Author: Dora Calott Wang, M.D.

Publisher: Riverhead Books

ISBN 978-1-59448-753-8

Click Here To Purchase The Kitchen Shrink: A Psychiatrist's Reflections on Healing in a Changing World

Dr. Wang is a graduate of Yale School of Medicine and University of California, Berkeley. (inside back cover, 2010) She is a psychiatrist by training and has worked in private practice, as university professor, and on numerous hospital staffs. She and her family currently reside in New Mexico.

Dr. Wang writes about the changes that have occurred with regard to the inception of managed health care across this country. She describes scenarios where she was helping patients to get better and live healthier lives, but also scenes where insurers stepped in and began rationing care and dictating the time that medical professionals were allowed to spend with new and revisiting patients. She opens our eyes to the push by pharmaceutical companies for medications masking symptoms over preventative care that transpired as managed care became big business. Doctor Wang said, “…the insurance company has long replaced the doctor as a patient’s primary medical relationship.” (2010, p.2) And that medical care “…now seems an impersonal assembly line.”

Dr. Wang recalls with fondness how doctors used to treat their patients from cradle to grave and how that relationship was a personal one, quite unlike today. Toward that end she states, “Here the deep healing of patient’s mind and body occurred without machines or medicines, but through the doctor patient relationship, with the doctor as the instrument of change.” (2010, p.5) That doctor patient relationship changed in the late 1980’s to early 1990’s. American medicine had just been deregulated like the airlines and financial sector. Private for profit corporations began to nibble up our health care system that had previously been run by charitable organizations with emphasis on prevention and treatment. About these changes she said the following: “Insurance companies also started calling the shots, preferring to pay psychiatrists to prescribe medications, leaving psychotherapy for counselors, if at all.” Gone were the days where the psychiatrist spend time evaluating the patient and inquiring about incidents that may be precipitating factors in their current demise replaced by meeting or exceeding the bottom line.

Some of the vital statistics that Dr. Wang wrote about in The Kitchen Shrink have to do with percentage of our GDP (Gross Domestic Product). In 1980 health care costs took up 9.1% and were easily budgeted for. However, by 2001 health care had ebcome 18% of our total GDP. (2010, p.50) And, according to Dr. Wang, that the “…American medical system consumes one sixth of the national economy, more than any other nation…”. A major portion of time under managed health care is allocated to filling out forms and making calls to the insurers because without such paperwork the physicians will not get paid. (p.69)

Today’s hospitals resemble “assembly line medicine, where each doctor cares for only one body part…”. (2010, p.14) “Discharges are earlier and riskier…”. (p.23) Medical care is now a team based approach handled on the various world exchanges with profit for their stockholders as the motive to see more patients and deny more care as cost cutting/profit boosting measures. “The insurance company, not the family, physicians, ...” or the patient, “decide.” (p.41) Doctor Wang asks, “What kind of system is this?” And I totally agree.

I do not have health insurance and am waiting to see what changes occur under the newly legislated national health care. I found Dr. Wang’s book a very eye opening experience down a dark, entirely profit motivated, path that nobody should be forced to walk. I would recommend this book to all persons considering or currently enrolled in medical school and all medical professionals, as well as, all patients, who I am sure can sympathize with the plight of our current health care system and the sad direction it has taken since deregulation. Thank you Dr. Wang!

Click Here To Purchase The Kitchen Shrink: A Psychiatrist's Reflections on Healing in a Changing World