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Book Review - Doctor, Your Patient Will See You Now by Steven Z. Kussin, MD

Gaining the Upper Hand in Your Medical Care

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Updated October 02, 2011

Cover of the book Doctor, Your Patient Will See You Now by Steven Z. Kussin, MD

Doctor, Your Patient Will See You Now by Steven Z. Kussin, MD

Steven Z. Kussin, MD

In the past six years, the author, Dr. Steven Kussin, has survived two horrendous accidents and years of care and recovery. In his book, he shares what he learned as he suffered his own trek through the healthcare system.

So many "smart patient" books are penned by physicians, intending to teach patients what doctors prefer patients do in order to make their doctor jobs easier. But this book is different. Instead it reveals behind-the-scenes, and sometimes unsettling inside information allowing us patients a glimpse at why the system operates the way it does so we can learn to overcome obstacles to the care we truly deserve.

Overview

Steven Kussin, MD is a gastroenterologist and internist by training and experience - more than 30 years worth. His track record is impeccable, and even online, he was always highly rated by his patients, ranking especially high in trust, communication and the time he spent with them.

But Dr. Kussin is no longer in formal medical practice. His ability to continue practicing came to an end more than five years ago, when, driving home on a freezing cold winter's night, he and his partner, Annie, careened off the icy road into the reality that was to become his life for the next several years. Dr. Kussin spent those years as a patient who saw the best, the worst, and everything in the middle of the same medical system he had been a part of for his entire career.

As he transitioned from critically wounded through treatment, rehab and healing, he was disturbed and dissatisfied by what he observed and what he felt was missing from the experience. Like so many doctors who find themselves stuck in the system as patients, he realized that it is extremely difficult for patients to navigate the system without an incredible amount of background knowledge, most of which results from questions they don't even know to ask. He acknowledges early in the book that his hospital experience was one where he was treated with dignity, the nurses were pleasant to him, and his pain meds were brought to him when he needed them. Quoting from the Preface, "In other words, in many ways, I still have no idea at all of what it's like to be a patient."

Once he was able to do so, Dr. Kussin began keeping notes. From sharing his own experiences, to comments on observations, to inside information about the system, and some of the dirty little secrets we patients can benefit from knowing, he has created this handbook to help patients figure out for themselves how to work the system to get their best care and improved medical outcomes.

Excerpts from Doctor, Your Patient Will See You Now

Chapter 1: The Office

"Beware the doctor with a machine!" Dr. Kussin explains the reason so many patients are subjected to imaging tests in doctors' offices. That is, that the doctors own or lease the machines and can be reimbursed for using them, whether or not a patient will truly benefit from having the test. He also points out that as of 2011, it is "mandatory that doctors who refer Medicare patients to imaging machines they own disclose this fact in writing, and provide alternative sites that provide the same service."

Chapter 5: Choosing Your Doctor

In describing himself and his colleague doctors and whether or not they are good choices for us to make, Dr. Kussin writes, "Some of us are really bad players and others unforgivable wretches. Some have given up and others are no longer keeping up. Some of us are incandescent while others just burn out. Being happy with our doctor is, of course, wonderful. Being safe with her is an entirely separate and far more important consideration. Mortal stakes. You might be loving your bad doctor to death."

Chapter 14: Abandon Ship

In discussing failure to diagnose, Dr. Kussin writes about "shotgun medicine." "As your problem closes in, your doctor feels outgunned and you get "shotgunned." Shotgun medicine is a term every doctor knows and a technique each has used. It's a close-range blast from both barrels of a doctor's arsenal that puts you in the middle of a fusillade of test and treatments. No aim is required when the aim is to eliminate every conceivable condition that might b causing your status to deteriorate. This is not defensive medicine. It's desperation medicine."

Book Details: Doctor, Your Patient Will See You Now

Pros:

• The bullet points at the beginning of each chapter offer an excellent overview of what is in store when you read it. Later, when you want to look something up, you can reread the bullet points to help you decide whether that's the chapter that held the pieces of information you're looking for.

• Dr. Kussin's sophisticated sense of humor is worth taking the time to read and absorb. While there were times I had to stop and process a statement, I definitely felt is was worth the second thought to appreciate and enjoy his wit.

• I recommend you purchase the printed version of this book, and keep your highlighter and post-its handy. There is a great deal you'll want to return to, because each section tackles a new aspect of healthcare. You won't need all the bits of information at the same time.

• In the back of the book, you'll find a treasure trove of additional resources, from medical study results, to great websites, to a valuable bibliography.

Cons:

• Dr. Kussin is quite a wordsmith, and loves to use big words (no doubt from his career as a physician), some of which I had to look up to understand. He's also a master of metaphors and cleverly written, pun-like descriptions. This is not a book you can skim. Be sure you have the time to read it and process it as you go along.

• The organization of the book is not a sequence I ever would have chosen. For example, there is a section in Part II called The Hospital. But later in the book, Parts IV and V are focused entirely on hospital care. Overall, however, the various locations of information do not subtract from the excellent ideas and approaches offered.

A copy of this book was provided for free to the reviewer, Trisha Torrey.

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