Feb. 13--Richard S. Klein, MD is attempting to navigate the most controversial area of medicine in the USA in his new book, Surviving Your Doctors. The story begins with an ER physician providing treatment which masks the cause of abdominal pain and the patient dies. The book is replete with similar stories of malpractice events which happen in various medical contexts.

The book recommends getting catastrophic coverage for patients who cannot afford full coverage. In my own experience, there are other alternatives like the Hill Burton Program which forgives facility mortgage debt in exchange for free or significantly reduced health care. In addition, the National Institutes of Health provides free care for patients who qualify for the protocol. In my own experience, the alternative of last resort is to stay healthy through diet, exercise, maintaining medical appliances at home, stress reduction and the judicious use of supplements like ACES, calcium carbonate and Vit. D [Vitamin A, C, E and Selenium = ACES]

According to the author, a mere 5% of physicians are responsible for 50% of the malpractice claims. On-line record keeping is mentioned as a potential solution provided that mechanisms are available to prevent the deletion of automated records. The book suggests that patients carry thumbnail drives with medical data for emergencies. I routinely keep important medical records available for emergencies. Some of my own records date back 40 years. In my own experience, personal record keeping is necessary due to statutes of limitations and local law which may limit the time physicians are legally required to keep records.

Another sordid tale involved the story of a massive gastrointestinal bleed caused by a gastric ulcer which ate its way through the stomach wall of a patient. Just several days before, the physician ignored a positive result for blood in the stools. This story highlights the need for patients to discuss out-of-range test conditions with their physicians and second opinion consulting doctors. In addition, there are a number of symptoms you should never ignore. i.e.

-- blood in the stools or urine

-- black dots in the urine or significantly lower volume of urine

-- limitation of range of motion

-- sharp throbbing pains

-- the inability to produce sweat

-- chronic red eye

-- significantly out of range conditions on your blood/urine work, x-rays

A strength of the book is that the Dr. Klein provides guidance on how to avoid some of these medical errors. For instance, patients should list complaints, review lab results, make certain that the name is on all testing tubes, keep copies of test results and obtain second opinions where necessary. Selecting Board Certified physicians is another important step. I have several physician diplomats in my roster of care providers.

The author advises us to beat the odds by having yearly physicals. Never ignore signs of disease like severely discolored skin, lumps, chronic pain, range of motion restriction and a plethora of symptoms too extensive to list in a finite review.

The book provides good descriptions of classic symptoms. For instance, patterns of fever typified by severe shaking chills may connote bacteria released into the bloodstream from urinary tract infections or pneumonia. Food poisoning may be treated by preventing dehydration via replacement of fluids and electrolytes lost during bouts of vomiting and diarrhea. In my own experience, food poisoning can be lessened by eating at restaurants having a high volume of customers with fresh food either cooked or delivered daily.

Surviving Your Doctors describes classic problems with outpatient care. The issues involve complications which develop at home. A thorough physician will give you an emergency number to call or instruct you to get emergency medical treatment if warranted. In addition, the physician should explain what will constitute an emergency situation. Sometimes, errors are made in radiology or in the lab work labelling or interpretation.

There are classic signs of medical malpractice; namely:

-- lack of physician skill

-- overworking

-- injury caused by medical support staff

-- unsafe drugs or combinations of drugs

-- hospital acquired infections like MRSA

The author puts a number on medical malpractice. The cost is $36 billion dollars per year and growing. A national database of errors is suggested as a potential remedy. I believe that artificial intelligence and "Advice Giving" algorithms can assist physicians in understanding symptoms comprehensively for a variety of standard and nuanced disease processes.

The book has an extensive bibliography. I would add the Journal of the Lancet to the citations list. In addition, there should be another chapter which covers nutrition. The Paleolithic Diet may be the preferred eating regimen consisting of lean beef, fish, fruits, vegetables, seeds, nuts and water. Our government should continue to tax vices at a high rate, as well as junk food and soda.

In addition, our schools should get back into the business of offering gymnastics in grade school, high school and college. There should be special tax credits for athletics and the maintenance of athletic facilities beyond college. i.e. the workplace.

Richard S. Klein, M.D. is a practicing physician in Yorktown Heights, New York. He specializes in Internal Medicine and Infectious Diseases. An Associate Professor of Medicine, Dr. Klein teaches medical students at the New York Medical College. An internationally renowned caregiver, Dr. Klein has been knighted by the Italian government and received medals and awards from the Israeli government. As a young sailor, he was awarded lifesaving commendations for his work as a field medic assigned to the U.S. Marine Corps. You'll find the author online at www.richardsklein.com

Surviving Your Doctors: Why the Medical System is Dangerous to Your Health And How to Get Through It Alive (Rowman & Littlefield/ 2010) by Richard S. Klein MD

Joseph S. Maresca Ph.D., CPA, CISA, MBA: His significant writings include over 10 copyrights in the name of the author (Joseph S. Maresca) and a patent in the earthquake sciences. He holds membership in the prestigious Delta Mu Delta National Honor Society and Sigma Beta Delta International Honor Society. In addition, he reviews many books for Basil & Spice.

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