Sunday, January 31, 2010

Makous, Norman, M.D.. Time to Care: Personal Medicine in the Age of Technology.

With Bruce Makous. TowPath Publications. 2009. 464p. illus. bibliog.. index. ISBN 978-0-9776686-1-8. $14.95.

Due to millions of dollars being spent on unnecessary tests and incorrect treatments, technology- based healthcare in the United States has caused an economic squeeze that already has led to rationing of medical care and services. Here Makous, a noted, now retired, extensively trained and credentialed, primary care cardiologist, who practiced in Philadelphia, PA until 2000 (M.D., University of Wisconsin Medical School, Madison, WI, 1947; American Board of Medical Specialties Certification, Internal Medicine, 1957; Subspecialty Certification, Cardiovascular Disease, 1961; faculty of The University of Pennsylvania Medical School, 1959-1995, and Thomas Jefferson Medical University, 1994; formerly, Regional President, American Heart Association; Distinguished Achievement Award, American Heart Association of Pennsylvania; author of "The Road Taken" (2006);, with the enthusiastic, thematic and directional support of his son Bruce, a leading healthcare fundraiser and published author (Riding The Brand (2004) and Virtually Dead (2006);, proposes that the patient-doctor relationship that was displaced by technology be returned to its central, fundamental position in the delivery of medical care and services in order to humanize treatment, improve the quality of care, reduce unnecessary spending and ineffective practices, increase doctor-patient satisfaction, and result in a happier and healthier society. In six parts, comprised of seventy-one, short, easy-to-read, conversational chapters, Makous discusses his medical education and healthcare services before the technological revolution, dramatic shifts in medicine resulting from technological innovations, the impact of these changes and developments in the field of cardiology, involvement by the government, hospitals, insurers, and others in the delivery of medical care and services, insights into the future of the medical system, and more. By means of his holistic approach to the subject, the author provides a wide ranging overview of the healthcare system as well as many explicit and implicit ideas and suggestions for making it better. Some of the subtopics he covers include, but are not limited to, the fundamental tenets of medical education and practice, the art of diagnosing, the art of educated guessing, shotgun testing, hospital practices, private practices, turnstile practices, medicine as an art and science, taking medical histories and doing medical examinations, patient-doctor communications and relationships, doctor-doctor communications and relationships, choosing a doctor, psychiatric cardiology, the “laying on of the hands,” follow-up visits, house calls, patient worlds, patient views, lifestyles, and expectations, screenings, emergency rooms, treatment standards and guidelines, age bias, end of life issues, advance directives, technology upgrades, new drugs, paradigms of medical science, the medical reimbursement systems, doctors as servants of many masters, referrals, malpractice issues, universal care, and rationing. Filled with dozens of case anecdotes, evidencing the historical and contemporary, crucial role that the doctor-patient relationship has played and serves in the delivery of excellent healthcare in the United States, this sufficiently well-documented—it includes a glossary of medical terms, diagrams, photographs, the author’s curriculum vitae, and a list of additional readings, but lacks footnoting and endnoting of the text-- compelling, fascinating, convincing, noteworthy publication, based on sixty years of medical practice by an expert physician-consultant is a must-read as the nation continues to struggle with healthcare reform. For general and more specialized readerships, it will be of particular interest to patients, aspiring physicians, practicing physicians, healthcare professionals, lawmakers, and others, who have significant, immediate stakes in the nation’s medical system. It should be required reading for all of the abovementioned persons and other individuals, who care about the current and future status and quality of healthcare delivery and services in the United States. Strongly recommended for many public, academic, and special library book collections. Advance Reading Copy. Availability:, Barnes &, and