In By the Bedside of the Patient, Nortin Hadler places current efforts to reform medical education--from the undergraduate level through residency programs and on to continuing medical education--in historical context. In doing so, he traces the evolution of medical school curricula, residency and fellowship programs, and the clinical practices they promoted. Hadler examines crucial junctures in history to locate the seeds for reform. Some believe that medical education and training should highlight literature, ethics, and culture, while others emphasize science and efficiency to abbreviate the time from entry to licensure. Neither of these approaches, Hadler argues, maintains or improves patient care, which should be at the core of medical education and practice. Hadler contends that most reform attempted thus far constitutes, at best, little more than a reshuffling of the basic curriculum and, at worst, an augmenting of medicine's predilection to measure, grade, and record. Examining generational changes in medical education, Hadler mines sixty years of training and practice to identify mistaken approaches and best practices. Ultimately, in the contemporary era of managed care, Hadler argues for a clinical practice that draws on the best available scientific knowledge, transmits the wisdom of experienced clinicians, reforges an empathetic relationship between physician and patient, and treats each patient as an individual--all centered on restoring the mandate to care.
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Nortin M. Hadler, M.D., M.A.C.P., M.A.C.R., F.A.C.O.E.M., is emeritus professor of medicine and microbiology/immunology at the University of North Carolina at Chapel Hill. He is author of The Citizen Patient: Reforming Health Care for the Sake of the Patient, Not the System, among other books.
In this interesting, experience-based study, Nortin Hadler presents a cogent history of how the medical profession has changed over the past sixty years.--Catherine DeAngelis, University Distinguished Service Professor Emerita, Johns Hopkins University School of Medicine, and Editor in Chief Emerita, Journal of the American Medical Association
Dr. Hadler has written a superb and thoughtful book. By the Bedside of the Patient offers a full and wise pad of prescriptions to help preserve the crucial social contract between patients and their doctors.--Howard Markel, Center for the History of Medicine, University of Michigan
Every physician should read this book because every patient needs such complete care. Dr. Hadler is the ideal, as learned, pure in motive, keen in observation, gentle in treatment, and loving of the whole patient as anyone who has ever practiced medicine. He fights for his patients against all odds, all outsiders, no matter how rich, powerful, or trendy. He battles industries, institutions, and conventional wisdom in order to restore our humanity, our feeling of invincibility. He upends much of modern medicine because we are good people caught in a bad system. Hadler is a polite revolutionary, but he is also a necessary one.--U.S. Congressman Jim Cooper
Dr. Hadler has produced a well-written, coherent, and provocative book that focuses on the need for a fundamental transformation of the health-care system if both patients and physicians will continue to be the central focus. Its personalized nature and character sketches capture the reader's attention and make this book even more enthralling.--Gerald N. Grob, Rutgers University
Dr. Nortin Hadler is a perfect person to write this narrative, having lived--with a critical eye--through the key changes in medical education, practice, and institutional structure. His forceful writing about complex and controversial medical topics will be both engaging and compelling to readers and scholars alike.--David S. Jones, Harvard Medical School
Nortin Hadler's book is a brilliant account of the changes in American medicine over the past five decades, which have adversely affected the patient-physician relationship. Dr. Hadler presents innovative solutions to restore medical professionalism in the future.--Arthur Rubenstein, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania
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