My book covers all the health care settings a reader may encounter: outpatient (the most common type of health care setting encountered by patients), the inpatient (hospital), preventive (patients who are not sick but seek preventive services), and end-of-life care setting. The latter may be especially pertinent in the view of the recent public tragedy of the Terri Schiavo case.
Personal stories of the patients that I encountered make this reading easy to relate to. The experiences of patients are used as starting points to show how doctor's decisions are affected by a variety of non-medical considerations.
I introduce a concept of a Medical Box—forces that have a stronger hold on most physicians than the heavy chains of prison shackles. Here are, what I call, the four corners of the Medical Box:
The current Medical Model—disease oriented thinking.
The text illustrates how each of these is played out in everyday patient care. A number of practical recommendations are offered. The most important theme, overarching the entire book, is empowering prospective patients to use their own common sense and trust their own judgment in making medical decisions about their medical care.
A foreword to the book is written by Colin P. Kopes-Kerr, MD, JD, MPH, who is a Vice Chairman of the Department of Family Medicine, and Program Director of the Family Medicine Residency Program, at University Hospital and SUNY Stony Brook School of Medicine, Stony Brook, NY.
Customer Reviews:
"Primum Non Nocere".......2006-07-30
House, E.R. and Grays Anatomy are not realistic portrayals of the American medical system. According to Dr. Resnik physicians are so afraid of litigation that any deviation from pre-set protocols to treat the patient as an individual and not the so-called disease is unusual. Doctors like Greg House, John Carter would be immediately dismissed and find it impossible to acquire mal-practice insurance. It is chilling to think that the media inspired idea of the omnipotent good-hearted doctor like Marcus Welby or reassuring throaty voiced Dr. Kelly Bracket from Emergency is so false.
When sickness strikes us or a loved one, we expect that in this technological twenty-first century age of marvels that just like our cars or appliances that have `crapped the bed':
A. We can be fixed with some kind of medication or therapy.
Or
B. Our parts can be removed and replaced and we can continuer our lives already in progress and unabated.
Doctor Reznik has pried our heads from the sand, removed our rose-colored glasses and has cut off our source of pap from the glass teat. He has taught us to advocate for ourselves and ask questions, even while the insurance and pharmaceutical behemoths perpetuate the myth that an American homeostasis of mental and physical health is only one more pill, test or procedure away.
Review: The Secrets of Medical Decision Making.......2006-06-27
In this work, Dr. Reznik alerts the consumer to the reality of today's medicine and its practices. He presents a medical industry that places the individual physician in a `box' that influences his decision-making beyond what is always best for the patient. Dr. Reznik position is that the modern physician is unduly influenced by the fear of litigation, the need to follow untested medical guidelines, the pressure of the pharmacology industry and the demands of the insurance companies. He presents a compelling case for his beliefs. His thesis is presented in short chapters of two or three pages that use interesting case studies to inform the reader about their need to ask questions and take charge of their own medical needs.
His writing style is easy to digest and compelling. This work is an effortless read and easy for the layperson to understand. My one complaint is in the displayed copies of medical records, notes and tests results as the printing is blurred and difficult to see.
Dr. Reznik's concern that many patients allow the medical industry to take over their individual decision-making is unfortunately very accurate - too many patients get caught up in endless consultations and unnecessary tests. My one very strong objection is to Dr. Reznik's dismissal of the need for cancer screening. As a cancer survivor myself, I believe the truth gives the patient the power of control. To tell the public that cancer screening, especially mammography, is not necessary is extremely dangerous and endangers lives unnecessarily.
Important, Enlightening, Instructive, an Eye Opener.......2006-05-26
Oleg I. Reznik M.D. has coined the term "Medical Box" to illustrate the boxed-in thinking imposed on physicians. He calls the four corners of the box: fear of litigation, financial and time pressure, guidelines of Health Care authorities, and the current Medical Model, disease oriented thinking.
Dr. Reznik uses vignettes from actual medical records, his own experience, and from the experiences of his colleagues to further illustrate the implications of the obstacles placed on the physician and the medical profession as a whole.
Each vignette reflects the perspective of the physician, the patient and family, sometimes the societal, and finally the spiritual/philosophical view as it relates to treatment, suffering, guilt, and in the final preparation of facing death.
Reznik supports the belief that the patient should assume more responsibility in learning the options available to him, the side effects that may result, and the expected results of taking action. He suggests asking these three questions. What is the doctor trying to find out from the testing? How will this additional information affect medical management and prognosis? What does the testing entail? What are the risks of test or procedure?
"Secrets of Medical Decision Making" freely uses detailed descriptions of medical treatments, tests, and procedures written in a layman's language. Rezik has produced an outstanding work. This is a guide to help patients avoid becoming victims of the health care machine. It is truly an eye opener. Dr. Rezik is well qualified to write this book. He is a board certified family physician. This study is an important addition to studies on patient advocacy. Rezik has done thorough research and has provided comprehensive reference documentation. Physicians, medical practitioners, and patients will all benefit from reading this book. It is both, enlightening, and instructive. This is a book to be read and read again.
Informative. Always ask "why?".......2006-03-01
Reviewed by Kelli Glesige for Reader Views (2/06)
If you want to know why doctors make some of the recommendations they do, then here is the book for you. Speaking as both a physician and a patient, Reznik helps us to understand what motivates our physicians and why they often say the things they do. "The Secrets of Medical Decision Making" is a book we can all benefit from reading because we all need health care at some time, or we are put in the situation of needing to make medical decisions for another. Oleg I. Reznik, M.D. has a goal of making us conscious and informed in the medical decisions we must make; by doing so we could have a much better health care system than we currently have.
Reznik calls our current health care system The Health Care Machine because it has become so mechanical. So many demands must be met that it is almost like an assembly line. As patients, we need to have freedom to make our choices and to question the system. The physicians and other health care workers are placed in a position called The Medical Box within The Health Care Machine because they are pressured to have only a standard, mechanical response to any given set of problems. As patients, we need to be aware of this system and the way it works so we can be aware of the limitations. Doctors are not omnipotent, which so many of us want to believe, and they should be relieved of such a burden, but so often, they are forced to stay "in the box" to protect themselves.
To ease our understanding of the material Reznik presents, he addresses four different viewpoints with each topic. Patient/Family Perspective deals with issues that would be most relevant to prospective patients and their families. Physician's Perspective gives the physicians viewpoint on the discussed topic. Societal Perspective gives the ramifications on the society as a whole. Spiritual/Philosophical Perspective talks about the spiritual and philosophical aspects of medical care because these cannot be taken from any attempt at trying to understand a human being. Dr. Reznik presents true stories of actual clinical studies in his book to help explain the "rules of the game" in this game of health care. He wants us to understand what drives the doctor so that we can learn to be more self-reliant.
I found the information on several different medical tests to be quite informative. We are given some questions to think about before agreeing to a test and the reasons why doctors prescribe the tests to begin with. Reznik speaks at length about prostate screening and the treatment of prostate cancer, mammograms, and how the statistics on cancer survival have progressed. All the information he presents is quite interesting and worth one's time to read in order to be a more informed individual.
Everyone may not find all the information presented by Reznik to be relevant, but we can all benefit from the ideas presented. I personally will feel less intimidated the next time I ask, "Why?" when the doctor recommends something I am not sure about. Take charge of your health and do what is best for YOU. Reading this book is well worth anyone's time who wants to be an informed patient.
.
Highly Informative!.......2006-01-14
Dr Reznik has written a highly informative book that Americans need to read for the knowledge that most of us don't have. In today's constantly changing medical world, we need all the help that we can get. Many thanks to Dr Reznik for sharing with us.
(posted for a friend in Cicero, NY, not able to access the website)
Book Description
The movement toward creating more sustainable communities has been growing for decades, and in recent years has gained new prominence with theincreasing visibility of planning approaches such as the New Urbanism. Yet there are few examples of successful and time-tested sustainable communities.
Village Homes outside of Davis, California offers one such example. Built between 1975 and 1981 on 60 acres of land, it offers unique features including extensive common areas and green space; community gardens, orchards, and vineyards; narrow streets; pedestrian and bike paths; solar homes; and an innovative ecological drainage system. Authors Michael and Judy Corbett were intimately involved with the design, development, and building of Village Homes, and have resided there since 1977.
In Designing Sustainable Communities, they examine the history of the sustainable community movement and discuss how Village Homes fits into the context of that movement. They offer an inside look at the development of the project from start to finish, describing how the project came about, obstacles that needed to be overcome, design approaches they took, problems that were encountered and how those problems were solved, and changes that have occurred over the years. In addition, they compare Village Homes with other communities and developments across the country, and discuss the future prospects for the continued growth of the sustainable communities movement.
The book offers detailed information on a holistic approach to designing and building successful communities. It represents an invaluable guide for professionals and students involved with planning, architecture, development, and landscape architecture, and for anyone interested increating more sustainable communities.
Customer Reviews:
A neutral guideline to understand the principle.......2002-02-28
The book has indicated the underlying theory, substantial framework for the implementation of the pinciple, and the practice of the p.p. in international society. Overall, most articles have done good job in describing their appraisal of the principle. I strongly recommend the book because of those authors' enthusiasms in advocating the application of the precautionary principle to address the scientific uncertainty. Even some of the articles cite insufficient information to support their points.
On Target but Fragmented--Needs New Edition with Summary.......2001-06-02
This is the second best of several books on environmental policy I have reviewed, and it merits careful scrutiny in part because it brings together a number of expert authors and there is in essence "something for everyone" in this edited work. What is lacks, though, is a good summary chapter that lists how the "precautionary principle" should be applied across each of the top ten environmental areas of concern--something that could circulate more easily than the book, and perhaps have a beneficial policy impact at the local, state, and national levels--and I suggest this because the meat of the book is good, it needs an executive summary.
The chapter that was most meaningful to me, the one that I think needs to be migrated into business education, international affairs education, science & technology policy education, is by Gordon K. Durnil, Chapter 16, and it deal with "How Much Information Do We Need Before Exercising Precaution." This is a brilliant piece of work that dissects our current environmental policy information collection, processing, and analysis system, and finds it very deceptive, disingenuous, and consequently seriously flawed.
For the best on the environment, read "Pandora's Poison". For the best on public health, read "Betrayal of Trust." For a very fine cross-over book that has good chapters from various good people, this is the book to buy and enjoy.
Ambitious and full of food for thought.......2000-07-02
"Protecting Human Health and the Environment" discusses what is involved in coming up with a meaningful, workable definition of the "precautionary principle." It also talks about how this principle (which comes down to the "First, do no harm" of Hippocrates) can be given effect in environmental policy, law, and specific problems. The book is a collection of articles that were first presented at the Wingspread Conference in 1998. This variety of voices and perspectives is one of the real strengths of the book: the precautionary principle is a huge idea that involves some fundamental shifts in American thinking about science, nature, and environmental protection; and this is the first book I've read which really manages to convey that. Those who think that the "precautionary principle" is another enviro plot to co-opt American policy and advance unfounded, neo-Luddite agendas really need to read this book. It is rich in thought-provoking ideas, backed up by meticulous review of existing policy, law, and science -- powerful without being dogmatic, sincere without being cloying. And those who grasp the severity of the threats to sustainability facing human society should find a deeply coherent, beautifully articulate means of responding to these threats. Unlike many of the sweeping solutions advance over the years to the human inability to moderate its behavior for the good of the whole, implementation of the precautionary principle actually seems possible! Indeed, it is already being pursued. Let's hope that lots of courageous and energetic folks get their hands on this one.
Book Description
Multi-Criteria Decision Making (MCDM) has been one of the fastest growing problem areas in many disciplines. The central problem is how to evaluate a set of alternatives in terms of a number of criteria. Although this problem is very relevant in practice, there are few methods available and their quality is hard to determine. Thus, the question `Which is the best method for a given problem?' has become one of the most important and challenging ones.
This is exactly what this book has as its focus and why it is important. The author extensively compares, both theoretically and empirically, real-life MCDM issues and makes the reader aware of quite a number of surprising `abnormalities' with some of these methods. What makes this book so valuable and different is that even though the analyses are rigorous, the results can be understood even by the non-specialist.
Audience: Researchers, practitioners, and students; it can be used as a textbook for senior undergraduate or graduate courses in business and engineering.
Customer Reviews:
Worst MCDM book.......2004-10-07
I was really surprised how such a book can be published. It deals only with AHP! AHP! AHP! [If you would like to know more about Analytic Hierarchy Process[AHP] - Just buy books written by Saaty ] and very little about other decision making techniques . Triantaphyllou's book has no organization and clear structure. Believe me you will end up learning nothing from this book. There are several other good books which are available better look for it folks
A comprehensive study on AHP and other popular MCDM methods.......2001-08-10
This is a very good book for people who are involved in evaluating different alternatives and each alternative has its own strengths and weaknesses. It is also a very good reference for students and researchers who are studying/working in the area of decision analysis. It is especially useful for people who are interested in trying to find out which MCDM method is the best and who have used or intend to use the AHP method in their work or research. It has extensive and intensive coverage on the AHP method for ranking alternatives, other pairwise comparison methods for extracting weights, their shortcomings and improvement, and their comparisons with other popular MCDM methods. The discussions on the ranking abnormalities of the AHP method and its revised versions are very informative. The comparisons are supported using numerous numerical examples, the conclusions are convincing, and the contents easy to understand.
A must-read for practioners and researchers. Excellent!.......2001-07-12
I read this book with great interest. I am a Faculty Member at the New York University. This book is very clear to the point. I liked very much the in-depth analyses of many real-life MCDM issues and also the many numerical examples. The computational results are very thorough and revealing. The first book of its kind. An Excellent piece of work!!!
Comments from Dr. E. Triantaphyllou, email: trianta@lsu.edu.......2001-06-01
Multi-Criteria Decision Making (MCDM) has been one of the fastest growing problem areas during at least the last two decades. Thus, due to the importance of this field, many MCDM methods have been proposed. Ironically, often these methods contradict each other when they are posed to solve the same decision problem. This, in turn, has increased the confusion in MCDM theory and practice.
As Professor H.-J. Zimmermann from Aachen, Germany, remarked in the foreword for this book, this is exactly where this book has its focus and why it is that important: Rather than suggesting another MCDM method without any convincing justification, this book concentrates on the best known and most frequently used methods, compares them extensively and makes the reader aware of quite a number of "abnormalities" of some of the methods of which users are often not conscious. The book also considers very critically the most touchy points in solving real MCDM problems, namely, the quantification of qualitative data, how to derive relative weights of importance from ratio and difference comparisons, and also how to perform a sensitivity analysis with many MCDM methods.
This book provides a unique perspective into the core of MCDM methods and practice. Many theoretical and empirical analyses are presented and are complementary to each other. This allows the reader to gain a deep theoretical and practical insight into the topics covered in this book. In addition, the author offers at the end of each chapter and at the end of the book suggestions for further research. More information on this book can be found in the personal web site of the author which is located at the Louisiana State University in the U.S.A.
A nice book!.......2001-05-12
I enjoyed reading it! Nice exposition of the various subjects.
Average customer rating:
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Environmental Health Risks and Public Policy: Decision Making in Free Societies
David V. Bates
Manufacturer: University of British Columbia Press
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Risk-Benefit Analysis: Second Edition (Department of Physics)
Richard Wilson , and
Edmund A. C. Crouch
Manufacturer: Harvard Center for Risk Analysis
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Against the Gods: The Remarkable Story of Risk
ASIN: 0674005295 |
Book Description
Over the centuries, mankind has slowly reduced the risks and hazards that even as recently as a century ago kept life expectancy to a mere 45 years. Our average lifespan has improved to 77 years by remarkable progress in public health and safety. But with this improvement has come a demand for greater efforts to improve both life expectancy and the quality of life. The first edition of this book, published in 1982, was a pioneer in the development of logical, yet simple, analytic tools for discussion of the risks which we all face. This new edition, revised, expanded, and illustrated in detail, should be of value both to professionals in the field and to those who wish to understand these vital issues.
Customer Reviews:
Exceding Professional Ethics.......2007-08-19
This Author reminds the reader to aim for exceding the "standard of care".
Anticipating risk is a part of benevolent care for the client/patient, and a safeguard of liability for the professional.
This is a book to store for easy reference and one I will readily recommend to colleagues.
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Aiding Decisions with Multiple Criteria: Essays in Honor of Bernard Roy (International Series in Operations Research & Management Science)
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Book Description
Aiding Decisions With Multiple Criteria: Essays in Honor of Bernard
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