Overkill Atul Gawande Summary

In the United States, healthcare has been one of the most controversial issue. Everyone needs to see a doctor when they don’t feel well or for routine check-ups. However, the reality is that not everyone could afford to see a doctor regularly to prevent serious illness. As a result, many people have died due to finding out their illness a bit too late because they have waited until the last minute to see a doctor and it was too late for the doctor to do anything about it. The situation could have been different if they were not lacking healthcare coverage. The government has stepped in to fix the issue but the problem persists due to the complexity of the healthcare system and its involvement with the political system. The Democratic and Republican

The articles I chose for my annotated bibliography were about healthcare cost and quality. The theme in many of these articles was about healthcare cost and does it affect patients experience. In some settings like hospitals, the cost of quality affects patient experience. The largest component of the U.S. Gross Domestic Product goes to healthcare spending (17% in 2009), and yet the quality is unsatisfactory. It was also interesting to find out that more people die each year in the United States from medical errors than from highway accidents, breast cancer, or AIDS (National Academy of Science's Institute of Medicine, 2002).

Chasing Zero is a documentary which was meant to both educate the viewer on the prevalence of medical harm as well as to enlighten both the public and health care providers on the preventability of these events (Discovery, 2010). The documentary expounded on the fact each year more people die each year from a preventable medical error than die due to breast cancer, motor vehicle accidents or AIDS (Institute of Medicine, 1999). Medical harm can result from adverse drug events, surgical injuries, wrong-site surgery, suicides, restraint-related injuries, falls, burns, pressure ulcers and mistaken patient identities (Institute of Medicine, 1999). Incidences of medical error have been reported in the media for many years. The most startling

"Johns Hopkins patient safety experts have calculated that more than 250,000 deaths per year are due to medical error…" (John Hopkins Medicine). This soaring number has caused medical errors to become the third leading cause of death in the United States. For many people, medicine seems foreign and unknown. People who have lost loved ones due to medical error desperately look for a reason, and many times that blame falls upon doctors. Media has put a negative connotation on doctors as well, causing their reputation to plummet whenever a hospital procedure turns badly. A renown surgeon and author, Atul Gawande, uses his knowledge and experience to give people a new perspective on medicine. In the article "When Doctors Make Mistakes," Gawande uses rhetorical appeals: ethos, pathos, and logos to prove the need for a change in the medical systems and procedures. He analyzes how the public looks at doctors, giving a new perspective to enlighten the reader that even the best doctors can make mistakes.

Being Mortal is a captivating book that I was thrilled to have read for nursing school. Atul Gawande takes you on his journey about what an older adult truly wants and feels when making the transition into old age. He truly takes the time to show you different examples and circumstances in which an older adult must give up something they love in order to mold into what society has made available for older adults. According to the CDC, “In 2014 there were an estimated… 1,369,700 current residents in nursing homes…” (Harris-Kojetin, Sengupta & Park-Lee, 2016, p. xi). This is an astounding number of older adults that are being cared for by others, and that number is only going to continue growing. Throughout Being Mortal, you are taken on a trip

T.R. Reid uses cost, quality, and choice to fully evaluate healthcare systems all around the world. As an American citizen, I have always thought our system was unfair. The poor suffer more than the rich for going to see a doctor for the same reason. In chapter one of The healing of America, T.R. Reid comments on how many Americans have also started to notice that the American healthcare system is not as great as we once thought. Not only is it unfair, but it is also expensive and unsuccessful (9). By looking at all the other countries’ healthcare systems, Reid would then be able to better pinpoint how America can better its health care system by taking portions of those health systems.

Death is a difficult topic for most people to discuss. Even those in the medical profession, such as doctors and surgeons, have a tough time discussing the prospect of death with patients. In Atul Gawande’s Being Mortal, Gawande delves into what really matters as life comes to an end, new ways of helping the elderly enjoy their waning days, and the role of doctors and medicine in curing diseases and dealing with patients. Sheri Fink, a reporter for the New York Times, reviewed this book on November 6, 2014 for The New York Times Sunday Book Review in “Atul Gawande’s ‘Being Mortal’”. She thinks Being Mortal is a “valuable contribution to the growing literature on aging, death, and dying”, and does a good job of introducing the topic of

Quality health care is an issue in America for everyone, despite our numerous tests and advances in technology. In his article, “Overkill,” Atul Gawande argues against a common assumption that our healthcare system is the best because of these medical advances. In fact, Gawande claims that our health care provides much unnecessary care that often causes harm and that costs a lot . He follows that claim by redefining “low-value care” as “no-value care” and provides considerable scientific data along with his own experience with his own patients to support his claim. He also states logical reasons by referring to expert authorities who critique our health care by viewing it from an economic perspective: like talking about information asymmetry where a doctor is more informed than the patient, thus the doctor has more power over the patient. All of these emphases strongly defend his controversial claim. But what stands out most is how Gawande uses several stories showing vastly different outcomes, depending on how informed the patient and doctor are including offering non invasive treatments. We need to explore how his unusual storytelling strategy exposes how surgeons and patients should care more about quality than the mere quantity of tests and what alternatives are available to change the unnecessary over testing and over-diagnosis which prevent good health care.

Atul Gawande in his book Being Mortal said “We are all aging from the day we are born” and aging brings death. But due to improvement in science and technology, the life expectancy has increased over the years and lots of diseases have been eradicated and symptoms controlled to prolong life. Despite these advancements, we can delay the death but cannot stop the damage. As these damages accumulate, there comes a time when one more damage shuts down the whole system bringing death to the whole organism. Gawande talks about diseases that affect the elderly and mentions that there is a shortage of geriatricians in united states which is affecting the access to care. He also mentions that it's not just worn and tear that causes aging or the genetically

This week’s article by Liz Welch titled, Physician, Healthy Industry discusses why our health care industry should not be run as a business. The doctor interviewed by Welch is a Boston-based physician, Dr. Rushika Fernandopulle who runs a company called Iora. He addresses the primary care experience including the coding, billing, and copays in our current health care industry. His argument is that the system should not make a physician do what they do not want to do. He states, “I’d seen 40 patients, and had to stay two hours after work to finish up notes, because that’s what these stupid systems make you do” (Welch, 2015, para. 2). Dr. Fernandopulle frustrations are with the paper pushing process that our health care system requires of all physicians, but he decides to focus on the patient and their concerns, rather than the paperwork aspect. The purpose of Dr. Fernandopulle interview was to reduce the rising health care costs and start looking at the patient closely to prevent unwanted and unnecessary emergency room visits.

The second case against this intrinsically flawed and morally corrupt method of delivering medical service lies in its inadvertent, yet alarmingly prevalent, fostering of suspicion, mistrust, and latency: the high prices of healthcare induced by privately-paid healthcare systems (a trip to a US emergency room costs an individual an average of $1233 USD!) encourage those without monetary stability to put off visits to the doctor or the hospital until absolutely necessary. This greatly increases the fatality of diseases whose positive prognosis relies on early identification, such as cancer or meningitis, especially if initial symptoms of this disease are mild – “It’s just a headache”, Bethany Barclay figured when her daughter fell ill one afternoon, “so why would I waste money otherwise spent on food or essentials on a visit to the doctor that is likely to amount to nothing?” Bethany’s daughter passed away the next day, in the back of an ambulance that only arrived after the girl began to suffer from violent seizures. Bethany, like Tim Wilkins and countless others, wasn’t the only one forced to bear the brunt of the United States’ cruel private payer healthcare system.

Have you noticed that doctors often are so quick to test patients with numerous labs and imaging? Are they always necessary? For example, through evidence-based practice it’s been shown that when a patient comes in with back pain more often all they need is physical therapy, not a STAT CT. Often providers feel they must do everything due to threats of possible legal actions. Cost containment could be also difficult because of patients itself. Because of never ending TV commercials, TV shows, and health magazines people start diagnosing themselves and demanding excessive test and diagnostics. Demanding certain tests or medications when there is no diagnostic reason increases costs to healthcare.

The current system as a whole rewards the reactive approach to healthcare and has policies in place to discourage a proactive approach to medicine. For example, Physicians are rewarded for the number of patients they see and not quality of care provided to these patient. This leads to physicians spending less time with their patients, less time for nutritional counseling and patient education. This perpetuates the cycle of reactive treatment only health care, and higher healthcare costs. In contrast, Preventative healthcare is more cost effective and works to deters patients from unnecessary procedures, avoidable Emergency Room visits and medical procedures over all. Patients take more personal responsibilities for being healthy when their

Modern Medicine is effective but can be dangerous, carries risks and research can be manipulated. Kate Mcbride works in healthcare but argues that modern medicine can be dangerous and can even make some diseases worse because they aren’t being treated the right way by getting to the root of the problem. That’s horrible because so many patients put trust in their doctors and believe that they are being completely cured. In fact, many people probably don’t realize that many pharmaceutical companies encourage physicians to prescribe certain drugs because of the financial benefits which seems immoral, greedy and just plain wrong for healthcare (Mcbride). Patients should be able to be treated safely and effectively instead of being used for income for pharmaceutical companies and the physicians. There is evidence that shows that many people are not getting quality medical care. According to a recent study done by a team of

Written about the structure and culture of biomedical heath care and a society that is attempting to prolong aging, Medicare funding, funding and development of research, and today’s definition of standard care, Sharon Kaufman brings to light the many dilemmas posed to the American health care system. Her ethnographic story, Ordinary Medicine: Extraordinary Treatments, Longer Lives and Where to Draw the Line reveals the booming biomedical research and clinical trials industry, the power held by Medicare and private insurance, and a rapidly changing standard of care once a medical treatment is considered reimbursable. This leads to systematic changes in the standard of care result in a massive amount of pressure being placed upon doctors, patients and families to make an ethically and medically sound decision in refusing or accepting therapy. Kaufman exposes the driving forces behind the expansion of biomedicine, society’s response to the growing industry on a personal and bureaucratic level.