Views & Reviews Review of the Week

Health care USA: don’t make a drama out of a crisis

BMJ 2008; 337 doi: (Published 23 July 2008) Cite this as: BMJ 2008;337:a946
  1. Jerome P Kassirer, distinguished professor, Tufts University School of Medicine, Boston, Massachusetts
  1. jpkassirer{at}

    A new book that promises to lift the lid on the US medical system offers little more than a soap opera, finds Jerome Kassirer

    Despite the fact that many if not most people have had some experience of hospital, it is a safe bet that few have much more than a fleeting notion of how a hospital or medical centre is organised and functions. Julie Salamon had an unparalleled opportunity to paint a realistic picture, enlighten the public, and dispel confusion, given that she had unfettered access to anyone in Maimonides Medical Center, a large hospital in New York, for an entire year. The hospital is a large, highly rated, exceptionally busy institution. Every year it discharges tens of thousands of patients and treats well over 100 000 outpatients. It not only has origins in the orthodox Jewish community (and still serves it) but exists in a most atypical environment of multi-ethnicity and multiculturalism, requiring translators in dozens of languages. Merely describing the institution is …

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