The one book that everybody in health care ought to read

This review concerns a book – Limits to Medicine: the Expropriation of Health, by Ivan Illich – that has relevance to both physical and mental healthcare. The review is 20+ years old and comes from Dr. Richard Smith (who was then editor of the British Medical Journal). It begins:

“I met yesterday with a young doctor friend who is thinking deeply about the health system and how it can be made sustainable.  There is one book that I recommend to every person in health care to read, and it’s a book published 40 years ago–Limits to Medicine: the Expropriation of Health by Ivan Illich. Below is a review of the book I published some 15 years ago. It’s time for me to read it again.

The good news is that although Illich is largely unknown to those under 45 his ideas are becoming daily more relevant and, most important, are being put into practice–handing back health to the people with doctors acting as advisers not priests.

The closest I ever came to a religious experience was listening to Ivan Illich. A charismatic and passionate man surrounded by the fossils of the academic hierarchy in Edinburgh, he argued that ‘the major threat to health in the world is modern medicine.’ This was 1974. He convinced me, not least because I felt that what I saw on the wards of the Royal Infirmary of Edinburgh was more for the benefit of doctors than patients. I dropped out of medical school that day. Three days later I dropped back in again, unsure what else to do. Now I’m the editor of the BMJ, which is ironic. Having deserted medicine, I’ve become a pillar of the British medical establishment (yes I am, like it or not).

I devoured both Medical Nemesis and Limits to Medicine, and now I’ve reread the latter—for the first time in 25 years. The power of the book is undiminished, and its prescience seems remarkable. What was a radical polemic in 1974 is in some sense mainstream in 2002. Medicine does seem to have over-reached itself and some reigning in will benefit not only patients but also doctors …”

You can read more from here.

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