Lessons about the corona virus and the slippery slope.

By Steven z. Kussin, MD

The Slippery SlopE of Healthcare

Why Bad Things Happen to Healthy Patients and How to Avoid Them

About the author

Steven z. Kussin, MD

Steven Z. Kussin, MD, is a physician, author, television commentator, and pioneer in the Shared Decision movement. He founded and led his clinical practice for three decades. He then wrote Doctor, Your Patient Will See You Now: Gaining the Upper Hand in Your Medical Care (2011). He founded the Shared Decision Center in Central New York. He retired from his center in 2015.

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About the Book

One picture is worth a thousand words. So, instead of posting a 25,000-word billboard for my book, I have, instead, 25 slides devoted to it. Pablo Naranjo and I created them. I met Pablo ten years ago, painting skateboards on the streets of NYC. His style was unique. His artwork graced the website for my first book, and I’m happy to have him on board for The Slippery Slope.
Each slide will have a few words to bring you along into The Slippery Slope’s message.

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Writing my first book was a breeze - no agents, publicists, or publisher. I was on my own and loved it. Only when it was completed did I bring on the crew.

Writing my second book was a fright. The publisher of my first book wanted a second. So, with their check and deadline in hand, I was now working for them. Now that the book is finally completed, I can enjoy and value the contribution of all who helped me.

Washing up on the shores of medical care is risky. There are strangers and dangers at every crossroad. Who are those strangers…where are those dangers? Welcome to my book!

That first step down The Slope is the dangerous one. Tests beget tests, so make sure you need the first one. If you are healthy, think twice. Learn before you leap. The first chapter introduces The Slope and offers an example and warnings.

Chapter 2 - Your Money or Your Life -the role of profit in medical care. It’s the healthy who subsidize the industry. It’s a three-ring-circus of overdiagnosis, overtreatment, and overdoses. And after that first step, your ticket is nonrefundable.

In Chapter 2, you’ll learn what 3 trillion dollars buy. Yes, money does rule medicine. The profits are unimaginable to all except those who are making it.

Chapter 3 - Crocodiles vs. Alligators. Crows vs. Ravens. They look alike, but they aren’t at all the same. MDs look like PhDs, but we also are different species. Medical care is not science. And most doctors are not scientists. Thinking we are scientists is a mistake and leads to misadventures on The Slope.

Doctors and scientists use different databases, languages, protocols, and role models. Our advice is NOT scientific. We are as deficient in science, math, and statistics as you are.

Chapter three is all about Doctors. Being busy is no excuse for doctors. From Benjamin Franklin, “If you want something done, ask a busy person.” The busier the doctor, the more responsive to your needs they should be.

This chapter will help you identify doctors with white coats but black hearts. There are bad players out there.

One of my favorite quotes. “Even the drunk driver will usually get you home safely, but why take the chance.” The Doctor chapter gives readers the tools to judge the best doctors in the best offices. The fact that most people do pretty well most of the time should not be reassuring.

We outline Patient-Centered Medical Homes, Direct Patient Care, and the One Patient One Doctor Models.

Karl Marx said it best. The ‘least bad provider’ model is introduced. Modest needs to not need to be extravagantly met. Matching providers’ abilities to your requirements result in better, safer care.

Why Stephen Curry doesn’t mow his lawn. A gardener does a good enough job allowing Curry to do what HE does best (and that pays more – a lot more!). It’s true too in medical offices. Make room for nurse practitioners and physician assistants. Learn why.

It’s your turn. Why do patients expect so much while at the same time, they accept so much? YOU…the best commercial consumers -the worst medical consumers. Why?

The express isle is convenient but beware. This chapter shows you when convenience is king and when it can kill. The section also discusses elective care…why some patients happily and unknowingly line up for The Slope.

TV. Direct to Consumer ads. Learn the tricks of the trade. These ads are pitch-perfect, perfect pitches. How and why they mispresent the facts.

Screening technologies. Let’s learn a bit about statistics. Early diagnosis always prolongs life by setting back the clock. It means nothing. What are the essential objectives of screening and prevention? In this slide, the train on each panel hits the victim at the same moment. What does early detection of a disease really accomplish?

For every thousand people who line up for preventive and screening, there’s only one winner. It’s The Number Needed to Treat. - it’s a terrific tool to use if any therapy or diagnostic test is recommended. What health risks will you take today for problems you will probably never get, or that are decades in the future?

How many people are harmed while trying to get healthier? Is it worth the risk to be the winner? Advice and resources offered for every screening and prevention technology.

Our last chapter…Shared Decisions. Your way to avoid The Slope or maneuver down it successfully.

There is no single solution to most medical problems. Learn about the alternatives and why your personal choices are rarely taken into account.

Understanding the issues about the medical care you didn’t ask for, agree to, understand, need, or want.

Shared Decisions. Why the healthy are hurt the first, suffer the most, at the times in their lives that they can afford it the least.

Alice in Wonderland asks, “Would you tell me, please, which way I ought to go from here?” The Cheshire cat answers, “That depends a good deal on where you want to go.” Shared Decisions…helps you know which road is the best for you, and to help you know when you have gotten to your destination. Doctor-only resources that show you the way.

REVIEWS

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. . .an empowering compendium of healthcare advice, focused on the pitfalls of overdiagnosis. Though Kussin places blame on healthcare providers for pushing unnecessary care—and on patients for demanding it—he isn’t aiming for exposé or outrage, but rather to arm readers with the tools for better decision making. . . . His affable, enthusiastic guide will leave readers feeling smart, informed, and better prepared for taking a nonalarmist and responsible approach to their own health.

– Publishers Weekly

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March 24, 2020

Book • published

The Slippery Slope of Healthcare: Why Bad Things Happen to Healthy Patients and How to Avoid Them can be purchased from Barnes & Noble or Amazon online.

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