American health care is a technological marvel. It’s also a culture-war football and an accessory to U.S. society’s grossest inequities. Three new books spotlight the dedication and dysfunction in its midst.
The family doctor represents an ideal: a physician to call our own, there for us through all our needs, the champion of our care. The role also cuts to the heart of our health care debate — a mainstay of socialized medicine, it is increasingly untenable within America’s patchwork of mostly private insurers.
In “Searching for the Family Doctor: Primary Care on the Brink,” management Professor Timothy J. Hoff depicts a field in crisis amid a system trending toward “transactional,” volume-driven, ever more “balkanized” care. Professional acumen is being usurped by algorithms, and patients’ expectations are conditioned by their experiences as consumers, Hoff writes. The family doctors he interviews are harried, careworn, buckling under administrative overheads and forced to embrace an impoverished version of the role for which they were trained. Compared to colleagues in adjacent specialties, they’re poorly remunerated.