Author: Oleg I. Reznik M.D.

ISBN: 1-932690-16-6

Publisher: Loving Healing Press

(Review of Advanced Review Copy-Publisher’s Uncorrected Proof)

The following review was contributed by:  NORM GOLDMAN:  Editor of Bookpleasures &CLICK TO VIEW  Norm Goldman's Reviews       

A gutsy” exposé of the state of the health care system serves as a timely reminder that much is needed in the manner in which physicians and patients interact in the dispensing and receiving of effective medical care in the USA.

Secrets of Medical Decision Making: How to Avoid Becoming a Victim of the Health Care Machine is hardly flattering, and you have to admit that Dr. Oleg I. Reznik  shows a great deal of courage as he analyzes many of the shortcomings of the health care industry in the USA.

More disturbing is the author’s convincing assertion that, unfortunately, physicians are victims of a boxed-in mentality or as he terms it the “Medical Box.”

A box that comprises four elements: fear of litigation, financial time and pressure, guideline of health care authorities and the current Medical Model-diseases oriented thinking.  

 Throughout the book Reznik provides several examples from his own personal experiences as a physician, as well as from others, to illustrate just how confining and harmful this mentality has proven to be in providing questionable and even at times mechanical care. As the author points out, many medical decisions are based on the avoidance of litigation rather than quality of care. Consequently, unnecessary medical procedures are often prescribed without informing patients of possible dangers, let alone the added costs.   

 Rightly, Reznik does not shy away from hammering away at some questionable practices that often reflect conflicts of interest. A prime example is where we see lecturers of continuing education seminars being sponsored by pharmaceutical companies. The author recounts that during one of these seminars he questioned a speaker, who taught about the newer stricter guidelines for treating high cholesterol. Apparently, the speaker was sponsored by a pharmaceutical company that manufactured one of the new, expensive and powerful combination drugs for the aggressive treating of high cholesterol. When Reznik inquired whether there was any data that illustrated that people who took the medication ended up living longer, not just those who had fewer heart attacks, the speaker became visibly angry and raised his voice.

What was even more disturbing and a belief that is very often prevalent in medical decisions was the reply that the data was difficult to obtain and “that if he were an expert witness on a plaintiff’s side after a plaintiff had a heart attack and I (and he pointed his finger at me from the podium) did not treat this plaintiff according to these guidelines, he would ‘tear me up to threads.’ After a moment of silence, the lecturer completed the lecture and presented slides provided to him by the pharmaceutical company.

 From the patient’s perspective, Reznik reminds his readers that many of us have unrealistic expectations about the capabilities of drugs and testing. This is often influenced by the suggestions we receive from the media and the medical system. Tests are not infallible and very often do not bring  a definitive diagnosis. Following medical guidelines or popping some of the “so called” wonder drugs will not guarantee us permanent solutions to our ailments. 

As the author points out, there is such a thing as the Ulysses Syndrome, which is defined as “the ill effects of diagnostic investigations conducted because of a false-positive result in the course of routine laboratory screening: or: ill effects from follow-up diagnostic tests following a false-positive test.”

 Always vexing, when dealing with the topic of health care, is the manner in which facts and data are presented, so as not to leave readers with a sense of ennui.Reznik cleverly addresses this dilemma in breaking down his chapters into different perspectives or subheadings: patient/family, physician, societal, and spiritual/philosophical. This approach facilitates the flow and understanding of the material.

 This book is a plea for a new way of thinking and those who need convincing about the shortcomings of the health care system would do well to read this book.