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Health, Medicine and Justice: Designing a Fair and Equitable Healthcare System

Joshua Freeman

Friday Harbor, WA, Copernicus Healthcare, 2015, 307 pp., $18.95, paperback

Joshua Freeman, MD, is a recognized leader in family medicine, officer in the Society of Teachers of Family Medicine, and assistant editor of Family Medicine. He is chair of the Department of Family Medicine at the University of Kansas Medical Center in Kansas City, KS. He has a frequently published blog, “Medicine and Social Justice.” So when I sat down to read his new book, I expected mostly what I would hear him say at meetings, conferences, and in his blog. I got much more.

Dr Freeman took a 1-year sabbatical to write this book, and the result is a comprehensive analysis of American health care and the role of medical education. The thoroughness of his treatment of health care from many angles is impressive. The collection of tables and figures covers about everything of importance in understanding what is wrong in American medicine and is a great resource for teaching and presentations.

The book begins by addressing the purpose of a health care system and how the United States comes up short in many ways. The social determinants of health and cultural disparities are dealt with sensitively and in detail. Dr Freemen then shows how an over-specialized health care system harms the public and the importance of primary care. He looks at medical education and how our medical schools fail us in producing the physicians that society needs and how residency training reinforces the status quo. Dr Freeman looks at the importance of evidence-based medicine and good clinical guidelines in providing the right services, including the Choosing Wisely campaign. He addresses the role of profit in contaminating the higher calling of medicine to promote the health of the public. Dr Freeman provides not just problems but practical solutions. Hopefully these solutions will become politically feasible.

Health, Medicine and Justice is liberal without being a liberal polemic. For example, Dr Freeman is fair and balanced in discussing the Affordable Care Act, what it has accomplished, and how it has fallen short. He uses facts to back up his analysis rather than opinion. This book should be part of the community health and health care system education of both medical students and residents.

Joseph E. Scherger, MD, MPH

Eisenhower Medical Center

Rancho Mirage, CA


Copyright 2018 by Society of Teachers of Family Medicine