Uncaring. HOW THE CULTURE OF MEDICINE KILLS DOCTORS & PATIENTS
The former CEO of Kaiser Permanente Medical Group shines a light on the unseen and often toxic culture of medicine (US and non-US).
Uncaring tells the story of a profession that is both triumphant and dangerously flawed, filled with people who aspire to help others, yet who sometimes act coldly, callously, and indifferently toward the pain of others. This book takes you inside the doctor’s world, revealing unique insights about their training, their daily practices, and the culture they share. It is a book about people striving for perfection and about the impossibility of achieving it. It sheds light on the norms, rules, and expectations of doctors, and shows how culture shapes their thoughts and beliefs. It deciphers their evolving language, symbols, and codes. It highlights what brings doctors together and what isolates them from their colleagues and patients. Finally, this book examines the elements of physician culture that need to be corrected, the ones that should be preserved, and how to accomplish both.
The exploration begins by diving into the meaning and relevance of “culture,” an abstract concept with myriad definitions and applications. Part One, “Diagnosing Physician Culture,” takes you behind medicine’s protective curtain. There you’ll be introduced to the rituals, icons, and beliefs physicians share.
Part Two, “The Physician’s Pain,” explores the complex interplay between the healthcare system and physician culture, showing how both have contributed to a burnout crisis that is now wreaking havoc on US doctors.
Part Three, “Helping or Harming Patients?,” focuses on the impact physician culture has on patients and the ways it contributes to the deterioration of our nation’s overall health.
Having detailed the reasons doctors feel overwhelmed, fatigued, and in perpetual conflict with the world around them, Part Four, “The Social Ladder,” looks at how changes in society are ratcheting up the discomfort physicians experience. Like the proverbial straw that breaks the camel’s back, each new societal influence seems, on the surface, relatively insignificant and completely manageable. But together, these changing norms are proving too much for physicians to handle.
Part Five, “The Evolution of Physician Culture,” offers patients, doctors, business leaders, and elected officials a difficult but necessary choice—one they will need to make in a world now socially, economically, and politically ravaged by the coronavirus. As the nation’s “new normal” takes shape, all the options involving the future of American medicine will be painful and risky. This section outlines those choices and the path toward making US healthcare, once again, the best in the world. Through the process, physician culture has an opportunity to change for the better.
By the end of this book, having observed physician culture under the proverbial microscope, you will be able to see in fine detail what has long remained invisible. You’ll better understand the doctors who provide your medical care and how you can protect yourself from their cultural shortcomings. Some of the stories in this book will inspire you and generate a deeper appreciation for the role doctors play in your life. Others will sadden you, opening your eyes to the many ways that physician culture compromises your health, harms our economy, and holds our country back.
