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Jack Rubinstein, Associate Professor of Medicine, University of Cincinnati discusses his medical thriller, The Perfect Dose, and how it relates to real-world problems in the healthcare industry.

Dr. Rubinstein is affiliated with multiple hospitals in the greater Cincinnati area, including Cincinnati Veterans Affairs Medical Center and University of Cincinnati Medical Center. Dr. Rubinstein talks about his book, The Perfect Dose, which is a medical thriller that highlights corruption within the healthcare system, and those who threaten scientific progress. He outlines his reasons for writing the book, specifically mentioning that he thought a fictional thriller with interesting characters and story would establish a stage for societal dialogue regarding the very real, demonstrable problems within the American healthcare system. He discusses the case of Martin Shkreli, the much-maligned, now imprisoned American businessman and former hedge fund manager who sent shockwaves across the country when he raised drug prices thousands of percent. He uses Shkreli as an example of the constant battle in the industry—helping the most people possible versus helping shareholders of pharmaceutical companies make large profits. Dr. Rubinstein points out that many drugs are funded by the government agency, National Institutes of Health (NIH), which funds academia that conducts much of the research that leads to new drug development. Then drugs are often licensed to pharmaceutical companies who may charge a very high price for the drug as they sell it back to taxpayers, the very people who funded the drugs in the first place.

Dr. Rubinstein discusses many of the drugs and medical issues in his spectrum of study. He studies select drugs that have had success in specific areas of medicine and through his research has repurposed some of them for cardiovascular issues such as heart failure. He delves further into the off-label uses of many prescription drugs. Further, he expounds upon how his book highlights many issues in the American system versus other countries outside of the US. Dr. Rubinstein talks about his experiences caring for other doctors and their family members. He speaks extensively about what makes a doctor a good doctor, and the systems and standardized treatments that play a part in reputation.

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