Man's 4th Best Hospital Paperback – November 3, 2020

Disclaimer: I have been a physician for over 30 years. I read The house of god in college. I read it again in medical school. Reread it during the minuscule time available in internship as well as in residency. I have read the book over a half dozen times. The book was sarcastic, a bit crazy, cutting, very often truthful, and overall hilarious.Man's 4th best hospital is non of those things. It is a political screed pushing socialized medicine. Much of what is said about medicine, EMR's, and billing is blatantly false. It is not the least bit funny. Its sarcasm is boring. And the characters we loved in the first book haven't progressed at all as people.No physician I know loves the EMR with which we are tasked to work. I am stuck with EPIC which is referred to many times in the book. But what is portrayed in the book about the unholy alliance between billing and coding is so oversold it is outrageous. For example, while diagnosis codes allow hospitals to maximize billing for inpatients, this has nothing to do with outpatient medicine. You can code any diagnosis you please and it does not change how you bill a patient. But the book implies that it is the same. This is just a very small example of the many falsehoods that are rife within this book.What Shem conveniently omits is that the EMR and its used among physicians is the direct consequence of the government's involvement in medicine. The government mandated it's use. It punishes physicians that use paper charts by decreasing reimbursement. It rewarded hospitals and groups for using these comprehensive, clunky, flawed systems. All the click boxes that he goes on about are mostly due to the government and something they instituted called meaningful use. In order for a doc or a hospital to get fair reimbursement for a visit things like smoking status, body mass index, and dietary review get included in every note for outpatients and what is needed for inpatient notes is well beyond this discussion. And then he implies in the book that socialized medicine is the cure to the money grubbing companies that responded to the government's call to expand the use of electronic medical records.Samuel Shem then holds up the Indian Health Service (IHS) and the VA as models where doctors can take better care of patients. This is absolutely laughable. The Wall Street Journal has had multiple expose articles about incompetence and malpractice in the IHS. As a veteran of the military, I make it my business to know about the VA. And while there are good docs in the VA, the overall level of care that is offered to our men and women who served is disgraceful. I can get my care at the VA, and would never do so. So one of the main root causes of the problem (government mandates in medicine) is going to be the cure by giving us the same care as Native Americans get from the IHS and veterans get from the VA. Thanks Sam, I'll take a pass on that.If I could give this book zero stars, I would do so. I loved the house of god. It was on my list of 10 most influential books I have had the pleasure of reading. I really enjoyed Mount Misery which talked about his one year in a psychiatry residency. Both of those books rang true in a large way, despite the sarcasm and artistic license. This book does not do that in any way, shape or form. It is a political opinion poorly hidden in a story, much of which is frankly garbage. I'm sorry I spent the money buying it and even more sorry I spent the time reading it.

The electronic health record is accurately portrayed for what it is; a revenue capture device with little relevance to actual patient care. There is a bit of high minded virtue signaling and the author is clearly advocating for socialized medicine. Numerous favorable references to the VA, Indian Health Service, and the free service in other countries are sprinkled throughout. The House of God is a classic. This is just tedious and pedantic.

HOG was great; this book is a waste of time. Full of predictable, opinionated social commentary which could be tolerated if the read was good. It’s not. Save your money.

I loved the House of God and enjoyed Mount Misery. While the House of God seemed truthful this book is a contrived, self-serving tale of fiction. The book is written under the guise of a story about how medicine should be whereas in reality it is a poorly written boring tale pushing socialized medicine. The author attempts to trash EMR by distorting the reality of the system and leaving out the benefit it provides.I would not waste my time with this book. It is false string of nonsense with little value and is poor entertainment. The author should take his east coast elitism and ride off into the sunset. Too bad this piece of trash book saw the light of day.

1) It is beautifully written.2) It is inspiring.3) The most important reason, which I say from the perspective of being a healthcare provider myself, is that it is largely truth. Yes, the book is fiction in the sense that stories are woven around characters, events, and places to engage the reader and take them on a journey of discovery, and of course not everything written is fact. But the book also brilliantly describes how medicine and the patient-physician relationship has, in the U.S. healthcare system, been systemically crippled by layer upon layer of unnecessary and costly bureaucracy: a bureaucracy that – whatever its initial intent – has had the effect of dehumanizing medical care, interfering with its effective delivery, driving costs up, ruining the lives of the physicians who are trying to make things better, and worst of all, often seriously harming patients. The author doesn’t simply decry what has happened to our healthcare system, but he is kind enough to propose numerous solutions to this crisis that could – if implemented – quickly restore a much higher quality, patient-centric, cost-effective health care system in this country. This book is a must-read for patients, physicians, and healthcare policy makers.

I think every doc can remember where he or she was when reading the original House of God. Even now, 40 years after it was written, that book is almost required reading for anyone medical. The Man's Best brings us up to date, where the HoG cast now comes back as attending physicians. Still cynical, but mellowed and humane. I couldn't put it down. These 2 books are truly amazing. I don't think I've encountered any colleague who hasn't read the first volume. Pick up the 2nd - you won't be disappointed. For what it's worth, I'm a 71-year old academic endocrinologist.

The brilliant sequel to The House Of God.Epic. Pun intended.

This book is a beautiful modern rendition of the original house of god. Shem has done a fabulous job of highlighting the problems and challenges faced by medical professionals today.