The Kitchen Shrink: A Psychiatrist's Reflections on Healing in a Changing World

The insurance companies, not doctors or patients, ultimately determine most medical care, isn’t what my family and friends want to know. Most of us don’t want to ask. But when I asked my own physician…she confirmed that my insurance company ultimately decides what treatments and tests I receive…not my physician” (53). "The Kitchen Shrink" by Dora Wang is an honest and forthright memoir that reads like a mystery unraveling. The mystery is how deregulation in the 1980’s has allowed a for-profit system to change not only how a patient receives care, but also how doctors give that care. These changes even seem to leave doctors and medical personnel just as confused as the rest of us. In "The Kitchen Shrink", Wang peels back the layers to reveal the changing role of doctors and medical personnel across the board since for-profit care has become the norm. Wang uses a combination of personal experiences, case studies, and historical landmarks to examine how the insurance industry influences patient care. Ultimately, decisions as to what, how, and who to treat are made by the clerk at the end of a phone line who never even sees the patient. This is a candid peek into the ever-changing world of pre-certifications, permissions, and trails of paperwork that somehow leave the patient holding a bag of lost medical procedures and rejections. Wang’s dedication and frustration in working through this system, in an effort to care for her own patients, reminds us all that there are still dedicated and caring physicians willing to jump through hoops to get the care their patients need. The doctors and other medical personnel that do, in fact, care about their patients go a long way to renew your faith in advocates that simply want to do the best for their patients. Wang has given us a compassionate and touching view of the medical profession. Wang’s conversational tone makes this book accessible to any reader. It’s not laden with strong medical language, but certainly delves deep enough for the reader to understand. This is especially true in some of the case studies illustrating the urgent and life-changing effects insurance company decisions have had on the lives of patients and their families. "The Kitchen Shrink" is a must read for anyone wanting a more intimate view of how the for-profit medical insurance system has changed medical care. This is an especially important book now, when our nation is locked in a debate over healthcare reform. But, the history of how medical care became a big business is only part of the reason why everyone should read this book. The author’s personal stories as well as the case studies she courageously shares will really pull you in and tug at your heart. Wang looks at this industry from all perspectives: as a medical professional, colleague, caretaker, daughter, wife, and mother. Ultimately, her road becomes very much like our own; she, too, is caught within a system that sees no faces and hears no heartbeats, but only responds to the bottom line.