Sunday, January 23, 2011

Book Review: The Color of Atmosphere

The Color of Atmosphere: One Doctor's Journey In and Out of Medicine

Thanks to the publisher, via NetGalley, I had the opportunity to read Maggie Kozel's memoir of her time as a medical student and pediatrician.  Born in a dysfunctional family, the daughter of alcoholic parents, Maggie decided while a student in a Catholic high school that she wanted to be a doctor.  We followed her through medical school, residency, the Navy, work in a community charity clinic, private practice and, finally, out of practice and into teaching.  

While mostly a memoir, this book is also a not-to-subtle call for the United States to adopt the medical model used by the US military in the early 1980's.  In short, every patient (and at that time this model was used to treat family members and retirees as well as active-duty service people) had an assigned medical clinic or hospital.  When you got sick, you went there and were treated.  Work was delegated down to non-physician providers when possible.  No money changed hands.  She could order the treatments she thought best without worrying about being paid or about malpractice.  Patients didn't have to worry about paying for it.

Kozel complains about parents who wanted antibiotics for colds or who didn't listen to her when she suggested that "Johnny" needed more playtime and less screen time.  She complains about doctors who avoid tough cases because of the time commitment and the risk of malpractice suits.  Mostly she complains about the insurance reimbursement system which, in her opinion, rewards the wrong thing.  An example she gives is well-baby checks.  In the military hospital, kids the same age were scheduled for checks on the same day.  First, the nurse talked to a room full of parents going over milestones, discipline issues, and other stuff that gets discussed with everyone at those visits.  Then a corpsman would weigh and measure the kids.  The doctor would check them over and answer any remaining questions--or send them to someone who would, and would refer the parents to anyone else they needed to see.  In civilian practice, she was the one who had to do all the work because the insurance company wouldn't pay extra for the nurse to do it--hiring a nurse to do those sessions would cut into their income.  

While I found the ending of the book to be a bit self-absorbed, I enjoyed seeing the life of a modern pediatrician through her eyes.  Grade: B


  1. Wow the Navy runs things different. I had both James and Abigail in military hospitals and used the clinics for well baby check-ups. Theresa while born in a civilian hospital used clinics for well baby.

    While they did schedule all well baby on the same day there was never a nurse giving a class first...

  2. My son is in medical school so books like this always intrigue me. Thanks for the review!

  3. The thing about the well baby checks is REALLY interesting. I understand the benefit of well child visits, but by my third child in five years I was getting pretty tired of these pointless visits to the doctor, especially when the doctor spent 6 months freaking out because my third child wasn't gaining enough weight for her taste. I LOVE LOVE LOVE this idea of the group visit!

    There is so much wrong with our system. I'd better stop before I get my soap box built up too big. :)


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