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February 4, 1998

MedicineDemanding Medical Excellence: Doctors and Accountability in the Information Age

Author Affiliations

Harriet S.MeyerMD, Contributing EditorJonathan D.EldredgeMLS, PhD, Journal Review EditorRobertHoganMD, adviser for software


Not Available


by Michael L. Millenson, 433 pp, $24.95, ISBN 0-226-52587-2, Chicago, Ill, University of Chicago Press, 1997.

JAMA. 1998;279(5):407. doi:10.1001/jama.279.5.407-JBK0204-5-1

War is the slaughter of many in the sport of the few. Medicine is "a certain art of manslaughter," and often "there is more danger in the physician and the medicine than in the sickness itself." Will Durant, The Story of Civilization: The Reformation (quoting Agrippa)

The central purpose of Demanding Medical Excellence is to show "the ways medical treatment [and] the practice of medicine can be dramatically improved." To accomplish this, Michael Millenson takes you through a journey that spans this century. We travel from the early years of unrestrained tonsillectomies through variances in coronary bypass outcomes to contemporary concerns with evidence and quality. His emphasis is on our tepid concern for outcomes and our reluctance for self-scrutiny. We have long known that there is much scope for improvement in all aspects of medicine. Plato, Molière, and Shaw have ridiculed our beliefs and practices. Thus, Millenson, a science writer, senior analyst, Pulitzer nominee, and erstwhile Chicago Tribune staffer, joins a long line of crusty critiques.

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