Review Johns Hopkins internist Berger attempts to broadly balance the science of medicine (evidence-based guidelines) with the choices that individuals want (patient preferences). He poses a pertinent question: 'How do we bridge the doctors’ advice, full of numbers, directions, and scientific studies, with the life that we have to live?' An honest response might be, 'It often isn’t easy.' Focusing on common diseases—arthritis, chronic pain, depression, diabetes, and high blood pressure—Berger suggests methods for choosing treatment options in the context of individual inclinations. He emphasizes the need to understand the benefits and risks that accompany any medical action, the limits of biomedical science, and excesses in health care (testing and prescribing). His thoughtful discussions of medical uncertainty, decision making, inflated expectations, out-of-control testing, and the dogged pursuit of diagnosis are among the best parts of the book. Berger’s call for a 'patient-centered route to care' is hardly new, but determining for yourself (aided by guidance and support from your physician) how to be medically treated (or not) never gets old. (Booklist)The author, Dr. Zackary Berger, is a primary care doctor, internist, epidemiologist, and bioethicist, and is affiliated with Johns Hopkins School of Medicine. His work offers excellent narratives about physicians with firsthand experiences assisting their patients with health care decisions. Berger shares some good hints about effectively caring for patients and, at the same time, adhering to the regulated, shared decision-making and evidence-based guidelines that a primary care provider is charged to follow. Most significantly, Dr. Berger offers strong suggestions for managing patients with diabetes, hypertension, depression, and arthritis, while being sure to properly engage with the patient and his or her family. He specifically describes how important it is to involve the patient as an individual and not to make generalizations about certain patient categories. This book is a good reading assignment for all health care professional students. It also includes a comprehensive reference list and multiple websites for accessing evidence-based guidelines.Summing Up: Recommended. Upper-division undergraduates and above; faculty, professionals and general readers. (CHOICE)If you are a patient, caregiver or health care provider I highly recommend Making Sense of Medicine. It will make all of you think. Patients, I hope it empowers you to ask questions and become a partner in your health care. (Women of Teal)Medicine is a place where science tries to address a multiplicity of human needs. But often these needs go beyond anything that science can meet. Listening, compassion and openness to the complexity and uncertainty of life will always be at the heart of real medicine. Dr Berger's book is clearly based on many years of wise and patient-centered practice, and he weaves his narrative with fluency and flashes of humor. It is a wonderful read, aimed at a general audience but full of insight for every health professional. (Richard Lehman, primary care physician, regular columnist for the BMJ, senior advisory fellow to the UK Cochrane Centre)With sympathetic rigor, Dr. Berger calls clinicians and patients alike to reconsider the nature of evidence and experience in medicine. This is not therapeutic nihilism, it is a deeply human call to see each other as we are and find specific, authentic paths through illness, pain, and disability. (Samuel Morris Brown, author of Through the Valley of Shadows: Living Wills, Intensive Care, and Making Medicine Human)Medicine cannot achieve its potential without the fullest contribution of the ultimate stakeholder - the empowered, activated patient; the Institute of Medicine says "best care at lower cost" requires "Patient-clinician partnerships," explicitly citing "engaged, empowered patients." This book is an essential resource for scientifically minded patients and caregivers who want to understand medicine's limitations and biases, to enable - as the Introduction says - "deciding for yourself," in partnership with empowering clinicians. (Dave deBronkart, "e-Patient Dave" deBronkart, Cancer survivor and founding co-chair Society for Participatory Medicine)Science, humanity, or the space between? That’s the territory doctors and their patients navigate daily, with 'the space between' requiring maps, flashlights, and trail markers that must be built while on the journey. Zack Berger’s book is a thoughtful, penetrating assessment of that 'space between,' including hazards to navigation like racism, and the pathways that reveal themselves when doctors and patients work together to manage the uncertainty that is a central feature of science, and of medicine. A joyful and necessary call for partnership in the most human of sciences – medicine – this is a must-read for anyone interested in improving the quality and character of healthcare. (Casey Quinlan, Mighty Casey Media) Read more About the Author Zackary Berger, M.D., Ph.D., is a primary care doctor, internist, epidemiologist, and bioethicist. He is an Assistant Professor at the Johns Hopkins School of Medicine, where he maintains an active practice in adult medicine and teaches with residents and medical students. His research on doctor-patient communication, bioethics, and clinical epidemiology has been published in the Annals of Internal Medicine and the Journal of General Internal Medicine, as well as in numerous venues for the general public. He is also the author of Talking to Your Doctor: A Patient's Guide to Communication in the Exam Room and Beyond (Rowman & Littlefield, 2013). Read more
A**Y
Berger suggests that perhaps the best path to improving and managing illness is to recognize ...
The first, and arguably the most salient sentence you read when you open Dr. Zackary Berger's book "Making Sense of Medicine; Bridging the Gap Between Doctor Guidelines and Patient Preferences." is found inside the jacket cover—“The more we know about medicine, the more we realize that many health questions have no one true answer." With this line, and this line alone, one is confronted with a truth that many might prefer to turn away from. But not only does Berger not turn away from such candor but engages the reader in a way that invites them into the exam room with him to witness the very real and challenging complexities that exist between doctor and patient. From the first to the last page, Berger adeptly balances that which is intellectual, philosophical, technical, and last but certainly not least, that which is human. This is not your run-of-the-mill theory and practice text—it is one doctor's, one man's diligent effort to challenge the way medicine is perceived and practiced, to challenge the way patients view their role in the care they receive, to push against notions that science is omnipotent, that doctors are omniscient or possess the "correct" solutions at any given moment. Ultimately, Berger suggests that perhaps the best path to improving and managing illness is to recognize each patient as a unique individual with a unique set of needs and preferences. Some might see this as a revolutionary idea—and certainly Berger's writing of this book which contains true stories, real scenarios might qualify as revolutionary. After all, Orwell wrote, “…telling the truth is a revolutionary act.” This well-wrought, intelligent and inventive book calls on all of us to look at medicine with a very different mindset. Despite many myths that maintain otherwise, there are no magic solutions in medicine, but there are solutions—real, and however imperfect ways in which all of us can achieve better results for not only ourselves but for others as well.
B**R
often treating poor people or members of minorities less well
Zack Berger has done it again!! Making Sense of Medicine is an engaging, informative volume that every one of us should read right away. He takes patient-centered care to new heights, opening up options for us that we would not have considered. His expression “patient preferences” is the mantra of the book, reminding us again and again that not only MD’s, but we too play a significant role in medical decision-making. He also argues that the medical establishment is skewed in favor of white patients, often treating poor people or members of minorities less well. Zack Berger grabs the reader’s attention with real case histories. Once you start reading, you won’t put this book down until you finish it. This volume will not just benefit patients but will get MD’s to think differently about how they practice medicine.
D**N
great read, full of clear observations and intelligent conclusions
Insightful, great read, full of clear observations and intelligent conclusions.
A**R
I have already recommended the book to other patients and will continue to ...
“A general diagnosis of our health-system problems is that we don’t get the right treatments to exactly the right person just when and where they need it.” This quote underlies the premise of "Making Sense of Medicine" by Zackary Berger, MD. Berger's book is a must read for anyone interested in healthcare, from doctors to industry executives to patients engaged in their care. He presents and helps the reader navigate the dichotomy between “evidence based medicine” / “population health” and “patient-centered care.” He examines many of the larger questions that physicians often fail to realize in the day-to-day: How does poverty affect patients? How does subconscious racism affect doctors and their patients? How do doctors and patients work together to prioritize and determine goals? How do we deal with the fact that patients are not just statistics but are people with thoughts, ideas, real lives, and yes, even pain? And, finally, is “evidence based medicine” really evidence based?As a patient I walked away from this book knowing that should I ever live near where Dr. Berger practices I would most certainly want him to be my physician. As someone with a chronic illness, I would want any and all of my physicians reading his book. I have already recommended the book to other patients and will continue to do so.
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