Sandeep Jauhar was a Ph.D. student in physics at Berkeley when a girlfriend’s incurable illness made him yearn for a profession where he could affect people’s lives directly. Once situated at a New York teaching hospital, Jauhar wrestled with his decision to go into medicine and discovered a gradual but deepening disillusionment with his induction into the profession. Jauhar’s conception of doctoring and medicine changed during those first eighteen months as he asked all the hard questions about medicine today that laypeople are asking—and reached satisfying and often surprising conclusions about the human side of modern medicine. Today he is a thriving cardiologist and the director of the Heart Failure Program at Long Island Jewish Medical Center. He writes regularly for the New York Times. He lives with his wife and their son and daughter on Long Island.
Jauhar's new book is Doctored: The Disillusionment of an American Physician.
From his Q & A with Sarah Kliff at Vox:
SK: One of the parts of your book I found most disturbing is about how referrals work. Your experience seems to suggest that referrals are a lot about money and relationships, and that a lot of follow-up care and tests are unnecessary. Why do doctors accept referrals for procedures that they don't think are necessary?Learn more about the author and his work at Sandeep Jauhar's website.
SJ: There's an etiquette. If someone asks you to see a patient, and you refuse, you're never going to get a referral again. Your business could dry up. I'm not under nearly as much pressure as an interventional cardiologist [who does surgeries]. What are you supposed to do when you feel like the patient doesn't need the care? It's a conflict that has to get resolved, and sometimes the physician who is being referred to just acquiesces.
SK: The case that jumped out at me in your book the most was the old woman who you didn't think should have surgery, but she did anyway, mostly because another cardiologist seemed worried about losing out on the surgeon's business. It's a scary situation to think about as a patient.
SJ: It is scary. That case did have a discretionary element. I wasn't 100 percent sure I was right and that the surgeon was wrong. I, as a cardiologist, was saying, we shouldn't do anything, but we ended up doing it. She did end up...[read on]
The Page 69 Test: .
The Page 99 Test: Doctored.