Too Big to Succeed

Book excerpt: Medicine in the United States is big business. We spend 50 percent more on health care per capita than other developed countries, but a multitude of measures indicate that we are not getting health-care value for our money. In Too Big to Succeed, author Dr. Russell J. Andrews details why health care in America has become more expensive but less effective and outlines a new paradigm for health-care delivery. Too Big to Succeed describes how American medicine is on an unsustainable course: costs are increasing while benefits are deteriorating in comparison with other developed nations. Beginning with the Hippocratic Oath and the the premedical student, Andrews traces the myriad ways in which the profit motive has infiltrated American medicineincluding medical school training, current models of health-care delivery, medical professional societies, medical research, and medical drug and device development. Presenting an insiders look into the current crisis in health care, Andrews demonstrates that until both the physician and the patient return to the relationship that underlies medicine, physicians will not experience the joy of healing those who seek their help and patients will not appreciate that a good physician is a permanent part of their lives.