The Social Transformation of American Medicine: The rise of a sovereign profession and the making of a vast industry

14 Nov

The Social Transformation of American Medicine: The rise of a sovereign profession and the making of a vast industry

The Social Transformation of American Medicine: The rise of a sovereign profession and the making of a vast industry

Paul Starr

Language: English

Pages: 528

ISBN: 0465079350

Format: PDF / Kindle (mobi) / ePub


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

development of American medicine: first, the rise of professional sovereignty; and second, the transformation of medicine into an industry and the growing, though still unsettled, role of corporations and the state. Within this framework I explore a variety of specific questions, such as: why Americans, who were wary of medical authority in the early and mid-nineteenth century, became devoted to it in the twentieth; how American doctors, who were bitterly divided and financially insecure in the

the automobile, like the railroad, widened the doctors' market geographically. In 1912, a Chicago physician noted that the residential mobility of patients required doctors to drive a car. "Chicago today is a city of flats [apartments], and people move so, that a patient living within a block today may be living five miles away next month. It is impossible to hold one's business unless one can answer calls quickly, and this is impossible without a motor car. I have not only held my own, but have

battle was finally settled when one side brought in a six-pound cannon!44 Physicians were not exactly supposed to behave this way. Professional tradition insisted that doctors present a unified front to the public, no matter how divided they were in private. The AMA's code of ethics, like others before it, prescribed a "peculiar reserve" toward the public in all professional disputes. The code enjoined consulting physicians to discuss cases entirely in secret and to present patients with a single

man, and Osier, the great clinician, were both dedicated to research, but they were also broadly educated and had a lively interest in the history and traditions of their profession. Though Hopkins accentuated science, it did not stand for a narrowly technical vision of medicine; this was the secret of its special eclat. It radiated cultural as well as scientific assurance, especially in the person of Osier, whose learning and urbanity made him the profession's favorite doctor. Welch became its

actors, cultural authority may also reside in cultural objects, including products of past intellectual activity, such as religious texts (the Bible), recognized standards of reference (dictionaries, maps, mathematical tables), scholarly or scientific works, or the law. Authority, in this particular form, may be used without being exercised; typically, it is consulted (even by people in authoritative positions), often in the hope of resolving ambiguities. Though they are often combined, social

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