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  • Writer's pictureMiriam Diaz-Gilbert

Review of F. Perry Wilson's How Medicine Works and When It Doesn't

Learning Who to Trust to Get and Stay Healthy



If you are a doctor, a hospital administrator, a pharmaceutical executive, or a patient, F. Perry Wilson’s new book— How Medicine Works and When It Doesn’t: Learning Who to Trust to Get and Stay Healthy (Grand Central Publishing) — is a must-read. Dr. Wilson, a physician and researcher at Yale New Haven Hospital, writes that his book “shines a light on why doctors have lost touch with their patients, why patients have lost faith in their doctors, and how to get back to that therapeutic alliance that we all need in order to be truly healthy."


Wilson makes the distinction between "medicine" with a lowercase “m” to refer to medications, pills, and injections, and "Medicine" with a capital “M” to refer to the art, science, and practice of caring for the health and well-being of individuals.


How Medicine Works and When it Doesn’t is an ambitious but necessary book that tackles many issues in Medicine today. Wilson's conversational writing style makes this important book reader-friendly. Topics of the many problems in Medicine include errors of omission—prescribing the wrong medication or operating on the wrong limb, and errors of commission—misdiagnosing a patient, as well as the role of diet in patient health and treatment, under-standing that what will work for one patient will not work for another, and the recognition that failure is the most common outcome of any new treatment.


Wilson provides insight into the various elements that have failed to focus on patient care. These include medical research fraud and hospitals employing ten administrators for every one doctor instead of focusing on patient care. Physician burnout, as a result of dealing with insurance companies, and sitting in front of the computer to complete useless training modules, like how to best walk in a hospital hallway, do not contribute to patient care.


Wilson makes clear the harmful role of the self-interested pharmaceutical companies, whose “goal of helping people is in the service of the goal of helping themselves and their stockholders.” Ever wonder if your doctor is influenced by pharmaceutical companies? Wilson encourages readers to log onto OpenPaymentsData.CMS.gov/Search to see how much their physicians have been paid and by whom. I searched for one of my doctors; my search revealed that in 2021, this particular doctor was paid high five-figures by pharmaceutical companies. I am shocked by the amount. This is an example of when Medicine does not work.


How Medicine Works and When It Doesn’t is jam-packed with important issues in Medicine and patient care. While the chapters on motivated reasoning, causality, and randomized trials might have your head spinning, Wilson weaving anecdotes throughout the book of his encounters with patients and what patients have taught him over the years are wonderful examples of trust between patient and doctor, and the willingness of doctors to learn from their patients.


Wilson writes, "The most powerful force in Medicine is trust.” How Medicine Works and When It Doesn't aims to encourage everyone to think about Medicine in a new way and for doctors to ask "Whose side am I on?"


©2023


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