The Sequel To The Bestselling And Highly Acclaimed The House Of GodYears After The Events Of The House Of God, The Fat Man Has Been Given Leadership Over A New Future Of Medicine Clinic At What Is Now Only Mans th Best Hospital, And Has Persuaded Dr Roy Basch And Some Of His Intern Cohorts To Join Him To Teach A New Generation Of Interns And Residents In A Medical Landscape Dominated By Computer Screens And Corrupted By Money, They Have One Goal To Make Medicine Humane Again What Follows Is A Mesmerizing, Heartbreaking, And Hilarious Exploration Of How The Health Care Industry, And Especially Doctors, Have Evolved Over The Past Thirty Years 1 It is beautifully written.
2 It is inspiring.
3 The most important reason, which I say from the perspective of being a healthcare provider myself, is that it is largely truth Yes, the book is fiction in the sense that stories are woven around characters, events, and places to engage the reader and take them on a journey of discovery, and of course not everything written is fact But the book also brilliantly describes how medicine and the patient physician relationship has, in the U.
S healthcare system, been systemically crippled by layer upon layer of unnecessary and costly bureaucracy a bureaucracy that whatever its initial intent has had the effect of dehumanizing medical care, interfering with its effective delivery, driving costs up, ruining the lives of the physicians who are trying to make things better, and worst of all, often seriously harming patients The author doesn t simply decry what has happened to our healthcare system, but he is kind enough to propose numerous solutions to this crisis that could if implemented quickly restore a much higher quality, patient centric, cost effective health care system in this country This book is a must read for patients, physicians, and healthcare policy makers.
HOG was great this book is a waste of time Full of predictable, opinionated social commentary which could be tolerated if the read was good It s not Save your money.
Disclaimer I have been a physician for over 30 years I read The house of god in college I read it again in medical school Reread it during the minuscule time available in internship as well as in residency I have read the book over a half dozen times The book was sarcastic, a bit crazy, cutting, very often truthful, and overall hilarious.
Man s 4th best hospital is non of those things It is a political screed pushing socialized medicine Much of what is said about medicine, EMR s, and billing is blatantly false It is not the least bit funny Its sarcasm is boring And the characters we loved in the first book haven t progressed at all as people.
No physician I know loves the EMR with which we are tasked to work I am stuck with EPIC which is referred to many times in the book But what is portrayed in the book about the unholy alliance between billing and coding is so oversold it is outrageous For example, while diagnosis codes allow hospitals to maximize billing for inpatients, this has nothing to do with outpatient medicine You can code any diagnosis you please and it does not change how you bill a patient But the book implies that it is the same This is just a very small example of the many falsehoods that are rife within this book.
What Shem conveniently omits is that the EMR and its used among physicians is the direct consequence of the government s involvement in medicine The government mandated it s use It punishes physicians that use paper charts by decreasing reimbursement It rewarded hospitals and groups for using these comprehensive, clunky, flawed systems All the click boxes that he goes on about are mostly due to the government and something they instituted called meaningful use In order for a doc or a hospital to get fair reimbursement for a visit things like smoking status, body mass index, and dietary review get included in every note for outpatients and what is needed for inpatient notes is well beyond this discussion And then he implies in the book that socialized medicine is the cure to the money grubbing companies that responded to the government s call to expand the use of electronic medical records.
Samuel Shem then holds up the Indian Health Service IHS and the VA as models where doctors can take better care of patients This is absolutely laughable The Wall Street Journal has had multiple expose articles about incompetence and malpractice in the IHS As a veteran of the military, I make it my business to know about the VA And while there are good docs in the VA, the overall level of care that is offered to our men and women who served is disgraceful I can get my care at the VA, and would never do so So one of the main root causes of the problem government mandates in medicine is going to be the cure by giving us the same care as Native Americans get from the IHS and veterans get from the VA Thanks Sam, I ll take a pass on that.
If I could give this book zero stars, I would do so I loved the house of god It was on my list of 10 most influential books I have had the pleasure of reading I really enjoyed Mount Misery which talked about his one year in a psychiatry residency Both of those books rang true in a large way, despite the sarcasm and artistic license This book does not do that in any way, shape or form It is a political opinion poorly hidden in a story, much of which is frankly garbage I m sorry I spent the money buying it and even sorry I spent the time reading it.