Guarded Prognosis: A Doctor and his Patients Talk about Chronic Disease and How to Cope With It 

The subtitle tells much more about this book than the title. For doctors do not treat aggregates of patients, they treat individual humans. Lockshin argues that governments, insurance companies, hospitals, and HMOs should listen to individuals rather than the impersonal figures aggregates produce. Many of Lockshin’s patients have lupus, arthritis, or scleroderma. Since those diseases affect different patients in different ways, Lockshin’s emphasis on the individual makes sense; each person’s sense of health priorities, he says, should be carefully considered when choosing a treatment program. Lockshin draws a clearcut distinction between medicine and science: the former deals primarily with individuals, the latter with theories and groups. Since HMOs have come into the picture, many doctors are being forced to think of each potential patient in terms of whether this treating of this person is going to be an occasion of profit or of loss, and he asks, “Are you sure that you know for whom your doctor works?”

William Beatty,  Booklist

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