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Patients in Peril: The Demise of Primary Care in America

Patients in Peril: The Demise of Primary Care in America

By: Gregg Coodley
Publisher: Atmosphere Press
Publication Date: November 2022
ISBN: 978-1639886265
Reviewed by: Barbara Bamberger Scott
Review Date: December 5, 2022

Gregg Coodley, author and physician, has arrayed statistics and suggestions in this wide-ranging look at a disturbing change that has taken place in American medical care in recent years.

Coodley’s book begins with the general history of becoming a doctor in the US. Once considered a rather lowly and often maligned profession, medical practitioners have risen to a level of high respect as education expanded to tighten requirements and allow for established certifications. The major basis for doctors was traditionally the personal care physician (PCP) model: someone who would take care of most or all a patient’s medical needs, even visiting them in the hospital, communicating directly with the patients and family and recommending any outside care needed. This model has gradually altered, as insurance, government, and private industry have intervened in the realm of American medical practice.

The current model for patient care has changed so that now a patient in the hospital may see a “hospitalist” – sometimes a different one every day – and far more of his/her care will be siphoned off to a wide variety of specialists. Change of insurance can result in mandatory change of PCP, the poor will see only the often-changing group of caregivers in public facilities, and only the very wealthy can afford to engage one doctor for all care. One result of this is that far fewer medical students opt to become PCPs, and that patients are no longer treated directly by someone who knows them, will have observed them for a long period of time, and can offer greater comfort and healing because of the relationship. America is unique in this model, with proportionately far fewer PCPs than elsewhere in the world. Coodley, who boldly established a PCP clinic to benefit his local community, sets forth various possible changes that would offer a better template for medical care, with a reversion to the traditional “family care” doctor being the goal.

Coodley, who has authored/co-authored other factual materials, presents his case here in an intelligent, well-organized forum, so that almost any sensible reader will, from the first page of this extensive exploration, feel a kinship with the author’s clear treatise, his ideals and cogent suggestions for change. He supports his thesis with a vast number of references, factual data and telling statistics, casting light on financial dealings and governmental interventions that have made simple medical care almost too complex for ordinary citizens to comprehend.

Quill says: Gregg Coodley’s book, Patients in Peril: The Demise of Primary Care in America, should be given serious attention and his ideas widely propagated so that Americans needing medical care can feel that they are being offered the best possible options.

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