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Greenleaf Book Group
Service Provider
Caught in the Crosshairs of American Healthcare
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.
Ever wonder why healthcare, from your annual wellness visit to an extended hospital stay, is not what it used to be? This insightful and inspiring account from Sederer (author of Improving Mental Health: Four Secrets in Plain Sight) offers answers to what’s gone wrong with insurance, profiteering, inequitable care, outdated infrastructure and more—all while telling the rousing story of one hospital pushing back to put patients first. Hired in 1989 to help prevent McLean Psychiatric Hospital, a Harvard teaching unit in the shadows of Cambridge, from closing or becoming a managed-care “trophy” institution, Sederer chronicles the evolution of McLean and his teams’ efforts to pull it out of a “death spiral,” while providing a blueprint for America’s healthcare future.

Sederer recounts his long fight to prevent change for the worse as “for-profit intermediaries” try to seize greater control from doctors and nurses. Sederer’s experiences, observations, and recommendations amount to a troubling wake-up call. His six-year, boots-on-the-ground odyssey is a sobering journey of how the American healthcare system has declined from a progressive system run by healthcare professionals typically with the best interest of the patient and their families at heart to a near-monopoly of profit-driven corporations that view patients as products that should be managed as efficiently as possible.

At times, the book reads like a thriller with Sederer and his team of underdogs taking on corporate America. Along the way he is not afraid to dispense strong medicine as well as wisdom gained from experience. Sederer illuminates a lot of territory as he navigates the “merciless new era of corporate medicine,” the over-prescription of certain drugs, irresponsible doctors, the loss of family involvement in recovery, and more. Ultimately McLean, like the old-fashioned family doctor, survives the onslaught with its leading position in psychiatric research and treatment intact. Sederer offers here nothing less than a real-life prescription for change that should be urgent reading for healthcare administrators, officials, and providers.

Takeaway: A doctor’s rousing account of saving a patient-focused hospital from profiteers.

Comparable Titles: Brian Alexander’s The Hospital, Ricardo Nuila’s The People’s Hospital.

Production grades
Cover: A-
Design and typography: A
Illustrations: N/A
Editing: A
Marketing copy: A