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Medical Catastrophe

Confessions of an Anesthesiologist

Ronald W. Dworkin MD

Hardback
eBook
Unnecessary death rarely happens at the hands of doctors, but it does happen. Sometimes the cause is medical error. But sometimes the cause is politics. The issues underlying many medical catastrophes are numerous: a power struggle between providers, uncertainty over who’s in charge, hesitation to practice good medicine for fear of being fired, specialization run amok, part-time doctoring. Doctors often prefer to ignore the problems, but patient safety demands that they be aired.

And so does the future of the medical profession. Beneath the politics lies confusion: Doctors no longer know who they are. They don’t know how much authority they should wield. They don’t know what distinguishes them from other healthcare professionals. They don’t what about being a doctor should make them proud. When doctors lack a firm sense of who they are, the whole of medicine lacks an essential core, giving rise to personal and professional politics—and catastrophes. Patients may be relying on a system that has veered off course.

In dramatic and revealing stories of patients in the operating room and interactions with colleagues, Ronald W. Dworkin traces his path from medical school to anesthesiology residency to his early years in private practice, with the experiences of his father and grandfather, also doctors, hovering overhead, in his quest to answer the question: What is a Doctor? Sometimes funny, sometimes scary, sometimes poignant, the story of what it means to be a doctor in today’s medical setting comes to life, as Dworkin outlines the contours, the challenges and rewards, of modern medicine, and how it must be rescued in order to preserve the profession and protect patients from disasters.
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Rowman & Littlefield Publishers
Pages: 220Size: 6 x 9
978-1-4422-6575-2 • Hardback • March 2017 • $35.00 • (£23.95)
978-1-4422-6576-9 • eBook • March 2017 • $34.99 • (£23.95)
Ronald W. Dworkin, MD, works as an anesthesiologist while also teaching political philosophy in the George Washington University Honors Program. His essays on medicine, and on American culture and politics, have appeared in such publications as The Wall Street Journal, National Affairs, Policy Review, The New Atlantis, and The Public Interest. His other books include Artificial Happiness (2006), How Karl Marx Can Save American Capitalism (Lexington, 2015), and The Rise of the Imperial Self (Rowman & Littlefield, 1996).
Macho
3. The Trap of Over-specialization
4. When No One is in Command
5. When Patients Become Consumers
6. A Tale of Two Offices
7. When Doctors Lose Control of Their Own Personalities
8. When Doctors Lose Control of Their Own Rules
9. The Problem of Going Part-time and When to Retire
10. I Come Full Circle
11. What is a Doctor?
Dr. Ron Dworkin's riveting Medical Catastrophe provides a revealing peek behind the curtain of the real business of medicine -- the ego clashes, the confusion, and the internal politics governing doctors' decisions. He may not have intended to scare patients, but he sure scared this reader.
Tevi Troy, CEO of the American Health Policy Institute and former Deputy Secretary of the US Department of Health and Human Services


Ronald Dworkin’s Medical Catastrophe: Confessions of an Anesthesiologist provides a unique perspective on an important sector of modern medical practice. Versed in policy and politics as well as anesthesiology---a medical field many specialists take for granted but know little about but which makes contemporary painless medical miracles possible and safe ---Dworkin proves patient care delivered one patient at a time is still the heart of medicine. In a style reminiscent of a novelist he brings the “illuminating power of incidental detail” to the fore reveal the texture, complexity, and consequences of medical decisions as they are: good, bad, and at times, ugly.
Vincent J. Kopp, MD, FAAP, Emeritus Professor of Anesthesiology and Pediatrics, Department of Anesthesiology, School of Medicine, University of North Carolina at Chapel Hill


Medical Catastrophe: Confessions of an Anesthesiologist is an eloquent and informed reflection on the privilege and plight of being a doctor. Dworkin's personal narrative grips us with descriptions of critical life-threatening events framed within the complex health system that sets those catastrophes in motion. Dworkin writes with the fluid prose of a storyteller and the perceptive eye of a historian and philosopher. A must-read for anyone interested in the doctors and hospitals that take care of us.
Carol Cassella, MD, author of Oxygen


At its heart, Ronald Dworkin's Medical Catastrophe is a book about why well-meaning doctors often do not– or cannot– do the right thing. Patients and health professionals will benefit from Dworkin's candid and unsparing assessment of why innovations designed to provide improved and safer medical care may wind up doing the opposite.
Barron H. Lerner, MD, PhD, author of The Good Doctor: A Father, A Son and the Evolution of Medical Ethics


Medical Catastrophe is not another discussion of medical mistakes and preventable mix-ups, or a call for more teamwork, protocols, and “best practice” guidelines to avoid error. Ronald Dworkin, in this deeply personal and highly original book, is on to something more basic—a candid exploration of the largely unacknowledged but vital role that all-too-human relationships and qualities play in catastrophes and near-catastrophes and a fair assessment of the impact that the profound restructuring of medicine is having on such everyday interactions. Our deepest predicament, he argues, is in the confusion that now surrounds the very meaning of being a doctor. This is the calamity that has to be addressed, and Dworkin offers a nuanced and insightful way forward.
Joseph E. Davis, Institute for Advanced Studies in Culture, University of Virginia


A harrowing tale of how the personal and the political collide in the medical world, putting patient safety on thin ice. It’s a page-turner, but the kind where you are almost too afraid to turn the page. Required reading for anyone concerned about medical error — doctors, patients, administrators, policymakers, and health insurance executives.
Danielle Ofri, MD, PhD, author of What Patients Say, What Doctors Hear


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