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Author: David Wilsford
Publisher: Duke University Press
ISBN: 9780822310921
Category : Medical
Languages : en
Pages : 382
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Book Description
All advanced health care systems face severe difficulties in financing the delivery of today's sophisticated medical care. In this study David Wilsford compares the health systems in France and the United States to demonstrate that some political systems are considerably more effective at controlling the cost of care than others. He argues that two variables--the autonomy of the state and the strength and cohesiveness of organized medicine--explain this variance. In France, Wilsford shows, the state is strong in the health policy domain, while organized medicine is weak and divided. Consequently, physicians exercise little influence over health care policymaking. By contrast, in the United States the state is weak, the employers and insurers who pay for health care are fragmented, and organized medicine is strong and well financed. As a result, medical professionals are able to exert a greater influence on policymaking, thus making cost control more difficult. Wilsford extends his comparison to health care systems in the United Kingdom, West Germany, Italy, Canada, and Japan. Whether the private or public sector finances health care, he discovers, there is now an important trend in all of the advanced industrial countries toward controlling escalating costs by curbing both the medical profession's clinical autonomy and physicians' incomes.
Author: David Wilsford
Publisher: Duke University Press
ISBN: 9780822310921
Category : Medical
Languages : en
Pages : 382
Get Book Here
Book Description
All advanced health care systems face severe difficulties in financing the delivery of today's sophisticated medical care. In this study David Wilsford compares the health systems in France and the United States to demonstrate that some political systems are considerably more effective at controlling the cost of care than others. He argues that two variables--the autonomy of the state and the strength and cohesiveness of organized medicine--explain this variance. In France, Wilsford shows, the state is strong in the health policy domain, while organized medicine is weak and divided. Consequently, physicians exercise little influence over health care policymaking. By contrast, in the United States the state is weak, the employers and insurers who pay for health care are fragmented, and organized medicine is strong and well financed. As a result, medical professionals are able to exert a greater influence on policymaking, thus making cost control more difficult. Wilsford extends his comparison to health care systems in the United Kingdom, West Germany, Italy, Canada, and Japan. Whether the private or public sector finances health care, he discovers, there is now an important trend in all of the advanced industrial countries toward controlling escalating costs by curbing both the medical profession's clinical autonomy and physicians' incomes.
Author: Mignonne Breier
Publisher: HSRC Press
ISBN: 9780796921536
Category : Medical
Languages : en
Pages : 134
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Book Description
"Many of the goals of South Africa’s new democracy depend on the production of professionals who have not only the knowledge and skills to make our country globally competitive, but also a commitment to working and living here. Despite numerous reforms, the South African health system, ten years into democracy, remains divided: first world private care that ranks with middle income countries internationally at the one end, and at the other extreme, in the rural public sector in particular, conditions that are superior only to the poorest of African countries. Much work has been done to change medical school curricula in line with the primary health-care focus of government policy, and international trends towards problem-based learning. The student profile in medical schools is now not only more representative of the demographics of South Africa, but also reveals a significant increase in female students. Whether these students will stay in the country after graduating, and serve where they are needed most, remains to be seen."--Publisher's website.
Author: Daniel A. Menchik
Publisher: Princeton University Press
ISBN: 0691223556
Category : Social Science
Languages : en
Pages : 328
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Book Description
How the authority of medicine is continuously shaped by relationships among physicians, industry, colleagues, and organizations Exploring how the authority of medicine is controlled, negotiated, and organized, Managing Medical Authority asks: How is knowledge shared throughout the profession? Who makes decisions when your heart malfunctions—physicians, hospital administrators, or private companies who sell pacemakers? How do physicians gain and keep their influence? Arguing that medicine’s authority is managed in collegial competition across venues, Daniel Menchik examines the full range of stakeholders driving the direction of the field: medical trainees, clinicians, researchers, administrators, and even the corporations that develop groundbreaking technologies enabling longer and better lives. Menchik takes us into Superior Hospital to witness surgeries and executive negotiations. He moves outside the hospital to watch professional committees craft standards for treatments, case management, and professional ethics. At industry-sponsored meetings, he observes company representatives who train some experienced doctors on their technologies, while deterring others who they think might injure patients. Using an innovative ethnographic approach tying individual actions and their collective consequences, he considers how stakeholders ally across the various venues of medicine, even as they are sometimes pressed into competition within those venues. Menchik finds that these alliances and rivalries strengthen the authority of medicine as a whole. From place to place, and group to group, we see how a medical specialty renews and reinvigorates itself. Beginning within the walls of the hospital, and moving to the professional and commercial venues that shape it, Managing Medical Authority offers an agenda-setting take on the social organization of medical authority.
Author: Danielle Ofri, MD
Publisher: Beacon Press
ISBN: 0807073334
Category : Medical
Languages : en
Pages : 267
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Book Description
“A fascinating journey into the heart and mind of a physician” that explores the doctor-patient relationship, the flaws in our health care system, and how doctors’ emotions impact medical care (Boston Globe) While much has been written about the minds and methods of the medical professionals who save our lives, precious little has been said about their emotions. Physicians are assumed to be objective, rational beings, easily able to detach as they guide patients and families through some of life’s most challenging moments. But understanding doctors’ emotional responses to the life-and-death dramas of everyday practice can make all the difference on giving and getting the best medical care. Digging deep into the lives of doctors, Dr. Danielle Ofri examines the daunting range of emotions—shame, anger, empathy, frustration, hope, pride, occasionally despair, and sometimes even love—that permeate the contemporary doctor-patient connection. Drawing on scientific studies, including some surprising research, Dr. Ofri offers up an unflinching look at the impact of emotions on health care. Dr. Ofri takes us into the swirling heart of patient care, telling stories of caregivers caught up and occasionally torn down by the whirlwind life of doctoring. She admits to the humiliation of an error that nearly killed one of her patients. She mourns when a beloved patient is denied a heart transplant. She tells the riveting stories of an intern traumatized when she is forced to let a newborn die in her arms, and of a doctor whose daily glass of wine to handle the frustrations of the ER escalates into a destructive addiction. Ofri also reveals that doctors cope through gallows humor, find hope in impossible situations, and surrender to ecstatic happiness when they triumph over illness.
Author: Jennifer Cleland
Publisher: SAGE
ISBN: 0857254626
Category : Medical
Languages : en
Pages : 204
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Book Description
There is more to a person than a particular symptom or disease: patients are individuals but they are not isolated, they are part of a family, a community, an environment, and all these factors can affect in many different ways how they manage health and illness. This book provides an introduction to population, sociological and psychological influences on health and delivery of healthcare in the UK and will equip today’s medical students with the knowledge required to be properly prepared for clinical practice in accordance with the outcomes of Tomorrow’s Doctors.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309145449
Category : Medical
Languages : en
Pages : 436
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Book Description
Collaborations of physicians and researchers with industry can provide valuable benefits to society, particularly in the translation of basic scientific discoveries to new therapies and products. Recent reports and news stories have, however, documented disturbing examples of relationships and practices that put at risk the integrity of medical research, the objectivity of professional education, the quality of patient care, the soundness of clinical practice guidelines, and the public's trust in medicine. Conflict of Interest in Medical Research, Education, and Practice provides a comprehensive look at conflict of interest in medicine. It offers principles to inform the design of policies to identify, limit, and manage conflicts of interest without damaging constructive collaboration with industry. It calls for both short-term actions and long-term commitments by institutions and individuals, including leaders of academic medical centers, professional societies, patient advocacy groups, government agencies, and drug, device, and pharmaceutical companies. Failure of the medical community to take convincing action on conflicts of interest invites additional legislative or regulatory measures that may be overly broad or unduly burdensome. Conflict of Interest in Medical Research, Education, and Practice makes several recommendations for strengthening conflict of interest policies and curbing relationships that create risks with little benefit. The book will serve as an invaluable resource for individuals and organizations committed to high ethical standards in all realms of medicine.
Author: Tania M. Jenkins
Publisher: Columbia University Press
ISBN: 023154829X
Category : Social Science
Languages : en
Pages : 531
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Book Description
The United States does not have enough doctors. Every year since the 1950s, internationally trained and osteopathic medical graduates have been needed to fill residency positions because there are too few American-trained MDs. However, these international and osteopathic graduates have to significantly outperform their American MD counterparts to have the same likelihood of getting a residency position. And when they do, they often end up in lower-prestige training programs, while American-trained MDs tend to occupy elite training positions. Some programs are even fully segregated, accepting exclusively U.S. medical graduates or non-U.S. medical graduates, depending on the program’s prestige. How do international and osteopathic medical graduates end up so marginalized, and what allows U.S.-trained MDs to remain elite? Doctors’ Orders offers a groundbreaking examination of the construction and consequences of status distinctions between physicians before, during, and after residency training. Tania M. Jenkins spent years observing and interviewing American, international, and osteopathic medical residents in two hospitals to reveal the unspoken mechanisms that are taken for granted and that lead to hierarchies among supposed equals. She finds that the United States does not need formal policies to prioritize American-trained MDs. By relying on a system of informal beliefs and practices that equate status with merit and eclipse structural disadvantages, the profession convinces international and osteopathic graduates to participate in a system that subordinates them to American-trained MDs. Offering a rare ethnographic look at the inner workings of an elite profession, Doctors’ Orders sheds new light on the formation of informal status hierarchies and their significance for both doctors and patients.
Author: Jonathan B. Imber
Publisher: Princeton University Press
ISBN: 0691168148
Category : Medical
Languages : en
Pages : 296
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Book Description
For more than a century, the American medical profession insisted that doctors be rigorously trained in medical science and dedicated to professional ethics. Patients revered their doctors as representatives of a sacred vocation. Do we still trust doctors with the same conviction? In Trusting Doctors, Jonathan Imber attributes the development of patients' faith in doctors to the inspiration and influence of Protestant and Catholic clergymen during the nineteenth and early twentieth centuries. He explains that as the influence of clergymen waned, and as reliance on medical technology increased, patients' trust in doctors steadily declined. Trusting Doctors discusses the emphasis that Protestant clergymen placed on the physician's vocation; the focus that Catholic moralists put on specific dilemmas faced in daily medical practice; and the loss of unchallenged authority experienced by doctors after World War II, when practitioners became valued for their technical competence rather than their personal integrity. Imber shows how the clergy gradually lost their impact in defining the physician's moral character, and how vocal critics of medicine contributed to a decline in patient confidence. The author argues that as modern medicine becomes defined by specialization, rapid medical advance, profit-driven industry, and ever more anxious patients, the future for a renewed trust in doctors will be confronted by even greater challenges. Trusting Doctors provides valuable insights into the religious underpinnings of the doctor-patient relationship and raises critical questions about the ultimate place of the medical profession in American life and culture.
Author: Ann K. Boulis
Publisher: Cornell University Press
ISBN: 0801463505
Category : Medical
Languages : en
Pages : 279
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Book Description
The number of women practicing medicine in the United States has grown steadily since the late 1960s, with women now roughly at parity with men among entering medical students. Why did so many women enter American medicine? How are women faring, professionally and personally, once they become physicians? Are women transforming the way medicine is practiced? To answer these questions, The Changing Face of Medicine draws on a wide array of sources, including interviews with women physicians and surveys of medical students and practitioners. The analysis is set in the twin contexts of a rapidly evolving medical system and profound shifts in gender roles in American society. Throughout the book, Ann K. Boulis and Jerry A. Jacobs critically examine common assumptions about women in medicine. For example, they find that women's entry into medicine has less to do with the decline in status of the profession and more to do with changes in women's roles in contemporary society. Women physicians' families are becoming more and more like those of other working women. Still, disparities in terms of specialty, practice ownership, academic rank, and leadership roles endure, and barriers to opportunity persist. Along the way, Boulis and Jacobs address a host of issues, among them dual-physician marriages, specialty choice, time spent with patients, altruism versus materialism, and how physicians combine work and family. Women's presence in American medicine will continue to grow beyond the 50 percent mark, but the authors question whether this change by itself will make American medicine more caring and more patient centered. The future direction of the profession will depend on whether women doctors will lead the effort to chart a new course for health care delivery in the United States.
Author: Anne Digby
Publisher: Cambridge University Press
ISBN: 9780521524513
Category : Medical
Languages : en
Pages : 376
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Book Description
A socio-economic history of medical practice from the first voluntary hospital to national health insurance.
