● How to Make a Killing: Blood, Death and Dollars in American Medicine
Tom Mueller
Review via Kirkus Reviews
A dispiriting look at the replacement of the Hippocratic oath by a PIN number that centers on the big business of kidney dialysis. Basing his account on interviews with hundreds of constituents of the “dialysis community,” journalist Mueller, author of Extra Virginity and Crisis of Conscience, describes a health care industry that is seemingly entirely focused on profit. Most dialysis takes place at clinics where a premium is placed on getting patients in and out quickly, with the withdrawal and reinsertion of blood occurring more rapidly than the body can comfortably accommodate—even though in many instances, “when administered this way, dialysis may shorten patients’ lives by stripping off bodily fluids too fast, triggering sudden drops in blood pressure that can damage the heart, brain, gut, and lungs and lead to stroke, congestive heart failure, and cardiac arrest.” If you complain, you’re likely to be denied care—and, worse, far too many nephrologists are disinclined to fight on behalf of their patients. One nephrologist recounts that a colleague told her he had developed “techniques for goading undesirable patients into acting out, in order to eject them from his facility.”
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