Dear Boss.

Book Address Health Care Revolution, Being a Good Boss

If there is a book that you believe ought to be reviewed in Physician Executive or if you wish to review a book, please call Wesley Curry at 813/287-2000.

Stoline, A., and Weiner, J. The New Medical Marketplace: A Physician's Guide to the Health Care Revolution. Baltimore, Md.: Johns Hopkins University Press, 1988. $12.95.

This is the book to buy for your medical director if you are looking for a brief yet thorough and witty summary of why we're in the health care mess we're in. While concise, the authors fully reference their work, thus allowing the nterested reader to pursue specific topics.

The authors begin with welcome historical background. Too often, we are treated to solutions to a health care "crisis" without any assistance in appreciating the problem's historical background. as the authors point out, we've been in a cost containment crisis for the past 50 years!

Stoline and Weiner, researchers at Johns Hopkins University, address the remainder of the book to current trends and solutions. They balance their chapters between issues of direct relevance to physicians (the malpractice crisis, for instance) and those that should be important to all in the health care system (ensuring access, for instance).

The New medical Marketplace constitutes a welcome addition to the explosion in new books on the American health care system. Readers, physicians and non-physicians alike, will benefit from the authors' prescription and prognosis and from the cartoons that illustrate their points. --Norbert Goldfield, MD, Goldfield and Associates, Northampton, Mass.

Werther, W. Ear Boss. New York, N.Y.: Touchstone Publishers, 1989. $14.95.

The author presents a series of letters that employees would like to send and bosses should read. The contents have to do with problmes that employees often recognize but that bosses may either refuse to acknowledge or are totally ignorant of. Presented here is just one, "The Machiavellian Trap."

Niccolo Machiavelli, in his 400-year-old book The Prince, noted that "since love and fear can hardly exist together, if we must choose between them, it is far safer to be feared than loved."

Many bosses fall into the trap of believing this maxim. They try to motivate people through fear. While fear may initially improve performance, the long-term effects are bad. Over time, productivity will fall.

What employees see is an approach that is similar to divide-and-conquer tactics. Instead of feeling like allies, employees feel like potential enemies. In the end, they are more concerned with survival (or getting even) than in producing at a high level.

The solution: Treat employees like allies. Train them in what's expected in a positive manner, and loyalty and enthusiasm will eventually create the desired level of productivity.

This book is a compilation of the wisdom of positive reinforcement. While it may be written in terms of what employees would like to say, it is really about what managers need to hear. Like so many other things bosses should listen to, this book will most likely fall only into the hands of managers who really care...and be ignored by those who need it most.

The book offers some points we all ought to be aware of. For those bosses with open minds, it gives a good foundation for what they ought to be thinking about when they "boss" (positively or negatively) their employees.--Richard M. Burton, MD, Director, communications, Pikes Peak Emergency Specialists, colorado Springs, Colo.