Peter A. Ubel

I absolutely love when patients come into work having "googled" cataracts. Even better when they've talked to their friends. And those that get a second opinion? Fantastic. But not as great as the previous two. If I had money to burn I'd spend every first appointment asking the Dr. what their preferences were... which is sometimes the better question to ask.

This book frankly illustrates the potential issues with making stressful medical decisions. It also illustrates reasons, beyond "they might sue," that doctors should care about educating their patients. He also gives some solid resources for dealing with decision-making, and a helpful list at the back to help patients know what to do.

He overlooks one point, though. Who has money to spend on these extra appointments? Obviously him. But few people and fewer of the people who end up being frequent visitors in the office have that type of money.

I was rather miffed in one thing, though. While he validly points out that one problem might be that MDs and DOs are uninformed when it comes to what patients would prefer, he can't really rid himself of biased viewpoint that patients really don't know what's best/what they want unless they've listened to the Dr. And I didn't like this condescension-ist way of looking at/writing about people. Some (a lot) of patients are really smart. Others just need the knowledge that they are responsible and accountable and they'll step up to the plate.… (plus d'informations)

De titel van het boek zegt het al: hoe vallen de beste beslissingen als het over jouw gezondheid gaat? Heeft de dokter-expert altijd gelijk of moet je maar opkomen voor je eigen mening?

Peter Ubel geeft het overzicht: van de strijd naar meer autonomie tot de valkuilen die opdoemen bij de nieuw verworven positie van de patiënt (en de arts).

Wie thuis is in de gedragseconomie, informatiegeletterdheid of communicatietheorieën, zal zich niet verbazen dat ook hier een glasheldere communicatie of verwerking van feiten niet volstaat. Het gaat over het inschatten van risico's, het overwegen van persoonlijke voorkeuren en over de intermenselijke relatie tussen arts en patiënt. Hij eindigt met enkele methoden om de beslissingen te verbeteren en baseert zich op positieve resultaten in de praktijk.

Persoonlijk deed het deugd om eens één thema helemaal uitgewerkt te zien in een boek, met veel verschillende aspecten uitgediept, alle consequenties benoemd. Maar ook leken in deze uithoek van de populair wetenschappelijk literatuur, zullen het boek vlot lezen denk ik. Persoonlijke verhalen en anekdotes worden voldoende afgewisseld met duiding over de wetenschappelijke en historische context (en omgekeerd).

Spijtig dat het boek nog niet in het Nederlands verkrijgbaar is.… (plus d'informations)

More reviews at: http://www.onstarshipsanddragonwings.com/2012/04/22/tangent-time-nonfiction-2/

Title: Pricing Life
Author: Peter A. Ubel, MD
Pages: 183 paperback
Summary: I will start off saying this book is bound to be super contentious given the current political atmosphere around health care and what our country should do about it. This book focuses on the US health care system and talks about something that apparently a lot of people hate: health care rationing. He starts by defining a working definition for health care rationing, since it is not something agreed upon at all. He continues by making the argument that we are getting to the point in health care progress that we really will have to ration health care services if we want to afford reasonable health care for everyone as a nation. The idea is that every year more and more expensive new therapies come out for the big scary diseases and most of the time they are highly unlikely to actually help that much, so where should the line be drawn of what is covered by health care providers and what isn’t?
I found the book quite approachable for a non-premed college graduate and interesting. It obviously is a very difficult issue, but Ubel explains his thoughts and suggestions very well and it’s something I’m glad health care professionals might start thinking about, since as a patient I had no idea how unnecessarily expensive normal procedures were and how unhelpful a lot of screenings are to do annually. If you are interested in this sort of thing, I definitely recommend it as an interesting and engaging read.… (plus d'informations)

Peter Ubel, a self-described "flaming moderate," begins the book describing some of the things free markets fail to address - redistribution to smooth out bad luck, externalities, irrational participants, and imperfect information. He focuses on the latter two in this critique of unconstrained free markets and the fundamentalists who endorse it. Pop economist Tim Harford, for example, claims habitual smokers and gamblers are merely rationally demonstrating revealed preference and advertising actually adds consumer value to products.

Human beings, who evolved thousands of years ago in small groups on African veldt, are unsurprisingly irrational and innumerate when faced with the modern world. We are often not very good at acting in our own (or society's) long-term best interest. Marketing is a huge and profitable business, working harder every day to find new ways to exploit human weaknesses. There are simple ways, Ubel claims, to address our failings without disproportionately hampering economic development or personal freedoms.

Not much is new in this book but it is a good readable introduction to some of the problems introduced by behavioural economics, with a slant toward health issues.… (plus d'informations)