The Finest Traditions of My Calling: One Physician’s Search for the Renewal of Medicine Info

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Patients and doctors alike are keenly aware that the
medical world is in the midst of great change. We live in an era of
continuous healthcare reforms, many of which focus on high volume,
efficiency, and cost-effectiveness. This compelling, thoughtful book is
the response of a practicing physician who explains how population-based
reforms have diminished the relationship between doctors and patients,
to the detriment of both. As an antidote to failed reforms and an
alternative to stubbornly held traditions, Dr. Abraham M. Nussbaum
suggests ways that doctors and patients can learn what it means to be
ill and to seek medical assistance.
 
Using a variety of
riveting stories from his own and others' experiences, the author
develops a series of metaphors to explore a doctor's role in different
healthcare reform scenarios: scientist, technician, author, gardener,
teacher, servant, and witness. Each role influences what a physician
sees when examining a person as a patient. Dr. Nussbaum cautions that
true healthcare reform can happen only when those who practice medicine
can see, and be seen by, their patients as fellow creatures. His memoir
makes a hopeful appeal for change, and his insights reveal the direction
that change must take.

Average Ratings and Reviews
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Reviews for The Finest Traditions of My Calling: One Physician’s Search for the Renewal of Medicine:

1

May 28, 2016

I found this book a real grind. I think I understand what the author is trying to say about the current state of medicine, but his style of writing and eliciting authors and texts that I hadn't heard about did not make for engaging reading at my end.
4

Jan 06, 2020

Abraham Nussbaum is director of inpatient psychiatry at Denver Health and lives in my neighborhood. I read this book awhile ago but found it very honest about the evolution of American medicine towards a factory mentality. He compares it to the Cheesecake Factory. He stresses the importance of the therapeutic alliance between doctor and patient. He discusses the beginning of evidence based medicine with interesting background on Archibald leman Cochrane (Cochrane Library) and WWII...and the Abraham Nussbaum is director of inpatient psychiatry at Denver Health and lives in my neighborhood. I read this book awhile ago but found it very honest about the evolution of American medicine towards a factory mentality. He compares it to the Cheesecake Factory. He stresses the importance of the therapeutic alliance between doctor and patient. He discusses the beginning of evidence based medicine with interesting background on Archibald leman Cochrane (Cochrane Library) and WWII...and the problems with evidence based medicine being the end all.
Refreshing perspective. ...more
5

May 15, 2017

I tend to reserve 5-star ratings for books that truly deserve them, and this one does. Nussbaum explores the reality of modern medicine, governed by life-saving but ultimately automating evidence-based guidelines and algorithms, and how he, his colleagues, and future colleagues might return to or rediscover the finest traditions of their callings. He advocates for going a step or two beyond algorithms and becoming wise physicians: physicians who can effectively navigate difficult relationships I tend to reserve 5-star ratings for books that truly deserve them, and this one does. Nussbaum explores the reality of modern medicine, governed by life-saving but ultimately automating evidence-based guidelines and algorithms, and how he, his colleagues, and future colleagues might return to or rediscover the finest traditions of their callings. He advocates for going a step or two beyond algorithms and becoming wise physicians: physicians who can effectively navigate difficult relationships with patients therapeutically, and still stay afloat among the myriad other responsibilities doctors today have.

As a medical student, this book was inspiring and I hope to be even nearly as wise and discerning as Nussbaum demonstrates he is (though doesn't boast about). I also appreciated references to some of my favorite scholars (which shows how nerdy I really am) such as Stanley Hauerwas, William Osler, Abraham Verghese, Atul Gawande, and even Hildegaard of Bingen!

Certainly don't read this if you're not interested in an insightful physician's honest take on medicine in the US. But if you are, you should read it. ...more
4

Apr 10, 2016

Thoughtful and interesting read though at times I was confused as to who the target audience was. If you're already fearful of the healthcare system, this won't help. ;-)
5

Sep 25, 2015

I wish this book were required reading for all medical residents. I wish that all physicians were as thoughtful and self-analytic as Dr. Nussbaum. As health care becomes more and more driven by efficiency, it is losing the most critical aspect of caring for the patient the relationship between the physician and the patient as a person. The author examines this issue with strong self-criticism and obvious heartfelt care. It renews my hope for medicine.

I need to note that I know/knew Dr. I wish this book were required reading for all medical residents. I wish that all physicians were as thoughtful and self-analytic as Dr. Nussbaum. As health care becomes more and more driven by efficiency, it is losing the most critical aspect of caring for the patient – the relationship between the physician and the patient as a person. The author examines this issue with strong self-criticism and obvious heartfelt care. It renews my hope for medicine.

I need to note that I know/knew Dr. Nussbaum. He was a medical student at UNC and interested in the history of health care. He was a delight as a student and I am not surprised that he has written a book of such depth and importance. ...more
5

Jan 13, 2018

Intriguing account of one man's journey from medical student to seasoned psychiatrist. Dr. Nussbaum intersperses some history in the medical field and its approach to training physicians with personal anecdotes of clinical encounters with patients. Disenchanted with modern medicine's view of a human as collection of mechanical parts and hospitals push to achieve efficiencies by grafting organizational reforms from factories and the military, Dr. Nussbaum seeks to renew a human approach to Intriguing account of one man's journey from medical student to seasoned psychiatrist. Dr. Nussbaum intersperses some history in the medical field and its approach to training physicians with personal anecdotes of clinical encounters with patients. Disenchanted with modern medicine's view of a human as collection of mechanical parts and hospitals push to achieve efficiencies by grafting organizational reforms from factories and the military, Dr. Nussbaum seeks to renew a human approach to medicine.

His accounts of working with mentally ill patients alternate between funny and moving, uplifting and heart-breaking.

Full disclosure: the author is my brother-in-law. ...more
5

Dec 12, 2017

This is the book about medicine reform that Ive been waiting for. Nussbaum brings his reflective experience as a psychiatrist to argue that the reformation of medicine begins with once again seeing patients as persons, rather than as customers. I further appreciated his reflection on some of the ancient predecessors to modern medicine, most notable William Osler and their focus on the virtue of the physician. Cultivating such professional virtue, Nussbaum argues, is one of the finest traditions This is the book about medicine reform that I’ve been waiting for. Nussbaum brings his reflective experience as a psychiatrist to argue that the reformation of medicine begins with once again seeing patients as persons, rather than as customers. I further appreciated his reflection on some of the ancient predecessors to modern medicine, most notable William Osler and their focus on the virtue of the physician. Cultivating such professional virtue, Nussbaum argues, is one of the finest traditions of medicine. ...more
5

Mar 01, 2016

[ARC courtesy Amazon Vine program]

Abraham Nussbaum has done a brave thing in writing "The Finest Traditions of My Calling." Tucked within its pages are very personal vignettes of his journey from eager student to sleep-deprived resident to ethicist who honors the tradition of his profession even as he acknowledges its weaknesses.

He freely describes his own mistakes such as spending the last hours of a terminal patients life down the hall from that man, writing up a flaw-free description of his [ARC courtesy Amazon Vine program]

Abraham Nussbaum has done a brave thing in writing "The Finest Traditions of My Calling." Tucked within its pages are very personal vignettes of his journey from eager student to sleep-deprived resident to ethicist who honors the tradition of his profession even as he acknowledges its weaknesses.

He freely describes his own mistakes – such as spending the last hours of a terminal patient’s life down the hall from that man, writing up a flaw-free description of his patient’s body rather than being with the person who occupies that ebbing body.

The intertwined strength and challenge of this book as Nussbaum has structured it is that he means it as a discussion, but unless you are used to viewing a book as a writer’s wish to have a conversation with you, it can be hard to realize why a writer is offering a series of perspectives and explorations in the way he has.

Running like a bright thread throughout this book is Nussbaum’s concern with “seeing much” and “seeing wisely.” One of the modern lions of medicine views these concepts as needing to be bound together, while Nussbaum spends much of his medical career perceiving them as somewhat independent. There is value, he says, in “seeing much” – in building up a body of knowledge – through learning, as well as through caring for countless patients. But there is also merit in seeing the individualities of the person – the soul, if you will, although he does not use that term – who occupies the body.

“Seeing wisely” for Nussbaum, then, is understanding more than the physical and mental issues that have led someone to need care. It is doing your best to comprehend that person’s background and ethos, and building a bond with him or her. Psychologists and psychiatrists (Nussbaum is the latter) describe this favorable tie as a “therapeutic alliance,” but it seems much more the norm for these specialties than others, especially in today’s ever-more-specialized style of medical care. In simpler terms, though, it is an acknowledgment that a person is more than an organism in need of a differential diagnosis and a treatment plan. He or she is a distillation of culture and space and place, all filtered through a singular awareness.

This book is not meant to be read straight through. Because it is a discussion, it is best taken a chapter at a time, with generous spaces in between for reflection. Because working through this book calls for a personal investment (shades of therapeutic alliance?) I will share the perspective I brought to these pages. I come to this subject from a family tradition of healthcare, with at least one member per generation wearing a long white coat, or providing support services, or conducting lab experiments aimed at understanding disease. Although I do not live their frustrations, I have been a sounding board for their eagerness and their doubts.

I also advocated for a loved one during terminal care, in search of physical comfort and emotional peace both for the loved one and those left behind. During that wrenching time, I saw flashes of the husbandry approach Nussbaum discusses. They were too infrequent, but they sustained me, and have helped me be a better advocate since then for other family members and for myself.
...more
5

Jul 08, 2016

Pondering the profound questions of becoming a physician and what has become of the profession of medicine, Dr. Nussbaum balances observations in health-care evolution to an "evidence-based" practice of groups rather than individuals with the cost of neglecting the therapeutic relationship with the individual patient, and necessary individual medical management. His journey parallels many of our journeys. We train for years with time-bound traditions of our calling to discover that the world Pondering the profound questions of becoming a physician and what has become of the profession of medicine, Dr. Nussbaum balances observations in health-care evolution to an "evidence-based" practice of groups rather than individuals with the cost of neglecting the therapeutic relationship with the individual patient, and necessary individual medical management. His journey parallels many of our journeys. We train for years with time-bound traditions of our calling to discover that the world changed, priorities changed, treatment changed in ways incongruent with our understanding of healing. Nussbaum draws from history, medicine, religion, humanities, psychiatry and more to explicate questions that need answering. How do we care for patients individually when we are checking off lists? How do we treat patients with care in 10-minute office visits, and then view the experiences as various billing codes? How does one not become burned-out, disillusioned, losing meaning in work? Despite the daunting questions asked, the book tells stories of people, patients Dr. Nussbaum feels he treated well or not as well as he could. In summary, a well-written, engrossing read with issues I will continue to ponder as I teach medical residents to better communicate with patients, and each other. ...more
5

Feb 27, 2016

The Finest Traditions of My Calling: One Physician's Search for the Renewal of Medicine by Abraham M. Nussbaum is a free NetGalley ebook. It seems almost kismet to be reading both this and The Tastemakers at the same time, being as they deal in semi-critical analysis of human nature: health & body care versus food trends.

One might think that, with a subtitle that suggests at a search for renewal, this book is written by a fiery radical that will stop at nothing until a full overhaul of the The Finest Traditions of My Calling: One Physician's Search for the Renewal of Medicine by Abraham M. Nussbaum is a free NetGalley ebook. It seems almost kismet to be reading both this and The Tastemakers at the same time, being as they deal in semi-critical analysis of human nature: health & body care versus food trends.

One might think that, with a subtitle that suggests at a search for renewal, this book is written by a fiery radical that will stop at nothing until a full overhaul of the healthcare system occurs. Not so with Dr. Nussbaum. His writing style is like a fabric bolt of fine-combed wool - supple, firm, warm, smooth, yet naturally mottled with fibrous burrs when he talks about blood and bowels. ...... Okay, so maybe that's not a fair description about what wool is like, but it's how Nussbaum writes. It's simple and insulating to follow him through his shifts and to naturally question the halting progress that medicine makes in caring for people, instead of perhaps seeing us as bodies with money and faulty mechanics. ...more
4

May 16, 2016

This is a physician's history of the philosophy of medical care interspersed with anecdotes from his personal experiences in becoming a doctor and practicing medicine as a psychiatrist. Some of those experiences are sad, others hilarious--like when, for two years after taking a new position, he gave out business cards giving his title as "Director of Impatient Psychiatry" until a friend pointed out the typo. The author offers his timely views on medicine's direction and where he believes it This is a physician's history of the philosophy of medical care interspersed with anecdotes from his personal experiences in becoming a doctor and practicing medicine as a psychiatrist. Some of those experiences are sad, others hilarious--like when, for two years after taking a new position, he gave out business cards giving his title as "Director of Impatient Psychiatry" until a friend pointed out the typo. The author offers his timely views on medicine's direction and where he believes it should best be heading--informative; interesting; and, at times, entertaining. ...more
4

Apr 13, 2016

Dr. Nussbaum makes a persuasive argument for "renewing" medicine by focusing more on the patient as a person. Weaving his own experiences as a medical student, intern, and resident with a broader view of medical history and contemporary practice, Dr. Nussbaum presents a readable and very human look at the strengths and failings of his profession.
5

Apr 04, 2016

An important point of view.

Well worth the time to read. I particularly like the author's style and ability to ask probing and powerful questions about his chosen field.
0

For more than a century, veteran physicians have written reports deploring the state of their profession, and in this earnest account, Nussbaum, director of adult inpatient psychiatry at Denver Health ...Full Review
0

A career physician ponders the positive and negative aspects of how health care reform is transforming the delivery of care and the medical profession itself. Nussbaum's (The Pocket Guide to the DSM-5 ...Full Review

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