Uncaring

How the Culture of Medicine Kills Doctors and Patients

By: Robert Pearl MD MD

Narrated by: James Fouhey

Doctors are taught how to cure people. But they don’t always know how to care for them.

Hardly anyone is happy with American healthcare these days. Patients are getting sicker and going bankrupt from medical bills. Doctors are burning out and making dangerous mistakes. Both parties blame our nation’s outdated and dysfunctional healthcare system. But that’s only part of the problem.

In this important and timely book, Dr. Robert Pearl shines a light on the unseen and often toxic culture of medicine. Today’s physicians have a surprising disdain for technology, an unhealthy obsession with status, and an increasingly complicated relationship with their patients. All of this can be traced back to their earliest experiences in medical school, where doctors inherit a set of norms, beliefs, and expectations that shape almost every decision they make, with profound consequences for the rest of us.

Uncaring draws an original and revealing portrait of what it’s actually like to be a doctor. It illuminates the complex and intimidating world of medicine for readers, and in the end offers a clear plan to save American healthcare.

Critic reviews

“No one is better qualified to write about what ails health care than Robert Pearl. Uncaring ought to trigger a rethinking of the professional culture of American medicine.”—Malcolm Gladwell, author of five New York Times bestsellers

“In Uncaring, Dr. Robert Pearl provides an X-ray examination of the medical profession and how it has both promoted and adversely affected American healthcare. It’s deep, insightful, and can be considered the modern version of what Francis Peabody wrote almost a century ago: ‘The secret of the care of the patient is in caring for the patient.’ We need to get that back.”—Eric Topol, MD, professor at Scripps Research and author of Deep Medicine

“How do so many young doctors who enter medicine filled with idealism and the desire to do good end up decades later as cynical professionals, caring about money, prestige, success—everything but the patient? Dr. Robert Pearl, in this riveting examination of the physician culture, diagnoses the pathologies in the system that too often strips the ‘caring’ out of health care."—Elisabeth Rosenthal, editor in chief of Kaiser Health News and author of An American Sickness

“Uncaring is a brilliant and incisive dive into physician culture, both its seamy underbelly and the moments that inspire. Pearl’s vast experience as a physician steeped in the culture, and as leader of one of the largest healthcare systems in America, allows him to write with authority, yet in a personal and engaging way, and at the end to offer solutions. The result is a wonderful and compelling read.”—Abraham Verghese, MD, professor of medicine, Stanford University, and author of Cutting for Stone

“Uncaring lifts the veil on the deeply conditioned culture that drives American physicians and our multi-trillion-dollar health care system. To solve our biggest challenges, we can’t ignore this elephant in the room, and Dr. Robert Pearl never flinches once. Sunlight is the best disinfectant, and Uncaring illuminates the shadows that many doctors themselves are reluctant to see.”—Zubin Damania, MD, host of The ZDoggMD Show, the internet’s most popular live medical show and podcast

Thought provoking, insightful and flawed.

I listened to every word, learning from Dr Pearl. It was a hard book for me to swallow--being a doctor myself. I loved his points, his stories, and I too have witnessed moments where culture is a problem in the course of practicing. I guess where I get hung up on is that there is "tone" here. He has tone against the suffering of doctors--although he does acknowledge it. His recipe for dealing with burnout has to do with falling back in love with the work, while sacrificing more, working harder, and putting patients first. He emphasizes the need for a return to general practitioners and preventative care. Good points. He talks about being an open book about what care costs. 100% agree.
I guess what bothers me is that I am a veterinarian--the virtual medical champions of preventative care. We are 100% transparent with our costs, and many of the colleagues I have worked with are giving well beyond 110%. Meanwhile we are killing ourselves at a rate that is double our MD counterparts. He has missed a key point in the recipe to helping physicians (and other health professionals), and their patients. There is no attention to a patients responsibility to themselves, the book comes across like every patient is a potential victim of the "culture" of physicians. This part is a turn off. I can tell he is brilliant, and I definitely learned from him. Just wish there was a bit more balance in those pages.

An Interesting Listen.

Overall a fascinating insight into medical culture. However, it was marred by the failure to recognize that the medical community, did not respond to the flu heroically, but rather with grotesque cowardice, that brought great harm to their patients and the larger world. Undoubtedly the admission of that shame and disgrace would be too difficult to bear for the author, for the reasons that he outlines in the book.

Thought provoking perspective

Dr. Pearl’s unique experience as the former CEO of Kaiser make this a valuable listen. He brings forward a perspective that makes you think about the realities of healthcare, as well as potential solutions to get the conversation started.

A Surgeon’s Perspective on the Book

Gripping. Hard to hear the raw truth, being a physician myself. However, what Dr. Pearl says is true. We must all look in the mirror and correct what is wrong with our culture and continue to embrace all that is so right. I will encourage my 3rd year medical student daughter to listen to the book. The earlier in our career we understand all these issues, the better chance we have of not falling victim to what is wrong with physician culture.

A must read for physicians!

Eloquently written with anecdotes and teachings that both inspire and provide humility. A must read for physicians and those interested in the highs and lows of healthcare in America. One of my favorite books in the last decade.