A Bitter Pill

An investigation into why the health care system does not work for old people, who are in fragile health, and what we can do about it.

Medical treatment of elderly people is not working. Worse, it is often harmful, says author John Sloan, a family physician who has worked primarily with the elderly for more than twenty years. In A Bitter Pill, he examines why medical treatment—from modern medicine's one-size-fits-all prevention strategy to hospital stays that don't benefit anyone—is failing them and identifies solutions to the problem.

In clear, accessible language, Sloan argues that we must understand what people in poor health at the end of their lives really need: comfort, dignity, and quality of life. He also argues that caregivers, sons, daughters, nurses, doctors, and social workers—all of us—must assume responsibility for what happens to the elderly and give these loved ones the kind of care we hope, one day, someone will give us.

John Sloan, MD, is a senior academic physician in the Department of Family Practice at the University of British Columbia and has spent most of his thirty years of practice caring for the frail elderly in Vancouver. He has lectured throughout Canada and in Europe and the United States, and is sought after as an inspirational speaker on geriatrics. He lives in Vancouver and Roberts Creek, B.C.

"Dr. Sloan treated the elderly at home for many years. (Yes, he made house calls!) His recent book, A Bitter Pill, is an utterly convincing indictment of the way we're wasting money on useless care for the elderly, while making their lives worse. It's essential reading for anyone who's interested in health-care reform, as well as for anyone who's responsible for an elderly person or anyone who is or will become one." -Globe & Mail "Frail old folks gobble up health-care resources; and too often gain no benefit. That's the message in Dr. John Sloan's provocative new book, A Bitter Pill: How the Medical System is Failing the Elderly. A Vancouver family physician, Sloan has spent the past 15 years doing home care exclusively for old people." -Toronto Star

"The good news is that at least a few Canadian physicians have developed a way to practice medicine that is tailored to the unique needs of [the elderly], an approach that increases comfort and dignity, allows the frail elderly to stay at home in comfort longer and choose the terms of their final days. John Sloan is the Vancouver-based general practitioner and UBC Medical School professor who has pioneered this new approach, which is long on common sense and kindness and notably short on high tech interventions and expensive multiple medications. He makes the case for it in his 2009 book A Bitter Pill: How the Medical System is Failing the Elderly." -The Tyee

"There is real anger in his newly released book . . . Sloan's experiences of seeing energetic patients transformed into near-zombies because of over-medication after trips to the hospital, have led him to call for radical changes to medical treatment for the elderly; including keeping them out of the hospital, if at all possible. These seemingly common-sense recommendations are radical because they swim against the stream of modern medicine." -The Province