She demonstrates, effectively, how the changes in the treatment of patients, due primarily to the influence of insurance companies that act like bullies, has harmed the most fragile of patients: those with mental problems and who need personal attention and interaction. According to Wang, "Insurance companies started to call the shots" in medicine, not only suggesting doses but also withholding approval of treatments that might aid the sufferers. In fact, at times their logic was so flawed that they'd refuse to cover a preventative procedure, which would save the money in the long term.
Wang describes the changes and problems with many anecdotal details that make it a fascinating read, and you can't help but see that medicine in other specialties is also likely to be turned into assembly line health-care, controlled by health insurance companies that not only lack medical degrees but also simple compassion and reasonableness.
One big player in the game that is as insidious as the insurance companies are the pharmaceutical companies. Wang notes with irony that her fridge is covered with Zoloft magnets, and that she writes on a Paxil notepad. While recent laws have cracked down on the practice of pharmaceutical companies providing free "goodies" for doctors, such as pens, clocks, scales, and vacations, the influence still remains strong. Incentives to prescribe their medications, rather than what the patient most needs, is a problem that doctors have to face. Additionally, with their face time with patients dramatically decreased, and the paperwork authorizing visits and procedures increasing, some doctors are leaving their practices out of frustration.
This book is eye-opening and at times, it makes you mad. Some cases of poor medical supervision has cost lives for no other reason than greed. Besides revealing this mess, though, Wang offers concepts to ponder in what your own medical care may be, and helps you see ways to benefit yourself by asking the right questions. This book would be a great supplement to How Doctors Think by Jerome Groopman, Mariner Books, 2008.
Special thanks to Julie Harabedian of FSB Associates and Riverhead Books for the Review Copy.