Gregg Coodley, MD

Gregg Coodley, MDGregg Coodley, MDGregg Coodley, MD

Gregg Coodley, MD

Gregg Coodley, MDGregg Coodley, MDGregg Coodley, MD
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    • BIO
    • Books
      • American Salvation
      • Taming Infection
      • Patients in Peril
      • The Green Years
      • Good Monarchs
      • The Magnificent Losers
    • Shop
    • Contact
  • Home
  • BIO
  • Books
    • American Salvation
    • Taming Infection
    • Patients in Peril
    • The Green Years
    • Good Monarchs
    • The Magnificent Losers
  • Shop
  • Contact

Patients in Peril

The Demise of Primary Care in America

Once, Americans could count on having a personal or primary  care physician who would see patients for new or chronic problems,  whether in the office or the hospital. The appeal of such a system is  more than psychological, for both primary care and continuity of care  with a physician over time are associated with improved patient care,  greater patient satisfaction, and lower overall costs. 


These  days are ending as primary care in the United States is rapidly  disappearing. Where once 80% of American doctors were in primary care,  now perhaps only a quarter of new graduates enter the field. Existing  primary care doctors are retiring prematurely while many of those  remaining feel demoralized, dispirited, and defeated. Experts predict  increasing shortages of primary care doctors. The collapse of primary  care will increase overall costs, hurt hospitals and insurers, but most  of all damage the care of patients.


Patients in Peril explains  the roots of the problem, the travails of primary care in America, the  role of medical schools, hospitals, insurers and government, and how  this all affects patients. Patients in Peril also offers practical  achievable reforms that would improve care, reduce costs, and  potentially avert this disaster.

Patients in Peril

Editorial Reviews

"In Patients in Peril: The Demise of Primary Care in America,  Gregg Coodley examines the state of healthcare in the United States,  drawing comparisons, pointing out the mishaps in the medical field, and  expounding on how things came to be. Not too long ago, most Americans  could count on having a personal or primary care physician. The  availability of physicians made it easy for every American to access  affordable healthcare, but not anymore. Gregg Coodley is comprehensive  in his writing, starting from the root of the problem, highlighting the  causes of the decline, and offering practical solutions.
The author  introduces the reader to his work by giving them an idea of how it  started. Then, he writes about the background of primary care in  America, sharing historical details not known by many. I applaud him for  how he chronicled the historical events and the progress made during  the period American colonies gained independence. It is interesting to  learn that doctors have been viewed in a different light through various  periods in history. For example, I was awed to learn of doctors during  the Jacksonian period in the 1830-the 1840s and how they were generally  regarded in the 1800s. Gregg Coodley is great at penning historical  tales, picking the most fascinating facts to write on. This  informative book has 21 chapters, all manageable in length. The author  is clear, uses recognizable terms, and engages the reader in his  writing. Although the content of this book is about healthcare and  medicine, the writing is engaging, using descriptions and case studies  to get his points across. Every chapter is distinct, and the topics are  diverse. I also like the fact that the author added images of ancient  paintings and modern pictures in between the chapters, as it made the  book more appealing to read.
In Patients in Peril: The Demise of Primary Care in America,  you will learn about the dangers of ignoring primary healthcare, the  benefits of primary healthcare, insurance, the rise of hospitalists,  vaccines, and medical training, among other issues. The use of data and  statistics by Gregg Coodley was an excellent concept for readers that  appreciate factual information. The highlight for me was the appendix,  where the author listed proposed reforms. I recommend this illuminating  book to medical professionals and readers who are conscious about their  health and the state of healthcare in America. "


-  Posted by Literary Titan 

https://literarytitan.com/2023/01/02/patients-in-peril/

 "Evidence that consolidation has improved quality is scant."
Written  by a primary care physician, this book gives critical insights into the  strengths and breakdowns in the United States healthcare system. The  book is well written, well organized, and well referenced, including  studies from The Lancet  and JAMA. Coodley writes an easily readable text for almost anyone. The  strongest case the author makes is that primary care physicians are the  cornerstone of quality care, yet the field is diminishing for a myriad  of reasons. He furthermore outlines what care model (HMO, private  practice, etc.) lends itself to the most satisfaction by patients,  "Safran et al. compared Primary care performance and patient  satisfaction in five different models of care. Contrary to the academic  expectations, the model that paid physicians on a fee-for-service basis  had their highest scores from patients." Coodley writes of a plethora  of good fixes for healthcare's current shortcomings, including how to  increase the ratio of primary care physicians to specialists and how to  increase patient satisfaction, "It comes down to insurance companies  being willing to give up some control with the possible reward of  increased profits." He compares the system in the USA to those in other  countries so that rather than starting from scratch, one can take what  is best from every system in curing the American healthcare system  dilemma. Perhaps those who need to read this book most are future  administrators, public policy students, and, more broadly, life's  students. This book belongs on the required reading list for college  because every single human needs healthcare, and the system must not  keep patients imperiled."


-Toby Berry, The United States Review of Books
 

 "Patients in Peril: The Demise of Primary Care in America by Gregg Coodley M.D. is a non-fiction medical book that details the history of general practice and primary healthcare in the United States. He describes how the decline in primary care is detrimental to doctors, patients, the healthcare system as a whole, and even insurers. Coodley begins by showing us how primary care has been managed for centuries and the series of transitions that have occurred to get to where we are now. He points out that almost every doctor is a stranger to the patient and how ineffective this practice is, as well as how much more it costs. Coodley provides references, verifiable facts, a clear understanding of the economics, and his experience
as an MD who has worked with primary care physicians for
decades. His revelations are terrifying and compelling.
In the interests of full disclosure, I live in a country with national
healthcare and have had the same primary care physician for close to thirty years. My doctor knows my name without reviewing a file, asks about my dad, and sends us Christmas cards. A for-profit healthcare system is foreign to me and for this reason, Gregg Coodley's Patients in Peril consumed me for days. It is difficult not to feel angry once we have the crystal clear picture that Coodley paints. Imagine a doctor being paid more for not treating a patient in need with everything they require. Imagine everyone but the doctor getting lab results first and a patient finding out they have cancer from a screen print mailed to their home. Imagine a patient in need of time-critical treatment and their doctor's hands being tied until an insurance company approves it. The problem is that all
of this is happening right now. It's going to take a whole lot more of Dr. Coodley's teaching before we finally fight for change, but this book is an excellent place to start. Highly recommended."


-Asher Syed, Readers' Favorite
 

 "Once upon a time, the family doctor was the central force in  medical treatment. 'Specialists' were only for very specific ailments,  and the family physician was a bigger gateway to medical care than  anything we experience today in America. Patients in Peril: The Demise of Primary Care in America pinpoints the history and peril of healthcare changes which have  increasingly picked apart the role of the traditional family physician.  It's a study that needs to be in the hands of anyone interested in  modern healthcare, whether they are doctors or patients. The demise  of the primary care physician is evident not just in the current  services provided (or not), but in the majority of medical school  graduates who choose specialization over generalization.
Primary care  is becoming an industry shortage and a rarity as primary care  physicians retire and are replaced not by new generations of doctors,  but by medical processing centers designed to reduce cost, eliminate  wasteful approaches, and devote a minimum of or limited amount of time  to the patient. Gregg Coodley charts the history of this trend,  identifying economic, social, political, and medical influences on its  incarnation and, more importantly, investigating the problems created by  the demise of the primary care doctor in America. When insurers take  over doctoring, real healthcare wanes—including the compassion of the  physician for his patients, home visits, and ultimately the quality of  care. Replacing and second-guessing physicians are administrative  processes that tax healthcare efforts instead of enhancing or improving  them. As Coodley tackles the subjects of prior authorizations,  medical training dysfunction, the rise of fee-for-service arrangements,  and the disparities created between physician and patient by systems put  in place to oversee both, readers gain a solid insight into the  problem, its history, and, in conclusion, some possible solutions.
The  latter is not the focus of this book. Its attention to the details of  how this demise happened and is incarnated in modern medical services  and patient/physician relationships provides an invaluable look at a  bigger picture of problems than most realize. This makes Patients in Peril a top recommendation for health libraries, whether in public library or medical school settings. Ideally, Patients in Peril will be assigned reading to medical school students and would-be  healthcare professionals in present and future generations. Its food for  thought should ideally spark debates, discussions, and active changes  and considerations beyond individual enlightenment."


-D. Donovan, Senior Reviewer, Midwest Book Review
 

 "Gregg Coodley, author and physician, has arrayed statistics  and suggestions in this wide-ranging look at a disturbing change that  has taken place in American medical care in recent years. Coodley's  book begins with the general history of becoming a doctor in the US.  Once considered a rather lowly and often maligned profession, medical  practitioners have risen to a level of high respect as education  expanded to tighten requirements and allow for established  certifications. The major basis for doctors was traditionally the  personal care physician (PCP) model: someone who would take care of most  or all a patient's medical needs, even visiting them in the hospital,  communicating directly with the patients and family and recommending any  outside care needed. This model has gradually altered, as insurance,  government, and private industry have intervened in the realm of  American medical practice. The current model for patient care has  changed so that now a patient in the hospital may see a "hospitalist" -  sometimes a different one every day - and far more of his/her care will  be siphoned off to a wide variety of specialists. Change of insurance  can result in mandatory change of PCP, the poor will see only the  often-changing group of caregivers in public facilities, and only the  very wealthy can afford to engage one doctor for all care. One result of  this is that far fewer medical students opt to become PCPs, and that  patients are no longer treated directly by someone who knows them, will  have observed them for a long period of time, and can offer greater comfort and healing because of the relationship. America is unique in this model, with proportionately far fewer PCPs than elsewhere in the  world. Coodley, who boldly established a PCP clinic to benefit his local  community, sets forth various possible changes that would offer a  better template for medical care, with a reversion to the traditional  "family care" doctor being the goal. Coodley, who has  authored/co-authored other factual materials, presents his case here in  an intelligent, well-organized forum, so that almost any sensible reader  will, from the first page of this extensive exploration, feel a kinship  with the author's clear treatise, his ideals and cogent suggestions for  change. He supports his thesis with a vast number of references,  factual data and telling statistics, casting light on financial dealings  and governmental interventions that have made simple medical care  almost too complex for ordinary citizens to comprehend. Quill says: Gregg Coodley's book, Patients in Peril: The Demise of Primary Care in America, should be given serious attention and his ideas widely propagated so  that Americans needing medical care can feel that they are being offered  the best possible options."


-Barbara Bamberger Scott, The Feathered Quill 

Patients in Peril

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