I have repeatedly benefited fromthe work of Muriel R. Gillick,M.D., a member of the Division of Aging at
the Brigham and Women's Hospital and professor of population medicine at
Harvard Medical School.
So, I was delighted to hear of her new book: Old
and Sick in America - The Journey through the Health Care System.
Gillick takes readers on a narrative tour of American health care,
incorporating the stories of older patients as they travel from the doctor's
office to the hospital to the skilled nursing facility, and examining the
influence of forces as diverse as pharmaceutical corporations, device
manufacturers, and health insurance companies on their experience.
Gillick offers readers an informed and straightforward view of health care from
the ground up, revealing that many crucial medical decisions are based not on
what is best for the patient but rather on outside forces, sometimes to the
detriment of patient health and quality of life.
Gillick suggests a broadly imagined patient-centered reform of the health care
system with Medicare as the engine of change, a transformation that would be
mediated through accountability, cost-effectiveness, and culture change.