Texas Heart Institute Journal-Review

Time to Care: Personal Medicine in the Age of Technology

Norman Makous, MD, with Bruce Makous. 464 pages. Philadelphia: TowPath Publications; 2009. US $14.95. ISBN 978-0-9776686-1-8. Available from Publisher, Po. Box 43522, Philadelphia, PA 19106.

Field of Medicine: Primary care.

Format: Softcover book. Trim size: 5.5 x 8.5 inches.

Recommended Readership: Anyone interested in knowing how much and why delivery of healthcare in America has changed over the past 60 years. Readers benefitting the most will be the young physicians and young patients who have no real experience with per­sonal medicine-medicine characterized by a strong pa­tient-doctor relationship.

Purpose: To show why a strong patient-doctor relation­ship must return to the center of our healthcare system in order to humanize treatment, help reduce unneces­sary spending, and lead to a healthier, happier society.

Content: 366 pages of text divided into 6 parts, con­taining a total of 71 chapters.

  • Part I looks at medical education and medical care before technology took center stage.
  • Part II shows how solo general practitioners or small groups of physicians in the same specialty were at one time the primary providers of medical care-an arrangement that solidified the relationship between doctor and patient.
  • Part III directs attention to the dramatic shifts in medicine brought about by technological advances.
  • Part IV reviews the impact of modern technology on medical practice, using the field of cardiology as an example.
  • Part V examines the role that government, hospitals, healthcare organizations, and insurers play in roday’s medical care; the efforts being made to manage the costs of such care; and current and future practices in the rationing of medical care.
  • Part VI offers insights into the future of healthcare delivery.

The book also contains a 3-page table of contents, a 3-page preface, a 5-page introduction, a comprehensive 14-page index, a 35-page glossary for the lay reader, the author’s 13-page curriculum vitae, a full-page diagram of the human heart, a list of 28 additional readings, an acknowledgment page, and a bit about the author and his son Bruce.

Strengths: The author’s commitment to and compas­sion for his patients reverberates throughout this book. By using dozens of case anecdotes from his 60-year ca­reer as a personal-care cardiologist, he effectively illus­trates how a strong patient-doctor relationship-the essence of personal medicine-brings joy and satis­faction to everyone involved. Relatively few physicians ever have such a long professional career, and even fewer ever document their experiences in a manner so clear and so detailed as Dr. Makous has.

Physical properties of the book also deserve credit. On the front cover are pictures of medical practice ranging from the horse-and-buggy days to the current world of body scanners; included is a snapshot of the author as a Lieutenant in the U.S. Navy, using his stethoscope to examine a patient. The pages of the book are of good stock with easy-to-read print, and selected cartoons and photographs provide spice and a touch of nostalgia.

Weaknesses: Everywhere in the text, certain words ap­pear in bold when first mentioned-a signal that they are included in the glossary. This innovation creates dis­tractions, because the boldfaced words always pop up suddenly, and often in the middle of a sentence. One could also question the need to include the author’s ex­tensive curriculum vitae. The book stands tall without it.

Overall Grade: e e e ¥2

Herbert L. Fred, MD, MACP, The University of Texas Health Science Center at Houston.

December 2009, Volume 36, Number 6, p. 631

Grading Key

e e e e e = outstanding; “”"” = excellent; “”" = good; “” ~ fair; ,,= poor