a set of behaviors that lead to superior clinical outcomes. Dr. Pearls prescription for the United States could make us one of the worlds healthcare leaders. It would be a powerful and effective treatment for a very ill healthcare system.

Alain C. Enthoven, PhD, Marriner S. Eccles Professor of Public and Private Management (Emeritus), Graduate School of Business, Stanford University, and member of the National Academy of Medicine

The relationship between doctors and technology is complicated. On one hand, technological advances have made it possible for physicians to prevent cancer, greatly reduce deaths from heart attacks, and streamline overall patient care. On the other hand, doctors bemoan computers and medical technologies because they stand in the way of the most important relationshipthe one between the physician and the patient. Thanks to the rapid digitization of healthcare, many of the doctors time-honored skills and virtues have become irrelevant or obsolete seemingly overnight. In a profession now fueled by clinical algorithms, electronic health records, and sophisticated machinery, physicians are being told their clinical intuition and decades of expertise no longer matterand could even prove harmful to patients. In