A Book Review On Atul Gawande's "Better"

862 words - 3 pages

How much do you really want to make? Many would love to make millions of dollars and do nothing to earn it. However, there are many who could care less about how much they make, and view it as a necessity for living and not as a luxury. Doctors come to a standstill when they are asked how much they make or would like to make. In a section of Atul Gawande’s novel, “Piecework,” he gives the reader a life lesson on how doing right in the medical field can be extensive and expensive. One must consider all the factors that go into a medical decision before assuming the worse.Atul Gawande sees the medical profession more as a business rather than actual healing. Today doctors get so caught up in mess of how much a particular surgery should cost that many forget about the patient’s care. At the beginning of “Piecework,” Gawande recently finished his residency and is looking to become an independent doctor. However, he was conflicted about how much they should pay him. He never thought or acted upon the annual salary of a new doctor before, because most doctors never boast about their yearly income. However, when he did ask certain doctors the conversation “turned out to be awkward…and they’d [mumble] as if their mouths were full of crackers” (Gawande 113). Gawande states that doctors should not have to respond, because their main goal is to take care and save the patients. The author explains certain things have a definite cost and one must follow those costs no matter how extreme they may be.Gawande describes how the government and many insurers have made some conclusions to the average cost of every surgery. This extensive book is called the “master fee schedule” (114). It lists costs of every surgery down to the exact penny. Gawande explains that the surgeries listed ranges from trimming one’s nails which can cost $10.15 to reconstructing a new born baby who was born without a diaphragm, which can cost at least $5,366.98 (114). This basic idea for a list of costs dates back to the times of Babylon. Gawande explains how the doctors were getting paid on a piecework salary, meaning he would receive more money if the surgery was extensive, and lifesaving. In the mid 1980s the schedule soon became modernized and insurers came together to stabilized the payment methods for these new discoveries, which they called “usual, customary, and reasonable fees” (115). In other words, Gawande states how the insurers were willingly enough...

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