End-of-Life Choice, Death with Dignity, Palliative Care and Counseling

NPR: Patients Face Serious Consequences From Discontent Among Doctors, Says Physician Book Authorby Jay


By Sean Crowley

“Even though I wasn’t ordering the [unnecessary medical] tests, I was in the office while these tests were being performed — and I felt really dirty about it.”

That is an excerpt from NPR Fresh Air host Terry Gross’ interview with Dr. Sandeep Jauhar, the creator and director of the Heart Failure Program at Long Island Jewish Medical Center, a teaching hospital.

He’s the author of an earlier memoir called Intern and contributes to The New York Times.

Jauhar’s new memoir, Doctored: The Disillusionment of an American Physician, is about how doctors are growing increasingly discontented with their profession. Below are highlights of his NPR interview about it:

“The growing discontent [among physicians] has serious consequences for patients …

“If you have run-of-the-mill chronic diseases like congestive heart failure or diabetes, the system is not designed to find you the best possible care. And that’s what has to change.

“… One of the issues with medicine today is that it’s just become so complicated. More and more people are surviving with chronic illnesses, so you have folks in every patient panel who have multiple chronic diseases …

“I’ve seen patients have their last days prolonged in misery because of the actions of their well-meaning family members who don’t want to let go, and sometimes even by physicians and — unfortunately, at least in one case — by me.

“I had a very dear patient of mine who had severe congestive heart failure and had a very leaky heart valve, and she became one of my favorite patients. … She was in her late 80s …

“… I went through a lot of … very aggressive interventions to try to save her. It wasn’t because of financial incentives — I’m on salary — it was because I just didn’t want to lose her. …

“About eight or nine days later she died. There’s no question that I deceived myself — that I thought somehow I could keep death at bay and that my judgment was clouded by my love for this patient and not wanting to let her go …

“Now I’m much more circumspect about how I handle these cases. And in recent years, I’ve created much more of a relationship with the palliative care team and the hospice team in my hospital. And I think it’s been much better for my terminally ill patients.”

You can listen to the entire radio interview with Dr. Jauhar, read the transcript of it and an excerpt from his book, Doctored: The Disillusionment of an American Physician, by clicking here.