Guarded Prognosis: A Doctor and His Patients Talk About Chronic Disease and How to Cope With It - Hardcover

Dr. Michael D. Lockshin is a pioneer in solving health-care issues that arise with the illnesses on which he has done his most renowned research - systemic lupus erythematosus, antiphospholipid antibody syndrome, and other autoimmune diseases which especially afflict women Dr. Lockshin is Director of the Barbara Volcker Center for Women and Rheumatic Disease, Hospital for Special Surgery and Professor of Medicine and Obstetrics-Gynecology at the Joan and Sanford I. Weill Medical College of Cornell University in New York. He is a graduate of Harvard College and Harvard Medical School. In the 1990s he was Extramural Director, then Acting Director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health and later Editor of Arthritis & Rheumatism, the premier rheumatology medical journal. He is the author two books, Guarded Prognosis, 1998, and, with Alida Brill, Dancing at the River’s Edge, 2009, as well as more than 300 medical journal articles and book chapters, primarily on systemic lupus erythematosus, antiphospholipid antibody syndrome, and pregnancy in rheumatic diseases. His most recent interests have been teaching principles of management of chronic illness. He has been the recipient of numerous professional honors. He resides with his wife in Pound Ridge, New York. See Dr. Lockshin's website www.MichaelLockshin.com for more information about Dr. Lockshin and his work.

Using his patients' personal stories to illustrate dramatically how medical care once worked and how it works today, a concerned and caring physician makes clear just why he fears the current system has a very poor prognosis. Director of the Center for Women and Rheumatic Disease at the Hospital for Special Surgery in New York, Lockshin specializes in lupus, a chronic disease that affects every organ in the body and brings its patients into contact with all segments of the medical-care system. Drawing on some 35 years of medical experience, he writes knowingly and sympathetically of patients who need long-term, expensive care, whose problems may require speedy treatment by specialists. In doing so, he questions how well such individuals would fare in a system where primary-care doctors act not as their patients' advocates but as gatekeepers, deciding who will have access to what kind of care. He acknowledges that cost is at the heart of the medical-care crisis, but points out that this cost comes largely from common, chronic, and crippling diseases. Lockshin outlines what he perceives as the elements of an ideal system and calls for a vigorous public debate over the issues, which, he notes, seem medical but are social and political as well. He argues that decision-making criteria concerning health-care resources and spending must include compassion as well as cost-benefit. The questions he raises about cost cutting, rationing of care, doctor-patient privacy, and individual needs and rights are ones that deserve careful consideration. An able spokesman for the poor and chronically ill, those whose voices he believes are seldom heard in the debate over health policy in this country, he has given us stories to remind us that abstract policies affect individuals who could be us or those we love. -- Copyright ©1998, Kirkus Associates, LP. All rights reserved.