A Bitter Pill: How The Medical System Is Failing The Elderly Paperback – Sep 28 2009
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There is real anger in his newly released book . . . Sloan's experiences of seeing energetic patients transformed into near-zombies because of over-medication after trips to the hospital, have led him to call for radical changes to medical treatment for the elderly—including keeping them out of the hospital, if at all possible. These seemingly common-sense recommendations are radical because they swim against the stream of modern medicine. —The Province(2009-11-28)
Sloan's experiences of seeing energetic patients transformed into near-zombies because of over-medication after trips to the hospital, have led him to call for radical changes to medical treatment for the elderly—including keeping them out of the hospital, if at all possible. These seemingly common-sense recommendations are radical because they swim against the stream of modern medicine. —The Province(2009-11-28)
Frail old folks gobble up health-care resources—and too often gain no benefit. That's the message in Dr. John Sloan's provocative new book, A Bitter Pill: How the Medical System is Failing the Elderly. A Vancouver family physician, Sloan has spent the past 15 years doing home care exclusively for old people. —Toronto Star(2009-12-03)
The good news is that at least a few Canadian physicians have developed a way to practice medicine that is tailored tothe unique needs of [the elderly], an approach that increases comfort and dignity, allows the frail elderly to stay at home in comfort longer and choose the terms of their final days. John Sloan is the Vancouver-based general practitioner and UBC Medical School professor who has pioneered this new approach, which is long on common sense and kindness and notably short on high tech interventions and expensive multiple medications. He makes the case for it in his 2009 book A Bitter Pill: How the Medical System is Failing the Elderly. —The Tyee(2010-07-26)
Dr. Sloan treated the elderly at home for many years. (Yes, he made house calls!) His recent book, A Bitter Pill, is an utterly convincing indictment of the way we're wasting money on useless care for the elderly, while making their lives worse. It's essential reading for anyone who's interested in health-care reform, as well as for anyone who's responsible for an elderly person or anyone who is or will become one. —Globe & Mail(2010-11-11)
About the Author
John Sloan, MD, is a senior academic physician in the Department of Family Practice at the University of British Columbia and has spent most of his thirty years of practice caring for the frail elderly in Vancouver. He has lectured throughout Canada and in Europe and the United States, and is sought after as an inspirational speaker on geriatrics. He lives in Vancouver and Roberts Creek, B.C.
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Top Customer Reviews
light on the care of the elderly and found it wanting. He proposes an attractive alternative based upon his own working experience. During these times of diminishing resources his suggestions for change must be considered by all those concerned. It is a win for all concerned!
Most Helpful Customer Reviews on Amazon.com (beta)
Some days, I can hardly bear to see what we do to/for our elderly, or what is considered the standard of care for people who are too frail to benefit from preposterous and potentially harmful interventions, yet aren't offered even the simplest kindnesses or basic interventions - hot tea, a warm blanket, an appetizing meal, or prompt toileting.
Dr. Sloan is no easier on the system which is sagging under the weight of care to a full house of those frail elderly who cannot and do not benefit from gee-whiz medicine, and daily regimens of three dozen pills, as the critically ill pile up in the ambulance bay and emergency room hallways.
Dozens of solutions are proposed every day. One of the simplest is offered here - compassionate, thoughtful, appropriate care of the elderly. Facing some very hard truths about what aging really involves, and how it inevitably ends, no matter how you intervene. But as Dr. Sloan shows, how you intervene does matter, but it doesn't always have to involve the heavy machinery of modern medicine.
Amongst the elderly, some are healthy and robust, but many are not. Dr. Sloan visits and attends to those seniors who are both frail and ill. Their numbers will only grow as longevity continues to increase and medical intervention continues to innovate. Regrettably however, conventional medical practices do NOT serve the needs of the frail.
As Dr. Sloan sees it, there is a radical disconnect between the methods of conventional medicine and the needs of the frail elderly. In most cases these people are suffering from multiple pathologies, their systems can no longer benefit from standardized medication, and their primary concerns are to maintain simple functions and gain some degree of comfort. More tests, more procedures, more drugs - none of these will any longer help.
What WILL help is to listen effectively to their articulated needs, and administer the kind of assistance that will restore functioning (walking, eating, etc.) and produce comfort (easing pain and constant worrying). None of this is really very hard to do - BUT it will only likely happen in the context of an understanding of both the benefits AND the limits of conventional medicine.
This is the case that Dr. Sloan makes. The available evidence clearly indicates that his is correct. The demographic trends now underway suggest that the current situation will only worsen. Both medical care givers AND the elderly themselves need to read this book, and then pass it onto someone in a policy-making role. Only through the coordinated actions of the elderly, medical practitioners, and health policy-makers can the true needs of the frail elderly be administered to, and the costly mis-application of resources be corrected.
I highly recommend this to anyone in health care (like me) who cares for the elderly, is elderly, or has plans to become elderly.
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