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"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.
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
Burnout affects a third of our population and over half of our health professionals. For the second group, the impact is magnified, as consequences play out not only on a personal level, but also on a societal level and lead to medical errors, suboptimal care, low levels of patient satisfaction, and poor clinical outcomes. Achieving wellbeing requires strategies for change. In this book, Dr. Pipas shares twelve lessons and strategies for improved health that she has learned from patients, students, and colleagues over her twenty years working as a family physician. Each lesson is based on observation and research, and begins with a story of an exemplary patient whose challenges and successes reflect the theme of the lesson. Along with the lessons, the author offers plans for action, which taken together create the framework for a healthy life. Each lesson concludes with resources and a "health challenge."
The ongoing troubles in Northern Ìreland have largely overshadowed the presence of over 40 ethnic and religious minority groups in the Province. This study of these groups focuses on the issues of racism, anti-racism, sectarianism, representation in the media, and the law.
While many doctors claim that Lyme disease—a tick-borne bacterial infection—is easily diagnosed and treated, other doctors and the patients they care for argue that it can persist beyond standard antibiotic treatment in the form of chronic Lyme disease. In Divided Bodies, Abigail A. Dumes offers an ethnographic exploration of the Lyme disease controversy that sheds light on the relationship between contested illness and evidence-based medicine in the United States. Drawing on fieldwork among Lyme patients, doctors, and scientists, Dumes formulates the notion of divided bodies: she argues that contested illnesses are disorders characterized by the division of bodies of thought in which the patient's experience is often in conflict with how it is perceived. Dumes also shows how evidence-based medicine has paradoxically amplified differences in practice and opinion by providing a platform of legitimacy on which interested parties—patients, doctors, scientists, politicians—can make claims to medical truth.
"Although physicians make use of science, this book argues that medicine is not itself a science, but rather an interpretive practice that relies heavily on clinical reasoning." "In How Doctors Think, Kathryn Montgomery contends that assuming medicine is strictly a science can have adverse effects. She suggests these can be significantly reduced by recognizing the vital role of clinical judgment."--BOOK JACKET.
How do policy and politics influence the social conditions that generate health outcomes? Reduced life expectancy, worsening health outcomes, health inequity, and declining health care options—these are now realities for most Americans. However, in a country of more than 325 million people, addressing everyone's issues is challenging. How can we effect beneficial change for everyone so we all can thrive? What is the great equalizer? In this book, Daniel E. Dawes argues that political determinants of health create the social drivers—including poor environmental conditions, inadequate transportation, unsafe neighborhoods, and lack of healthy food options—that affect all other dynamics of health. By understanding these determinants, their origins, and their impact on the equitable distribution of opportunities and resources, we will be better equipped to develop and implement actionable solutions to close the health gap. Dawes draws on his firsthand experience helping to shape major federal policies, including the Affordable Care Act, to describe the history of efforts to address the political determinants that have resulted in health inequities. Taking us further upstream to the underlying source of the causes of inequities, Dawes examines the political decisions that lead to our social conditions, makes the social determinants of health more accessible, and provides a playbook for how we can address them effectively. A thought-provoking and evocative account that considers both the policies we think of as "health policy" and those that we don't, The Political Determinants of Health provides a novel, multidisciplinary framework for addressing the systemic barriers preventing the United States from becoming the healthiest nation in the world.
A landmark work which precipitated major reforms in medical education. It recommended closing commercial schools and reducing the overall number of medical schools from 155 to 31, with the aim of raising standards. Includes frank evaluative sketches of each school based on site visits by the author.
Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.
A profound and insightful investigation into how the American Civil War transformed modern medicine. At the start of the Civil War, the medical field in America was rudimentary, unsanitary, and woefully underprepared to address what would become the bloodiest conflict on U.S. soil. However, in this historic moment of pivotal social and political change, medicine was also fast evolving to meet the needs of the time. Unprecedented strides were made in the science of medicine, and as women and African Americans were admitted into the field for the first time. The Civil War marked a revolution in healthcare as a whole, laying the foundations for the system we know today. In Healing a Divided Nation, Carole Adrienne will track this remarkable and bloody transformation in its cultural and historical context, illustrating how the advancements made in these four years reverberated throughout the western world for years to come. Analyzing the changes in education, society, humanitarianism, and technology in addition to the scientific strides of the period lends Healing a Divided Nation a uniquely wide lens to the topic, expanding the legacy of the developments made. The echoes of Civil War medicine are in every ambulance, every vaccination, every woman who holds a paying job, and in every Black university graduate. Those echoes are in every response of the International and American Red Cross and they are in the recommended international protocol for the treatment of prisoners of war and wounded soldiers. Beginning with the state of medicine at the outset of the war, when doctors did not even know about sterilizing their tools, Adrienne illuminates the transformation in American healthcare through primary source texts that document the lives and achievements of the individuals who pioneered these changes in medicine and society. The story that ensues is one of American innovation and resilience in the face of unparalleled violence, adding a new dimension to the legacy of the Civil War.