In an era where standardized protocols increasingly dictate clinical decisions, retired physician and former assistant teacher Dr. Bernardo A. Gutierrez is calling for a quiet revolution in healthcare, one led by doctors themselves.
In his new book, Prognostication: Principles and Practice, Dr. Gutierrez argues that true healthcare reform starts not at the top with sweeping legislation, but at the ground level with physicians reclaiming the ability to make patient-centered decisions free from bureaucratic interference.
“Protocols are helpful guidelines, but they were never meant to replace human judgment,” says Dr. Gutierrez. “We’ve created a system where physicians are discouraged from thinking critically. That’s not safe, and it’s not sustainable.”
Drawing from nearly five decades in medicine, including experience in internal medicine, cardiology, geriatrics, emergency care, and terminal care, Dr. Gutierrez delivers a sobering analysis of how protocol-driven care contributes to overtreatment, physician burnout, and skyrocketing healthcare costs. The book sheds light on the often-overlooked emotional toll placed on doctors who are forced to follow one-size-fits-all rules, even when they know the patient in front of them needs a more nuanced approach.
At the heart of the book is the practice of prognostication, a clinical skill that blends medical knowledge with personal insight to assess the likely course of an individual’s condition. Dr. Gutierrez insists this skill should be central to every doctor’s training and daily decision-making.
“When we treat a 90-year-old patient the same way we treat a 50-year-old simply because the protocol says so, we’re not providing care, we’re following a script. And scripts don’t save lives. Doctors do,” he says.
The book's message is particularly relevant for health policy experts and administrators seeking effective, patient-first reforms. Rather than adding more layers of regulation, Dr. Gutierrez recommends empowering physicians with better tools for prognostication, greater autonomy in clinical choices, and more opportunities for ethical discussion in their training and workplace environments.
Already, Prognostication: Principles and Practice is sparking important conversations among medical educators, administrators, and ethics boards about what it really means to offer appropriate care, and who gets to define it.
This is not a book about dismantling the healthcare system. It’s about restoring its humanity. Available now on Amazon and major bookselling platforms, Prognostication is a vital resource for those rethinking the future of medicine from both a policy and practice perspective.
About the Author
Dr. Bernardo A. Gutierrez is a retired physician and former assistant teacher of medicine with nearly 50 years of clinical experience in cardiology, internal medicine, geriatrics, emergency care, and end-of-life care. A strong advocate for personalized medicine, he draws on decades of bedside practice to challenge protocol-driven healthcare and promote compassionate, patient-centered decision-making.
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