An Uneasy Exploration of Modern American Medicine in “Doctored”

The state of medicine in America today leaves something to be desired, whether you’re a patient or a physician. In his eye-opening second book, Doctored: The Disillusionment of an American Physician, Dr. Sandeep Jauhar, a cardiologist and heart failure specialist, details the way things stand, explains how we got here, and describes what it means to be a doctor in today’s medical landscape.


In Jauhar’s first book, Intern, he explored his own journey into medicine and those first tough years in residency, when sleeplessness and overwork were common. This book takes a mid-life look at both his development as a doctor and the evolution of American medicine.

Over the last five decades, the practice of medicine here in the U.S. has changed considerably. Jauhar’s historical explanation of how we went from private fee-for-service practice, where doctors charged patients what they could afford, to our earliest instances of health insurance, to the introduction of Medicare in 1965 was fascinating. Medicare reimbursements changed medicine in unanticipated ways, and health management organizations (HMOs) were introduced in the early 1970s to (in theory) help keep costs under control.

As the system has developed from there, a confluence of factors has made it difficult for the doctor of today to really know you and have a relationship with you. First, there are the unintended consequences of the reimbursement system. And second, doctors understandably fear being sued for malpractice and must shoulder the necessary cost of expensive malpractice insurance.

What this creates, then, is a situation where doctors need to see as many patients as possible, and will be more inclined to order tests and procedures to both cover their own liability in case of a misdiagnosis and to be paid for those tests via reimbursement. In the early years of Medicare, many doctors’ salaries soared, but that trend has reversed for most physicians, thanks to reimbursement cuts and increased costs of practice. Another wrinkle here is that doctors’ salaries are linked to how much revenue they generate for the hospital, which can create misaligned incentives between good patient care and billing. For Jauhar, a hospital employee, this link isn’t as direct as it would be were he in private practice, but it’s still a consideration.

This book is an uneasy inside look at the many challenges doctors today must contend with. I’d recommend it for anyone thinking about going to medical school, as well as anyone interested in why our system is as it is currently. Jauhar is a smart, compassionate, and worthy guide.

(Originally published here:

Follow One Skeptic’s Path to Meditation in “10% Happier”

Television journalist Dan Harris was reading news headlines and stories for Good Morning America one June morning in 2004 when something scary happened to him: he had a panic attack on live national TV. Millions of people watched him stumble through his words and they then saw him end the segment early and awkwardly.


Harris was not new to the world of television or being on camera. He’d been working for ABC News for over just four years at that point, writing, producing, and taping segments for shows like the Peter Jennings-anchored World News Tonight. He had reporting experience in war zones, including Iraq, the West Bank, Gaza, and Afghanistan, where he dodged gunfire in the mountains near Tora Bora. He was competitive and driven to succeed in the cutthroat field of TV news.

Operating near exhaustion for years, not acknowledging trauma that developed from his war-zone work, and dabbling in illegal drugs here and there to mask his feelings, a crash of some sort seemed inevitable. The fact that it happened during a live national broadcast was, to put it lightly, a wake-up call for Harris. He had to figure this out or his beloved chosen career would undoubtedly be finished.

He began seeing a psychiatrist, and around the same time, started covering the religion beat for ABC, at the request of Jennings himself. He was not the spiritual type, but would find a solution to his problems in an unexpected place when he interviewed author Eckhart Tolle, which led to Deepak Chopra, which would eventually lead to Dr. Mark Epstein. He, in turn, would lead to Harris exploring Buddhist meditation. And it is meditation that would be the answer for Harris, allowing him to (paraphrasing the book’s subtitle): “tame the voice in his head, reduce stress without losing his edge, and find self-help that actually works.”

Harris is certainly not alone in adopting meditation. His book recounts the scientific evidence for meditation’s many psychological and even physical benefits. As well, several large companies, including General Mills, Procter & Gamble, Target, and Aetna now offer guided meditations or meditation rooms for their employees to de-stress during their workday. Meditation, it’s safe to say, is having a bit of a moment, but for good reason.

Harris is funny and self-deprecating and about as opposite of “new-age” as a person could be. He’s a perfectly skeptical guide, then, for a book about meditation. “Well, if it works for even him…,” you find yourself thinking. It’s a good read for anyone the least bit curious about this age-old practice.

(Originally published here: