County
County

Author: David A. Ansell

Publisher: Chicago Review Press

Published: 2012-05-01

Total Pages: 256

ISBN-13: 0897336208

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The amazing tale of “County” is the story of one of America’s oldest and most unusual urban hospitals. From its inception as a “poor house” dispensing free medical care to indigents, Chicago’s Cook County Hospital has been renowned as a teaching hospital and the healthcare provider of last resort for the city’s uninsured. Ansell covers more than thirty years of its history, beginning in the late 1970s when the author began his internship, to the “Final Rounds” when the enormous iconic Victorian hospital building was replaced. Ansell writes of the hundreds of doctors who underwent rigorous training with him. He writes of politics, from contentious union strikes to battles against “patient dumping,” and public health, depicting the AIDS crisis and the Out of Printening of County’s HIV/AIDS clinic, the first in the city. And finally it is a coming-of-age story for a young doctor set against a backdrOut of Print of race, segregation, and poverty. This is a riveting account.

Big Med
Big Med

Author: David Dranove

Publisher: University of Chicago Press

Published: 2022-11-18

Total Pages: 344

ISBN-13: 022682392X

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There is little debate that health care in the United States is in need of reform. But where should those improvements begin? With insurers? Drug makers? The doctors themselves? In Big Med, David Dranove and Lawton Robert Burns argue that we’re overlooking the most ubiquitous cause of our costly and underperforming system: megaproviders, the expansive health care organizations that have become the face of American medicine. Your local hospital is likely part of one. Your doctors, too. And the megaproviders are bad news for your health and your wallet. Drawing on decades of combined expertise in health care consolidation, Dranove and Burns trace Big Med’s emergence in the 1990s, followed by its swift rise amid false promises of scale economies and organizational collaboration. In the decades since, megaproviders have gobbled up market share and turned independent physicians into salaried employees of big bureaucracies, while delivering on none of their early promises. For patients this means higher costs and lesser care. Meanwhile, physicians report increasingly low morale, making it all but impossible for most systems to implement meaningful reforms. In Big Med, Dranove and Burns combine their respective skills in economics and management to provide a nuanced explanation of how the provision of health care has been corrupted and submerged under consolidation. They offer practical recommendations for improving competition policies that would reform megaproviders to actually achieve the efficiencies and quality improvements they have long promised. This is an essential read for understanding the current state of the health care system in America—and the steps urgently needed to create an environment of better care for all of us.

The Death Gap
The Death Gap

Author: David A. Ansell, MD

Publisher: University of Chicago Press

Published: 2021-06-16

Total Pages: 270

ISBN-13: 022679671X

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We hear plenty about the widening income gap between the rich and the poor in America and about the expanding distance separating the haves and the have-nots. But when detailing the many things that the poor have not, we often overlook the most critical—their health. The poor die sooner. Blacks die sooner. And poor urban blacks die sooner than almost all other Americans. In nearly four decades as a doctor at hospitals serving some of the poorest communities in Chicago, David A. Ansell, MD, has witnessed firsthand the lives behind these devastating statistics. In The Death Gap, he gives a grim survey of these realities, drawn from observations and stories of his patients. While the contrasts and disparities among Chicago’s communities are particularly stark, the death gap is truly a nationwide epidemic—as Ansell shows, there is a thirty-five-year difference in life expectancy between the healthiest and wealthiest and the poorest and sickest American neighborhoods. If you are poor, where you live in America can dictate when you die. It doesn’t need to be this way; such divisions are not inevitable. Ansell calls out the social and cultural arguments that have been raised as ways of explaining or excusing these gaps, and he lays bare the structural violence—the racism, economic exploitation, and discrimination—that is really to blame. Inequality is a disease, Ansell argues, and we need to treat and eradicate it as we would any major illness. To do so, he outlines a vision that will provide the foundation for a healthier nation—for all. As the COVID-19 mortality rates in underserved communities proved, inequality is all around us, and often the distance between high and low life expectancy can be a matter of just a few blocks. Updated with a new foreword by Chicago mayor Lori Lightfoot and an afterword by Ansell, The Death Gap speaks to the urgency to face this national health crisis head-on.

How the Clinic Made Gender
How the Clinic Made Gender

Author: Sandra Eder

Publisher: University of Chicago Press

Published: 2022-06-07

Total Pages: 341

ISBN-13: 022657346X

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An eye-opening exploration of the medical origins of gender in modern US history. Today, a world without “gender” is hard to imagine. Gender is at the center of contentious political and social debates, shapes policy decisions, and informs our everyday lives. Its formulation, however, is lesser known: Gender was first used in clinical practice. This book tells the story of the invention of gender in American medicine, detailing how it was shaped by mid-twentieth-century American notions of culture, personality, and social engineering. Sandra Eder shows how the concept of gender transformed from a pragmatic tool in the sex assignment of children with intersex traits in the 1950s to an essential category in clinics for transgender individuals in the 1960s. Following gender outside the clinic, she reconstructs the variable ways feminists integrated gender into their theories and practices in the 1970s. The process by which ideas about gender became medicalized, enforced, and popularized was messy, and the route by which gender came to be understood and applied through the treatment of patients with intersex traits was fraught and contested. In historicizing the emergence of the sex/gender binary, Eder reveals the role of medical practice in developing a transformative idea and the interdependence between practice and wider social norms that inform the attitudes of physicians and researchers. She shows that ideas like gender can take on a life of their own and may be used to question the normative perceptions they were based on. Illuminating and deeply researched, the book closes a notable gap in the history of gender and will inspire current debates on the relationship between social norms and medical practice.

Ethics by Committee
Ethics by Committee

Author: Noortje Jacobs

Publisher: University of Chicago Press

Published: 2022-08-26

Total Pages: 305

ISBN-13: 0226819329

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"Ethics boards have become obligatory passage points in today's medical science, and we forget how novel they really are. The use of humans in experiments is an age-old practice that records show goes back to at least the third century BC and, since the early modern period, as a practice it has become increasingly popular. Yet, in most countries around the world, hardly any formal checks and balances existed to govern the communal oversight of experiments involving human subjects until at least the 1960s. Ethics by Committee traces the rise of ethics boards for human experimentation in the second half of the twentieth century. Using the Netherlands as a case-study, Noortje Jacobs shows how the authority of physicians to make decisions about clinical research gave way in most developed nations to formal mechanisms of communal decision-making that served to regiment the behavior of individual researchers. This historically unprecedented change in scientific governance came out of a growing international wariness of medical research in the decades after World War II. Research ethics committees were originally intended not only to make human experimentation more ethical but also to raise its epistemic quality. By examining complex negotiations over the appropriate governance of human subjects research, Ethics by Committee advances our understanding not only of the history of research ethics and the randomized controlled trial but also, more broadly, of how liberal democracies in the late twentieth century have sought to resolve public concerns over charged issues in medicine and science"--

Challenging Operations
Challenging Operations

Author: Katherine C. Kellogg

Publisher: University of Chicago Press

Published: 2011-07-05

Total Pages: 244

ISBN-13: 0226430014

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In 2003, in the face of errors and accidents caused by medical and surgical trainees, the American Council of Graduate Medical Education mandated a reduction in resident work hours to eighty per week. Over the course of two and a half years spent observing residents and staff surgeons trying to implement this new regulation, Katherine C. Kellogg discovered that resistance to it was both strong and successful—in fact, two of the three hospitals she studied failed to make the change. Challenging Operations takes up the apparent paradox of medical professionals resisting reforms designed to help them and their patients. Through vivid anecdotes, interviews, and incisive observation and analysis, Kellogg shows the complex ways that institutional reforms spark resistance when they challenge long-standing beliefs, roles, and systems of authority. At a time when numerous policies have been enacted to address the nation’s soaring medical costs, uneven access to care, and shortage of primary-care physicians, Challenging Operations sheds new light on the difficulty of implementing reforms and offers concrete recommendations for effectively meeting that challenge.

Blepharitis
Blepharitis

Author: Asim V. Farooq

Publisher: Springer Nature

Published: 2021-04-16

Total Pages: 112

ISBN-13: 3030650405

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This book is a comprehensive overview of blepharitis that covers the various types of this common and challenging entity. Concise and unique, chapters are clinically focused, providing an equal emphasis on the medical as well as surgical management of this condition. The book concludes with a look at future directions in the field as they pertain to diagnosis and management. Blepharitis is an invaluable reference written specifically for comprehensive ophthalmologists, cornea and external disease specialists, residents, fellows, and optometrists.

A Heart for the Work
A Heart for the Work

Author: Claire L. Wendland

Publisher: University of Chicago Press

Published: 2010-09-15

Total Pages: 346

ISBN-13: 0226893286

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Burnout is common among doctors in the West, so one might assume that a medical career in Malawi, one of the poorest countries in the world, would place far greater strain on the idealism that drives many doctors. But, as A Heart for the Work makes clear, Malawian medical students learn to confront poverty creatively, experiencing fatigue and frustration but also joy and commitment on their way to becoming physicians. The first ethnography of medical training in the global South, Claire L. Wendland’s book is a moving and perceptive look at medicine in a world where the transnational movement of people and ideas creates both devastation and possibility. Wendland, a physician anthropologist, conducted extensive interviews and worked in wards, clinics, and operating theaters alongside the student doctors whose stories she relates. From the relative calm of Malawi’s College of Medicine to the turbulence of training at hospitals with gravely ill patients and dramatically inadequate supplies, staff, and technology, Wendland’s work reveals the way these young doctors engage the contradictions of their circumstances, shedding new light on debates about the effects of medical training, the impact of traditional healing, and the purposes of medicine.

Demanding Medical Excellence
Demanding Medical Excellence

Author: Michael L. Millenson

Publisher: University of Chicago Press

Published: 1999

Total Pages: 476

ISBN-13: 9780226525884

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A three-time Pulitzer Prize nominee as a health-care reporter for the "Chicago Tribune" illustrates serious flaws in contemporary medical practice and shows ways to improve care and save tens of thousands of lives.