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This illuminating study explores the role of professionals, patients, regulation and law in improving patient safety.
In the United States today we are confronted by a number of serious social problems, not the least of which concern the character of our basic human services. In each of the broad public domains of welfare, education, law, and health there are crises of public confidence. Each in its own way is failing to accomplish its essential mission of alleviating material deprivation, instructing the young, controlling and righting criminal and civil wrongs, and healing the sick. The poor, the student, the offender and the victim, the sick-all have in some way protested the failure of the institutions responsible for them. And these protests occur at a time when the human services are absorbing an increasingly massive amount of money and manpower. Awareness of that crisis intensified in the second half of the twentieth century. Increasing energy has been invested in research designed to determine what can be done. Each of the human services has long had its own research tradition, but during the sixties each has also made a concerted effort to mobilize and use the skills of such comparatively new disciplines as sociology. Owing to these new demands, sociology itself has grown. The hitherto obscure specialties of the sociology of law and medicine and the established specialties of criminology and educational sociology have taken on new vigor. In applying themselves the task of studying the human services, however, these segments of sociology have had to choose between two different strategies. Rather than dealing with the details of the human services for their own sake-and this lack of detail in a characteristic limitation of the second approach-this book shall instead attempt to stand outside the system in order to delineate one of its critical assumptions and a strategic feature of its basic structure. This book deals with the concept of profession, for the concept rests on assumptions about how services to laymen should be controlled and is realized by a special kind of
The changes in the US healthcare system since World War II are documented here, from new technologies, service-delivery arrangements, to financing mechanisms and underlying sets of organizing principles. The authors illustrate the work with five types of healthcare organizations.
"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.
Long before the United States became a major force in global affairs, Americans believed in their superiority over others due to their inventiveness, productivity, and economic and social well-being. U.S. expansionists assumed a mandate to civilize non-Western peoples by demanding submission to American technological prowess and design. As an integral part of America's national identity and sense of itself in the world, this civilizing mission provided the rationale to displace the Indians from much of our continent, to build an island empire in the Pacific and Caribbean, and to promote unilateral--at times military--interventionism throughout Asia. In our age of smart bombs and mobile warfare, technological aptitude remains preeminent in validating America's global mission. Michael Adas brilliantly pursues the history of this mission through America's foreign relations over nearly four centuries from North America to the Philippines, Vietnam, and the Persian Gulf. The belief that it is our right and destiny to remake foreign societies in our image has endured from the early decades of colonization to our current crusade to implant American-style democracy in the Muslim Middle East. Dominance by Design explores the critical ways in which technological superiority has undergirded the U.S.'s policies of unilateralism, preemption, and interventionism in foreign affairs and raised us from an impoverished frontier nation to a global power. Challenging the long-held assumptions and imperatives that sustain the civilizing mission, Adas gives us an essential guide to America's past and present role in the world as well as cautionary lessons for the future.
Medical Dominance, now in a revised edition, provides a fascinating account of the medical profession's successful domination of a wide range of health care services. Evan Willis delves into the past to explain the existing division of labour and health care, the rise of the medical profession to a position of economic power within the health system, and their defence of that dominant position. Now completely revised and updated, this edition also considers the related question of the policy implications of medical dominance. The defence by doctors of their position of power is highlighted by the author's exhaustive and original research into demarcation struggles between medicine and other health occupations, in particular midwifery, optometry and chiropractic. Conventional explanations of medical dominance are challenged by the argument that the role of developments in medical knowledge and in technology itself have been overstated. As well, greater account must be taken of the social relations and struggles which developed for control of that knowledge and technology.
Bring science to the discussion of whether dogs try to "dominate" humans. The fact is that domestic dogs have been selectively bred for hundreds of years to work cooperatively with people and this book corrects common misconceptions about canine behavior.
"Must be judged as a landmark in medical sociology."-Norman Denzin, Journal of Health and Social Behavior"Profession of Medicine is a challenging monograph; the ideas presented are stimulating and thought provoking. . . . Given the expanding domain of what illness is and the contentions of physicians about their rights as professionals, Freidson wonders aloud whether expertise is becoming a mask for privilege and power. . . . Profession of Medicine is a landmark in the sociological analysis of the professions in modern society."-Ron Miller, Sociological Quarterly"This is the first book that I know of to go to the root of the matter by laying open to view the fundamental nature of the professional claim, and the structure of professional institutions."-Everett C. Hughes, Science
Present-day health care policies in the United States are moving toward a system in which patients will be treated like industrial objects by doctors forced to work mechanically, says the distinguished medical sociologist Eliot Freidson in Medical Work in America. He offers a number of controversial proposals designed both to reduce costs and to avoid such dehumanization. In a series of essays that includes some of his classic work as well as significant new material, Freidson discusses the doctor-patient relationship, relations between physicians in various forms of medical practice, and the forces now reorganizing medical work. He shows how increasingly restrictive health insurance contracts insert a new, problematic element into both doctor-patient and colleague relations, and how bureaucratic methods of controlling medical decisions affect those relations. Finally, Freidson advances some basic principles to guide health care policy. He emphasizes that the physician's freedom to exercise discretion is essential if patients are to be treated as individuals rather than as administratively defined diagnostic categories. His recommendations include eliminating fee-for-service compensation, controlling health industry profits, and limiting the external administrative regulation of medical decisions while organizing medical work in such a way as to maximize effective and responsible self-governance.