Winner of the 1983 Pulitzer Prize and the Bancroft Prize in American History, this is a landmark history of how the entire American health care system of doctors, hospitals, health plans, and government programs has evolved over the last two centuries. "The definitive social history of the medical profession in America....A monumental achievement."—H. Jack Geiger, M.D., New York Times Book Review
Argues that the pace of medical discoveries has slowed in the last twenty-five years due to excessive emphasis on the social and political aspects of health care, and to controversies caused by ethical issues.
There are four major dilemmas at work in the rapid decline of the United States' healthcare system: the disappearing primary care sector, healthcare insurance reform, the influence of the pharmaceutical industry on the practice of medicine, and reform of malpractice litigation. In this book, Dr. Robert A. Linden provides a comprehensive explanation of these dilemmas, from the perspective of a primary care physician who has spent 30 years working directly with patients and seeing first-hand how changes in the system have impacted patients and physicians. Dr. Linden sorts out the fragments of information that most readers get through the media and fills in the blanks to provide a clear picture of what's wrong with the U.S. healthcare system, an impartial review of proposed solutions, and a look at what other countries have done to reform their healthcare systems. Unlike many academician authors who have covered the problems only in part with skewed information, this book will finally help the healthcare consumer understand the problems facing us and form their own assessments of what should be done to restore the American healthcare system.
Originally published in 1976 The Rise of the Medical Profession combines a sociological and historical approach to the rise of the medical profession in England. Sociologically it offers a theoretical framework which for the first time links the study of social mobility and professionalism with the theory of stratification. Historically, it examines the movement which led to the unification of the medical profession arising from effective social organisation among the surgeon-apothecaries in the early nineteenth century. It demonstrates that through the successful pursuit of the occupational strategy of professionalism the doctors have been able to raise their income and status in the community and to dominate the institutions and organisations of medical care. In their relationship with the state, they have been generally successful in securing a recognition of their privileged position. The future of the medical profession and of professionalism is discussed in the context of the changing balance between state power and that of free private occupation associations, whether of the type based on professionalism or unionism. The ideal-type conception of the middle class as essentially individualistic is challenged by the exploration of middle class collective action, particularly professionalism.
Much of the improved survival rate from heart attack can be traced to Eugene Braunwald's work. He proved that myocardial infarction was an hours-long dynamic process which could be altered by treatment. Thomas H. Lee tells the life story of a physician whose activist approach transformed not just cardiology but the culture of American medicine.
Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.
Men in hardhats were once the heart of America’s working class; now it is women in scrubs. What does this shift portend for our future? Pittsburgh was once synonymous with steel. But today most of its mills are gone. Like so many places across the United States, a city that was a center of blue-collar manufacturing is now dominated by the service economy—particularly health care, which employs more Americans than any other industry. Gabriel Winant takes us inside the Rust Belt to show how America’s cities have weathered new economic realities. In Pittsburgh’s neighborhoods, he finds that a new working class has emerged in the wake of deindustrialization. As steelworkers and their families grew older, they required more health care. Even as the industrial economy contracted sharply, the care economy thrived. Hospitals and nursing homes went on hiring sprees. But many care jobs bear little resemblance to the manufacturing work the city lost. Unlike their blue-collar predecessors, home health aides and hospital staff work unpredictable hours for low pay. And the new working class disproportionately comprises women and people of color. Today health care workers are on the front lines of our most pressing crises, yet we have been slow to appreciate that they are the face of our twenty-first-century workforce. The Next Shift offers unique insights into how we got here and what could happen next. If health care employees, along with other essential workers, can translate the increasing recognition of their economic value into political power, they may become a major force in the twenty-first century.
A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 "This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems. In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast? Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.
