The topic of this book seems timely given the increasing focus in recent years on equality and prevention of discrimination. But my initial reaction was, do we need a 300-page textbook on this topic? Is there so much to say? I’m afraid I was disappointed.
The book is entirely focused on disparities in access to care in the USA, and whereas this is important to document, the failure to be broader in remit and ask questions of access to care in low- and middle-income countries (where the ENT workforce is even more sparse, and public health issues even more stark) feels like an opportunity missed. In addition, I found the text descriptive, repetitive and superficial, comprising 16 chapters referencing studies that have documented data on this issue, including chapters on variation in access to care on the basis of age, geography, gender, ethnicity, and sexual orientation. Many of the proposed solutions focused on what can be done once the patient has arrived at the health centre, and there seems to be only a cursory analysis or critique of the wider failings of the US health system: a lack of public health initiatives, and the presence of perverse medical structures based upon insurance models that contribute to lack of access to care for those most in need. Almost all the chapter authors are US-based ENT surgeons, and a wider range of authors from public health or health policy backgrounds may have added depth to the analysis.
This topic is worthy of discussing, but maybe would have been better published as a special edition or supplement to a journal (indeed there are existing journal articles on this topic). The contents in this book serve as useful background reading for US based researchers or NGOs working in this specific field, but I feel will be of limited interest to a broader audience.
