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Rise of the Modern Hospital is a focused examination of hospital design in the United States from the 1870s through the 1940s. This understudied period witnessed profound changes in hospitals as they shifted from last charitable resorts for the sick poor to premier locations of cutting-edge medical treatment for all classes, and from low-rise decentralized facilities to high-rise centralized structures. Jeanne Kisacky reveals the changing role of the hospital within the city, the competing claims of doctors and architects for expertise in hospital design, and the influence of new medical theories and practices on established traditions. She traces the dilemma designers faced between creating an environment that could function as a therapy in and of itself and an environment that was essentially a tool for the facilitation of increasingly technologically assisted medical procedures. Heavily illustrated with floor plans, drawings, and photographs, this book considers the hospital building as both a cultural artifact, revelatory of external medical and social change, and a cultural determinant, actively shaping what could and did take place within hospitals.
More than any other building type in the twentieth century, the hospital was connected to transformations in the health of populations and expectations of lifespan. From the scale of public health to the level of the individual, the architecture of the modern hospital has reshaped knowledge about health and disease and perceptions of bodily integrity and security. However, the rich and genuinely global architectural history of these hospitals is poorly understood and largely forgotten. This book explores the rapid evolution of hospital design in the twentieth century, analysing the ways in which architects and other specialists reimagined the modern hospital. It examines how the vast expansion of medical institutions over the course of the century was enabled by new approaches to architectural design and it highlights the emerging political conviction that physical health would become the cornerstone of human welfare.
The Emergence of Modern Hospital Management and Organisation in the World 1880s-1930s analyzes core themes from a business history perspective to reach a new understanding about the history of modern large scale healthcare institutions, from the United States to China, with particular attention to Spain.
Finalist for the 1988 Pulitzer Prize in History. “[A] splendid history of the hospital in America... What makes this an important book is that Mr. Rosenberg has managed to tell the story of the hospital as a microcosm of American society... It is remarkable that an institution so central to our society, and to our medical system as the hospital has been for the last 100 years, has had to wait so long for a general historical analysis. It is Mr. Rosenberg’s accomplishment that the wait has been well worth it... Very well written and rich with interpretation, it deserves a wide audience not only among those concerned with medicine but also those with an interest in cities, social welfare and the professions.” — The New York Times “Charles E. Rosenberg’s long-awaited The Care of Strangers marks a milestone in our understanding of the hospital as a social institution... It should be read by anyone who wants a sophisticated analysis of the forces that have shaped the modern hospital system.” — Washington Post Book World “Rosenberg, a prize-winning historian, has written a detailed account of what has brought about the spectacular changes through which the hospital became accepted as the repository of medical knowledge and skills... Rosenberg interestingly deals with the main factors that elevated the hospital to its present eminence: medical-technological advances, especially in surgery, differential diagnosis, and drugs; demographic changes, with cities far outpacing rural areas in population; the assertiveness of doctors in promoting the hospital as a source of professional status and education; the widespread emergence of patient private payment and health insurance; the big expansion of federal subsidies for research and patient care... the book... is well-written and convincing... fascinatingly informative.” — The Los Angeles Times “A splendid contribution to medical history, one that should have a wide appeal to physicians, social scientists, and laypersons.” — Journal of the American Medical Association “The Care of Strangers unravels an intricate and multifaceted story; it is one worthy of Rosenberg’s unparalleled skills as a historian of medicine... In this book, as in much of Rosenberg’s mature scholarship, an enormous command of the sources matches his powerful integrative vision... This brilliant and ambitious book is the history of American medicine; it defines the field and is likely to organize the efforts of our subdiscipline for the next generation.” — Bulletin of the History of Medicine “Sociologists, economists, philanthropists, the members of the several health professions — even historians — tend to view hospitals from their own parochial perspectives. All would learn from Charles Rosenberg’s comprehensive view of authority, class relations, technology, and administration in the American hospital from 1800 to modern times. This superb book shows how that unique institution has always been a microcosm of American society.” — Journal of the History of Medicine and Allied Sciences “Rosenberg’s masterful synthesis of the history of the American hospital... offers readers, not simply the story of the development of a central institution of modern life, but an account that is also in many ways a history of the emergence of modern medicine... elegantly written and eminently readable.” — Reviews in American History “Rosenberg’s study makes a major contribution to the historiography of hospitals in America... This study is an elegantly written book that broadens the history of hospitals and places it squarely within the larger field of American social history... a major contribution not only to the history of medicine but also to the history of institutions and to American social history in general.” — American Historical 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.
Patients at Risk: The Rise of the Nurse Practitioner and Physician Assistant in Healthcare exposes a vast conspiracy of political maneuvering and corporate greed that has led to the replacement of qualified medical professionals by lesser trained practitioners. As corporations seek to save money and government agencies aim to increase constituent access, minimum qualifications for the guardians of our nation’s healthcare continue to decline—with deadly consequences. This is a story that has not yet been told, and one that has dangerous repercussions for all Americans. With the rate of nurse practitioner and physician assistant graduates exceeding that of physician graduates, if you are not already being treated by a non-physician, chances are, you soon will be. While advocates for these professions insist that research shows that they can provide the same care as physicians, patients do not know the whole truth: that there are no credible scientific studies to support the safety and efficacy of non-physicians practicing without physician supervision. Written by two physicians who have witnessed the decline of medical expertise over the last twenty years, this data-driven book interweaves heart-rending true patient stories with hard data, showing how patients have been sacrificed for profit by the substitution of non-physician practitioners. Adding a dimension neglected by modern healthcare critiques such as An American Sickness, this book provides a roadmap for patients to protect themselves from medical harm. WORDS OF PRAISE and REVIEWS Al-Agba and Bernard tell a frightening story that insiders know all too well. As mega corporations push for efficiency and tout consumer focused retail services, American healthcare is being dumbed down to the point of no return. It's a story that many media outlets are missing and one that puts you and your family's health at real risk. --John Irvine, Deductible Media Laced with actual patient cases, the book’s data and patterns of large corporations replacing physicians with non-physician practitioners, despite the vast difference in training is enlightening and astounding. The authors' extensively researched book methodically lays out the problems of our changing medical care landscape and solutions to ensure quality care. --Marilyn M. Singleton, MD, JD A masterful job of bringing to light a rapidly growing issue of what should be great concern to all of us: the proliferation of non-physician practitioners that work predominantly inside algorithms rather than applying years of training, clinical knowledge, and experience. Instead of a patient-first mentality, we are increasingly met with the sad statement of Profits Over Patients, echoed by hospitals and health insurance companies. --John M. Chamberlain, MHA, LFACHE, Board Chairman, Citizen Health A must read for patients attempting to navigate today’s healthcare marketplace. --Brian Wilhelmi MD, JD, FASA
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.
New York Times bestseller Business Book of the Year--Association of Business Journalists From the New York Times bestselling author comes an eye-opening, urgent look at America's broken health care system--and the people who are saving it--now with a new Afterword by the author. "A must-read for every American." --Steve Forbes, editor-in-chief, FORBES One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr. Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research, and his own experience, The Price We Pay paints a vivid picture of the business of medicine and its elusive money games in need of a serious shake-up. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine's noble heritage of caring for people when they are vulnerable. The Price We Pay offers a road map for everyday Americans and business leaders to get a better deal on their health care, and profiles the disruptors who are innovating medical care. The movement to restore medicine to its mission, Makary argues, is alive and well--a mission that can rebuild the public trust and save our country from the crushing cost of health care.