Demanding Medical Excellence: Doctors and Accountability in the Information Age

Finally, a health-care book that doesn't wring its hands over the decline of medicine at the hands of money-grubbing corporations. Instead, Millenson, a journalist and senior analyst for a health and welfare consulting practice, presents a portrait of American medicine improving, thanks in part to quality-control measures imposed by HMOs and health benefits managers. ""The keys to medical excellence,"" he says, ""are information and accountability."" Gone are the days when doctors were seen as magicians: Today, when patients are better informed about treatments and physicians held accountable for their results, people are getting better faster. He focuses on simple, practical measures that have already improved patient outcomes: a hospital in Salt Lake City that uses computers to prevent harmful drug interactions; a Harvard-affiliated health center that encourages asthma patients to be active in their own treatment. While Millenson is not an all-out HMO defender, he attacks the conventional wisdom that their cost-cutting puts all patients in danger; he argues that their emphasis on proven results, in fact, has forced doctors to find the most effective treatments. His research is exhaustive, including personal accounts from physicians, patients and health-care administrators across the U.S. If at times, his attempts to include all relevant information turn into unnecessary digressions, overall this is a readable account of what Millenson calls a ""quiet revolution"" in health care, and his optimism makes for a refreshing change. (Nov.)