Thursday, May 18, 2017

Sandeep Jauhar

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 2014 book is Doctored: The Disillusionment of an American Physician.

From the transcript of his 2014 interview with Fresh Air's Terry Gross:

GROSS: So because early in your career as a cardiologist you were have trouble making ends meet, you basically tried moonlighting. And you worked for a private practice. And the financial and work arrangement that you had with the head of the practice opened up your eyes to what some of the problems are that doctors in private practice face. So tell us a little bit about the work and financial arrangement that you had there.

JAUHAR: Well, a lot of academic physicians actually do moonlight to supplement their salaries. And I was introduced to a cardiologist who was mainly working in Queens and started working for him both in the hospital by seeing some of his patients in the emergency room for which I was paid a fixed supplement to my salary. And I also worked in his private office as well as satellite offices.

And so I would go on the weekends, see patients, and if the patient's needed cardiac testing, those patients would be referred back to his main office to get stress tests or echocardiograms. And what was made very clear from the beginning is that seeing patients was not financially that rewarding for the practice because seeing a patient, spending 20, 30 minutes with a patient might be reimbursed $80, $90. But sending a patient for a nuclear stress test was much more profitable. A nuclear stress test at the time when I started working was reimbursed roughly $800 to $900 and an electrocardiogram was reimbursed $350 to $400. So the whole point of the practice was to see patients - as many as possible - and order as many tests.

Now I wasn't ordering any of those tests, but I was - I mean, unless the patient really needed it. But I was supervising the stress tests that had been ordered by this physician who I was working with as well as some of his physician assistants. So even though I wasn't ordering the tests, I was in the office while these tests were being performed. And I felt very dirty about it.

GROSS: You felt that a lot of these tests were really unnecessary?

JAUHAR: Well, they were unnecessary. There's no question....[read on]
Learn more about the author and his work at Sandeep Jauhar's website.

The Page 69 Test: Intern: A Doctor’s Initiation.

The Page 99 Test: Doctored.

--Marshal Zeringue