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Local doctor diagnoses state of U.S. health care

If you want the inside scoop on what's wrong with our current medical system, local author Saul William Seidman, M.D., FACS, is scheduled to share his opinion at Main Street Cafe & Books 6:30-8 p.m. June 14.

Seidman, a retired neurosurgeon, will present evidence from his new book, "Inevitable Incompetence: Soaring Medical Costs, Dangerous Medical Care" (Universal, 2007), a lambasting of the current trend toward health maintenance organizations (HMOs) and socialized medicine.

The doctor knows what he is talking about - his book is based on 25 years' experience as a neurosurgeon, primarily at El Camino Hospital in Mountain View. He completed his neurosurgery residency at Yale University.

Seidman's wife, Grace, had a long-term bad experience with Kaiser Permanente, resulting in a successful lawsuit. Her dealings with the hospital provided Seidman with a foundation for the book.

He does more than complain about current trends. Seidman offers suggestions for reversing the prevailing tides and gives tips on improving the chances of receiving good medical care.

About the direction of medicine, Seidman wrote: "We have two choices. We can follow the delusion of 'universal health care' or we can accept a market approach to health care. Putting patients in charge of their medical care is a market approach. It guarantees competence, at least."

Seidman continued: "The corruption of medical care is the result of interference by nonphysicians in the process of patient care. … Bureaucrats now dictate policy. ... I was fortunate to practice neurosurgery in the golden age of medicine. ... Patients had the choice of whom they would trust."

Seidman said that administrators and bureaucrats - so-called medicrats - consume 30 percent of medical expenditures. "Inevitable Incompetence" offers a blistering invective of bureaucrats.

In the book, Seidman said that the most challenging problem with modern medicine is the lack of slow, careful diagnoses. The art and science of clinical diagnoses suffer from the availability of expensive diagnostic tests - doctors tend to order tests rather than take 30 minutes to talk with the patient, record a thorough history and listen to what the patient has to say.

"Today's HMO doctors are expected to limit each visit to six minutes," he wrote.

When Seidman was practicing medicine, he went to the waiting room himself to escort patients to the examination room to observe their gait, an important neurological function. He then spent up to 45 minutes listening to their explanations of what was wrong.

He blames "patient churning" - the policy of getting patients in and out as quickly as possible - for the decline in medical care.

Noting that neurosurgeons are not being adequately replaced - he claims a 33 percent drop in applications - Seidman laments the impersonal nature of current medical practice. He and his colleagues knew each other and spent time together, discussing medicine and getting to know each other's strengths and weaknesses. Within an HMO, he writes, doctors often are unaware of the competency of doctors to whom they refer patients, care is fragmented and a doctor does not take responsibility for a patient's total care.

A section of the book offers suggestions for checking up on your doctor: how to find out if a specialist is board certified, how to evaluate your doctor's skill level, how to find out if your doctor has been involved in disciplinary actions and how to determine the questions a doctor should ask the patient.

"Inevitable Incompetence" is available at Main Street Cafe & Books, 134 Main St., Los Altos. Seidman will sign books at the event. For more information, call 948-8040.

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