Caught in the Crosshairs of American Healthcare

by Lloyd I. Sederer

The inspiring true story of how a small group of dedicated leaders achieved radical and relentless change to save McLean, Harvard’s historic psychiatric hospital

Lloyd I. Sederer, MD, recounts the unfettered story of how McLean survived impending closure or sale to once again prosper and regain its international stature as the hospital where you would want a loved one to be treated for a psychiatric or substance use disorder.

Only growth and innovation can reverse an institutional fiscal crisis. Dr. Sederer describes how, over six years of hemorrhaging money, McLean eluded the now pervasive corporatization of American healthcare and was clinically and financially rebuilt despite the odds, all while serving with integrity and soul more patients than ever before.

Caught in the Crosshairs of American Healthcare offers leaders and aspiring leaders in healthcare and other complex organizations a candid look behind the curtain of McLean’s transformation into a hospital open to all, no longer only the rich and famous. Dr. Sederer also finely details



• the corporatization of medicine putting profits before patients,

• endless insurance hurdles,

• how to prove clinical improvements, and

• our broken and inequitable health and mental health systems of care.



Caught in the Crosshairs of American Healthcare shows that with grit, brains, and support, we can still change our world.

Genres: Nonfiction, Health

204 pages, Kindle Edition

Published January 9, 2024

Reviews

[Kris Zeller · Rating 4 out of 5]

I thought this book was a pretty fascinating look into the disaster that is the American health care system. It's disturbing to see how so many health care related decisions are made by people who have no actual health care / patient experience. It's also kind of interesting to unpack the way things are related; if you don't have someone pushing financially motivated policies, you could force the hospital to be insolvent and incidentally kill an institution that does so much good. There is a lot of very interesting points in this book, but I almost wish I would have read it (as opposed to listening to it) because I just don't retain information as well when I'm listening as opposed to reading and underlining....but I think the narrator was a bit of an issue as well. The author has a wealth of information about and so much experience that I really wanted to hear what he had to say..... but I struggled a lot with his narration whereas a voice actor type narrator might have made it move a little faster. Over all very well done though, I hope this book takes off because I wish more people took the time to learn about the health care system.

[Susan · Rating 2 out of 5]

I won this book in a Goodreads Giveaway. From the description given. I expected a book with social commentary about the state of corporate medical care in the US, perhaps with analysis of what we may be able to do about the lack of funding and help available for mental health care. That's not what this book is-- predominantly, this is a memoir, and a dry one, about the man who ran McLean Hospital for a few years, and the changes he made to their system during his tenure there and why. Frankly, ot was dull, and the voice it was written in seemed a tad callous and arrogant. I didn't enjoy the book, and I can't think of anyone save for a small number of people who work in high echelons of hospital admin who would have any interest in reading it. I'm sorry I didn't like it much. Just 2 stars.

[Paul · Rating 3 out of 5]

The story of how McLean Hospital, a mental health hospital in Boston, was saved. Probably of more interest to healthcare administrators. The most interesting parts of the book for me were the stories of patients and chapter 9 on the "corporatization of American medicine," a cautionary tale for everyone and further evidence of the need for national healthcare. Decisions regarding a person's healthcare should not be made by non-medical professionals who are only concerned about the bottom line.

[Erin Arra · Rating 4 out of 5]

This was an interesting take on common complaints of the American healthcare system. It discusses how it is important to determine what the patient wants vs physicians or other healthcare providers think is best. It discussed how w healthcare providers should counsel vs dictate and treatment should be a partnership. providers should meet patients where they are emotionally. There were also great points how electronic medical records safe taking away from patient care but more so assisting with billing. The author gave interesting examples to show evidence of their points.

[Abbi · Rating 1 out of 5]

This was painful for me to read. I feel like maybe if this book was restructured it would be better. Also maybe this book is meant for more intellectual type people who understand hospital administration or even just business administration, not someone who works in a hospital and has an interest in saving good hospitals from their downfalls. Another #GoodreadsGiveways book that I am thankful to have received.

[Divyesh Sheth · Rating 4 out of 5]

very good book on managing change

Healthcare is one of the most complex business. How to manage change in a revered hospital for better patient outcomes and financial health is a journey we all can learn from. There are great leadership insights and good explanation of how our healthcare system works in very accessible way.

[Jessica · Rating 4 out of 5]

This book is just one story about a facility in the broken system. Luckily it was managed and ran by people who had enough knowledge and care to invest in saving it. Sadly, so many other institutions have not been as lucky. The truth that is book reveals too is that mental health care has been pushed to the back burner for other specialties that bring in more money. Also, the health care industry as a whole has taken a huge hit over the last 2 decades, where the folks making most of the decisions on care have no education on the matter, they are accountants and bean counters, not the doctors and nurses we are seeking care from. I hope this can change. As consumers of healthcare we should become more educated and be a part of making that change happen.

Thank you for considering me in the giveaway and sending me a copy of this book. I will be recommending this to others.

[Sol]

this book contains information about the current climate of today's healthcare industry in America. as someone who's worked years and years in healthcare and is currently working in a psych facility, it's abundantly clear that there's so much more than what meets the eye.
 
bookmarking this for future re-read/s.

the audiobook for this is available through NetGalley

[Ashlee Beal · Rating 3 out of 5]

I got this book from a Goodreads giveaway. I enjoyed the stories of the various patients and doctors and the part about how medical decisions are made. Otherwise, I’m not sure this book was really written for everyday people but people in the healthcare industry would probably understand it a bit more on how the changes made improved the hospital.

[Kiel Ochalek · Rating 2 out of 5]

The book was not that enjoyable. A lot of the same points were repeated multiple times throughout. It was apparent that the author thinks very highly of himself. The topic was interesting but poorly written.

[Alan Lewis · Rating 4 out of 5]

Interesting

Not exactly what I thought this book would be about, it did touch somewhat in the subject of the healthcare crisis. It nevertheless was a very interesting read. I received a complementary copy via Goodreads Giveaways.

[Tracy Fox · Rating 4 out of 5]

This was a very interesting explanation of how to bring an excellent health facility from the brink of demise in the new world of healthcare.

[Janet · Rating 3 out of 5]

This was a Goodreads giveaway winner. Where there is a will, there is a way. I did like reading about improving the health care system.

[Ted Hennessy · Rating 4 out of 5]

This book is two narratives:
- an indictment of the Healthcare system as it evolved in the 1980-90 period, especially regarding mental health treatment. Medical care became less important, financial results more important. (That continues today.)
- a chronicle of the epic struggle by Dr. Sederer to move MacLean's Hospital forward, away from its great past approach, and into a re-focused institution that could survive in the new mecical-industrial system of the 21st century.
It's a very interesting glimpse into how mental health facilities run. Sederer includes lots of his own beliefs / observations about how to be a leader in a shifting environment. And he provides thumbnail descriptions of many of his associates at MacLean