If I Betray These Words
Moral Injury in Medicine and Why It's So Hard for Clinicians to Put Patients First
by Wendy Dean; Simon Talbot
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Pub Date Apr 04 2023 | Archive Date Mar 22 2023
Steerforth Press | Steerforth
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Description
“Wendy Dean diagnoses the dangerous state of our healthcare system, illustrating the thumbscrews applied to medical professionals by their corporate overlords… Required reading for all stakeholders in healthcare.” — Danielle Ofri, MD, PhD, author of When We Do Harm: A Doctor Confronts Medical Error
Offering examples of how to make medicine better for the healers and those they serve, If I Betray These Words profiles clinicians across the country who are tough, resourceful, and resilient, but feel trapped between the patient-first values of their Hippocratic oath and the business imperatives of a broken healthcare system.
Doctors face real risks when they stand up for their patients and their oath; they may lose their license, their livelihood, and for some, even their lives.
There’s a growing sense, referred to as moral injury, that doctors have their hands tied – they know what patients need but can’t get it for them because of constraints imposed by healthcare systems run like big businesses.
Workforce distress in healthcare—moral injury—was a crisis long before the COVID-19 pandemic, but COVID highlighted the vulnerabilities in our healthcare systems and made it impossible to ignore the distress, with 1 in 5 American healthcare workers leaving the profession since 2020, and up to 47% of U.S. healthcare workers now planning to leave their positions by 2025.
If I Betray These Words confronts the threat and broken promises of moral injury – what it is; where it comes from; how it manifests; and who’s fighting back against it. We need better healthcare—for patients and for the workforce. It’s time to act.
Advance Praise
A fierce denunciation of American medicine in which physicians are the heroes—mostly… An expert bottoms-up examination of our diseased health care system.
--Kirkus Reviews (starred review)
“This is a great story of an adventurous and wide-ranging doctor dedicated to bringing the human into medicine. Having felt the whip of money and ‘administrators,’ in both large institutions and small hospitals, she and Simon Talbot moved away from calling doctors’ difficulties 'burnout' — thus blaming doctors — to 'moral injury' —like soldiers floundering under unjust orders. A brilliant, expansive book.”
--Samuel Shem, MD, DPhil, Professor in Medicine at NYU Medical School, author of The House of God and Man's 4th Best Hospital
"A manifesto for our times! Wendy Dean diagnoses the dangerous state of our healthcare system, illustrating the thumbscrews applied to medical professionals by their corporate overlords. By making it impossible to do the right thing for patients, the profit-hungry system casually gouges the moral fiber of healthcare workers, threatening patient safety. Luckily, Dean lays out a path forward. Required reading for all stakeholders in healthcare."
--Danielle Ofri, MD, PhD, author of When We Do Harm: A Doctor Confronts Medical Error
“All good physicians embrace their role as ‘Chief Story Teller,’ explaining to patients and their families the meaning of symptoms, diagnostic tests and proposed treatments. Wendy Dean weaves together the stories of 13 healthcare clinicians who have grappled with moral injury resulting from the system in which they are forced to work, and also offers solutions. A brilliantly conceived and executed masterpiece.”
--Thom Mayer, MD, Medical Director of the NFL Players Association
“I was viscerally moved by this book. Although written by and about the challenges facing physicians in the civilian healthcare system, I shared many similarly exasperating experiences during my military medical career. Wendy Dean opens the door for the layman to see how physically taxing and mentally draining the practice of medicine can be, while allowing physician readers to recognize themselves in the scenarios she depicts. Regardless of where you stand, you need to read this book. Trust me. I’m a doctor.”
-- Joseph Caravalho, Jr., MD, Major General, US Army (Retired), and President and CEO of the Henry M. Jackson Foundation for the Advancement of Military Medicine
"Wendy Dean offers a stunning portrayal of the corrosive effects of valuing profits over people. Medicine is sick and the situation more dire than most realize, but Dean’s examples of visionary leadership inspire hope for a healthier future. Written by the expert on moral injury in medicine, this book is a critical read for all in healthcare."
--Lydia Dugdale, MD, author of The Lost Art of Dying: Reviving Forgotten Wisdom, and Director of the Center for Clinical Medical Ethics at Columbia University
Available Editions
| EDITION | Other Format |
| ISBN | 9781586423544 |
| PRICE | $29.00 (USD) |
| PAGES | 304 |
Featured Reviews
Jennifer J, Reviewer
I had been hearing grumblings from some of my doctors for years about there is more focus on record keeping then on patient care.
It wasn't until one of my primary care doctors went into a Direct Care Model on her own, that I really fully understood just how broken doctors were.
The authors do a wonderful job of describing and relating what a "moral injury" is and how it affects doctors.
Everyone in America knows the healthcare system is broken, but this is the first book that explored how DOCTORS are handling the cracks, the demand to keep making profits, and more importantly what can be done to remedy the situation.
I want to thank the authors for pointing out and writing about moral injury and the increasing challenges that doctors are under to keep making money for their 'healthcare' systems.
Sheila T, Reviewer
I received a free copy of, If I Betray These Words, by Wendy Dean, Simon Talbot, from the publisher and Netgalley in exchange for an honest review. It is not an easy profession being a doctor, all the training, med school, al the bills. Some hospitals make it really tough to treat patients, when all they see is profit, when you set a time limit for each patient so you can see as many patients as you can in a day/week/month, use can and may miss diagnosis. A really good read, I enjoyed it, though its a tough subject.
Kade G, Reviewer
I received a copy of this in exchange for my honest review. Thank you NetGalley.
I love medical books. I'm always drawn in to these books that have fun or unique patient stories. I love when doctors can show empathy towards patients and put themselves in their shoes as opposed to being condescending or frequently thinking they know our bodies better than we do.
I know their job isn't easy. The schooling, the grueling hours, etc. It must be hard to find a balance. We all know how broken the healthcare system is, but a lot of us don't realize the toll it takes on the doctors as well. This book describes that all well. Interesting and informative.
Ghada M, Reviewer
Such a timely and much needed book on the business of medicine and how administratiors can get in the way of the quality of care provided when profit motive and shareholders' satisfaction are regarded more highly than the patient’s health.
I loved how the issue was presented in the form of a biography, introducing the physicians individually as people who were only trying to do their jobs, getting increasingly frustrated with the status quo and subsequently gaslighted and punished for daring to criticise their employer's ways when they got between them and their oaths to heal. While this book particularly addressed the failings of the US healthcare system, I believe many of those faults apply globally: from overinflated medical bills to dysfunctional health insurance plans, rendering basic care an unaffordable luxury for many. Equally heartbreaking and mind-opening, If I Betray These Words is a must read for anyone who is frustrated with the current state of healthcare.
Hannah R, Reviewer
A very fascinating insight into the medical profession from a viewpoint that I have not read before. The author does a very good job of braking down part of the book that I really appreciated. Thank you to NetGalley and the publisher for an advanced copy of the book in exchange for a review.
Reviewer 594011
If you have ever suffered severe mistreatment, been refused treatment or been left permanently injured by the negligence of a medical practitioner, take care of yourself when reading this. I found it extremely triggering and just.. it was tough.
I haven't finished reading it but my review is ready.
I feel sick. I am sickened and just plain angry.
Everything you've ever feared about the medical industry is true, believe me, I've seent it, and suffered it.
💲They want your money, and your health💲
This book is the testimonies of the people who appear on the other side, the people who have sworn to do no harm, the people there to help you.
They are the whistleblowers, and they are courageous as fuck.
This world is a hard one, it really is, but...
Superheroes always win in the end.
"The only thing necessary for the triumph of evil is for good men to do nothing.”
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