Title: Big doctoring in America: profiles in primary care 
Author: Mullan, Fitzhugh
Published: University of California Press,  2002
Subjects: Medicine | Health Care | Sociology
Publisher's Description: The general practitioner was once America's doctor. The GP delivered babies, removed gallbladders, and sat by the bedsides of the dying. But as the twentieth century progressed, the pattern of medical care in the United States changed dramatically. By the 1960s, the GP was almost extinct. The later part of the twentieth century, however, saw a rebirth of the idea of the GP in the form of primary care practitioners. In this engrossing collection of oral histories and provocative essays about the past and future of generalism in health care, Fitzhugh Mullan - a pediatrician, writer, and historian - argues that primary care is a fascinating, important, and still endangered calling. In conveying the personal voices of primary care practitioners, Mullan sheds light on the political and economic contradictions that confront American medicine. Mullan interviewed dozens of primary care practitioners - family physicians, internists, pediatricians, nurse practitioners, and physician assistants - asking them about their lives and their work. He explains how, during the last forty years, the primary care movement has emerged built on the principles of "big doctoring"--coordinated, comprehensive care over time. This book is essential reading for understanding core issues of the current health care dilemma. As our country struggles with managed care, market reforms, and cost containment strategies in medicine, Big Doctoring in America provides an engrossing and illuminating look at those in the trenches of the profession.   [brief]
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Title: Intensive care: a doctor's journal
Author: Murray, John F. (John Frederic) 1927-
Published: University of California Press,  2000
Subjects: Medicine | Aging
Publisher's Description: Intensive Care is an affecting view from the trenches, a seasoned doctor's minute-by-minute and day-by-day account of life in the Intensive Care Unit (ICU) of a major inner-city hospital, San Francisco General. John F. Murray, for many years Chief of the Pulmonary and Critical Care Division of the hospital and a Professor at the University of California, San Francisco, takes readers on his daily ward rounds, introducing them to the desperately ill patients he treats as well as to the young physicians and medical students who accompany him. Writing with compassion and knowledge accumulated over a long career, Murray presents the true stories of patients who show up with myriad disorders: asthma, cardiac failure, gastrointestinal diseases, complications due to AIDS, the effects of drug and alcohol abuse, emphysema. Readers will come away from this book with a comprehensive understanding of what an ICU is, what it does, who gets admitted, and how doctors and nurses make decisions concerning life-threatening medical problems. Intensive care for critically ill patients is a new but well-established and growing branch of medicine. Estimates suggest that 15 to 20 percent of all hospitalized patients in the United States are treated in an intensive or coronary care unit during each hospital stay, so there is a real possibility that the reader will either be admitted to an ICU himself or herself or knows someone who will be. Murray not only offers a real-time account of the diagnosis, treatment, and progress of his patients over the course of one month but also conveys a wealth of information about various diseases and medical procedures in succinct and easy-to-understand terms. In addition, he elaborates on ethical dilemmas that he confronts on an almost daily basis: the extent of patient autonomy, the denial of ICU care, the withdrawal of life support, and physician-assisted suicide. Murray concludes that ICUs are doing their job, but they could be even better, cheaper, and--most important--more humane. His chronicle brings substance to a world known to most of us only through the fiction of television.   [brief]
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Title: Old, alone, and neglected: care of the aged in the United States and Scotland 
Author: Kayser-Jones, Jeanie Schmit
Published: University of California Press,  1990
Subjects: Anthropology | Aging | Medical Anthropology | Medicine
Publisher's Description: As the median age of the population increases, the care and housing of the elderly in the U.S. are of increasing concern. Jeanie Kayser-Jones compares a typical private institution in the U.S. with a government-owned home in Scotland.Her analysis compels attention to the systematic abuse of the inst . . . [more]
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Title: Starting at home: caring and social policy
Author: Noddings, Nel
Published: University of California Press,  2002
Subjects: Politics | American Studies | Anthropology | Social and Political Thought | Political Theory | Public Policy | Social Problems | Public Policy | Sociology | Sociology
Publisher's Description: Nel Noddings, one of the central figures in the contemporary discussion of ethics and moral education, argues that caring--a way of life learned at home--can be extended into a theory that guides social policy. Tackling issues such as capital punishment, drug treatment, homelessness, mental illness, and abortion, Noddings inverts traditional philosophical priorities to show how an ethic of care can have profound and compelling implications for social and political thought. Instead of beginning with an ideal state and then describing a role for home and family, this book starts with an ideal home and asks how what is learned there may be extended to the larger social domain. Noddings examines the tension between freedom and equality that characterized liberal thought in the twentieth century and finds that--for all its strengths--liberalism is still inadequate as social policy. She suggests instead that an attitude of attentive love in the home induces a corresponding responsiveness that can serve as a foundation for social policy. With her characteristic sensitivity to the individual and to the vulnerable in society, the author concludes that any corrective practice that does more harm than the behavior it is aimed at correcting should be abandoned. This suggests an end to the disastrous war on drugs. In addition, Noddings states that the caring professions that deal with the homeless should be guided by flexible policies that allow practitioners to respond adequately to the needs of very different clients. She recommends that the school curriculum should include serious preparation for home life as well as for professional and civic life. Emphasizing the importance of improving life in everyday homes and the possible role social policy might play in this improvement, Starting at Home highlights the inextricable link between the development of care in individual lives and any discussion of moral life and social policy.   [brief]
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Title: The war come home: disabled veterans in Britain and Germany, 1914-1939
Author: Cohen, Deborah 1968-
Published: University of California Press,  2001
Subjects: History | European History | German Studies | Military History | European Studies
Publisher's Description: Disabled veterans were the First World War's most conspicuous legacy. Nearly eight million men in Europe returned from the First World War permanently disabled by injury or disease. In The War Come Home, Deborah Cohen offers a comparative analysis of the very different ways in which two belligerent nations--Germany and Britain--cared for their disabled. At the heart of this book is an apparent paradox. Although postwar Germany provided its disabled veterans with generous benefits, they came to despise the state that favored them. Disabled men proved susceptible to the Nazi cause. By contrast, British ex-servicemen remained loyal subjects, though they received only meager material compensation. Cohen explores the meaning of this paradox by focusing on the interplay between state agencies and private philanthropies on one hand, and the evolving relationship between disabled men and the general public on the other. Written with verve and compassion, The War Come Home describes in affecting detail disabled veterans' lives and their treatment at the hands of government agencies and private charities in Britain and Germany. Cohen's study moves from the intimate confines of veterans' homes to the offices of high-level bureaucrats; she tells of veterans' protests, of disabled men's families, and of the well-heeled philanthropists who made a cause of the war's victims. This superbly researched book provides an important new perspective on the ways in which states and societies confront the consequences of industrialized warfare.   [brief]
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Title: Healing the masses: Cuban health politics at home and abroad
Author: Feinsilver, Julie Margot
Published: University of California Press,  1993
Subjects: Latin American Studies | Politics | Medicine | Public Policy
Publisher's Description: How has Cuba, a small, developing country, achieved its stunning medical breakthroughs? Hampered by scarce resources and a long-standing U.S. embargo, Cuba nevertheless has managed to provide universal access to health care, comprehensive health education, and advanced technology, even amid desperate economic conditions. Moreover, Cuba has sent disaster relief, donations of medical supplies and technology, and cadres of volunteer doctors throughout the world, emerging, in Castro's phrase, as a "world medical power."In her significant and timely study, Julie Feinsilver explores the Cuban medical phenomenon, examining how a governmental obsession with health has reaped medical and political benefits at home and abroad. As a result of Cuba's forward strides in health care, infant mortality rates are low even by First World standards. Cuba has successfully dealt with the AIDS epidemic in a manner that has aroused controversy and that some claim has infringed on individual liberties - issues that Feinsilver succinctly evaluates.Feinsilver's research and travel in Cuba over many years give her a unique perspective on the challenges Cuba faces in this time of unprecedented economic and political uncertainty. Her book is a must-read for everyone concerned with health policy, international relations, and Third World societies.   [brief]
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Title: Life without disease: the pursuit of medical utopia 
Author: Schwartz, William B 1922-
Published: University of California Press,  1998
Subjects: Science | Medicine | Economics and Business | History and Philosophy of Science | Public Policy
Publisher's Description: The chaotic state of today's health care is the result of an explosion of effective medical technologies. Rising costs will continue to trouble U.S. health care in the coming decades, but new molecular strategies may eventually contain costs. As life expectancy is dramatically extended by molecular medicine, a growing population of the aged will bring new problems. In the next fifty years genetic intervention will shift the focus of medicine in the United States from repairing the ravages of disease to preventing the onset of disease. Understanding the role of genes in human health, says Dr. William B. Schwartz, is the driving force that will change the direction of medical care, and the age-old dream of life without disease may come close to realization by the middle of the next century. Medical care in 2050 will be vastly more effective, Schwartz maintains, and it may also be less expensive than the resource-intensive procedures such as coronary bypass surgery that medicine relies on today.Schwartz's alluring prospect of a medical utopia raises urgent questions, however. What are the scientific and public policy obstacles that must be overcome if such a goal is to become a reality? Restrictions on access imposed by managed care plans, the corporatization of charitable health care institutions, the increasing numbers of citizens without health insurance, the problems with malpractice insurance, and the threatened Medicare bankruptcy - all are the legacy of medicine's great progress in mastering the human body and society's inability to assimilate that mastery into existing economic, ethical, and legal structures. And if the average American life span is 130 years, a genuine possibility by 2050, what social and economic problems will result?Schwartz examines the forces that have brought us to the current health care state and shows how those same forces will exert themselves in the decades ahead. Focusing on the inextricable link between scientific progress and health policy, he encourages a careful examination of these two forces in order to determine the kind of medical utopia that awaits us. The decisions we make will affect not only our own care, but also the system of care we bequeath to our children.   [brief]
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Title: The corporate practice of medicine: competition and innovation in health care
Author: Robinson, James C 1953-
Published: University of California Press,  1999
Subjects: Politics | Public Policy | Medicine | Economics and Business
Publisher's Description: One of the country's leading health economists presents a provocative analysis of the transformation of American medicine from a system of professional dominance to an industry under corporate control. James Robinson examines the economic and political forces that have eroded the traditional medical system of solo practice and fee-for-service insurance, hindered governmental regulation, and invited the market competition and organizational innovations that now are under way. The trend toward health care corporatization is irreversible, he says, and it parallels analogous trends toward privatization in the world economy.The physician is the key figure in health care, and how physicians are organized is central to the health care system, says Robinson. He focuses on four forms of physician organization to illustrate how external pressures have led to health care innovations: multispecialty medical groups, Independent Practice Associations (IPAs), physician practice management firms, and physician-hospital organizations. These physician organizations have evolved in the past two decades by adopting from the larger corporate sector similar forms of ownership, governance, finance, compensation, and marketing.In applying economic principles to the maelstrom of health care, Robinson highlights the similarities between competition and consolidation in medicine and in other sectors of the economy. He points to hidden costs in fee-for-service medicine - overtreatment, rampant inflation, uncritical professional dominance regarding treatment decisions - factors often overlooked when newer organizational models are criticized.Not everyone will share Robinson's appreciation for market competition and corporate organization in American health care, but he challenges those who would return to the inefficient and inequitable era of medicine from which we've just emerged. Forcefully written and thoroughly documented, The Corporate Practice of Medicine presents a thoughtful - and optimistic - view of a future health care system, one in which physician entrepreneurship is a dynamic component.   [brief]
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Title: Learning to go to school in Japan: the transition from home to preschool life
Author: Peak, Lois
Published: University of California Press,  1991
Subjects: Anthropology | Cultural Anthropology | Japan | Education
Publisher's Description: Japanese two-year-olds are indulged, dependent, and undisciplined toddlers, but by the age of six they have become obedient, self-reliant, and cooperative students. When Lois Peak traveled to Japan in search of the "magical childrearing technique" behind this transformation, she discovered that the answer lies not in the family but in the preschool, where teachers gently train their pupils in proper group behavior. Using case studies drawn from two contrasting schools, Peak documents the important early stages of socialization in Japanese culture.Contrary to popular perceptions, Japanese preschools are play-centered environments that pay little attention to academic preparation. It is here that Japanese children learn their first lessons in group life. The primary goal of these cheerful--even boisterous--settings is not to teach academic facts of learning-readiness skills but to inculcate behavior and attitudes appropriate to life in public social situations.Peak compares the behavior considered permissible at home with that required of children at preschool, and argues that the teacher is expected to be the primary agent in the child's transition. Step by step, she brings the socialization process to life, through a skillful combination of classroom observations, interviews with mothers and teachers, transcripts of classroom events, and quotations from Japanese professional literature.   [brief]
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Title: Working-class heroes: protecting home, community, and nation in a Chicago neighborhood
Author: Kefalas, Maria
Published: University of California Press,  2003
Subjects: Sociology | American Studies | Anthropology | Urban Studies | Ethnic Studies | Gender Studies | Politics | Social Problems | Urban Studies | Urban Studies
Publisher's Description: Chicago's Southwest Side is one of the last remaining footholds for the city's white working class, a little-studied and little-understood segment of the American population. This book paints a nuanced and complex portrait of the firefighters, police officers, stay-at-home mothers, and office workers living in the stable working-class community known as Beltway. Building on the classic Chicago School of urban studies and incorporating new perspectives from cultural geography and sociology, Maria Kefalas considers the significance of home, community, and nation for Beltway residents.   [brief]
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Title: Experiencing politics: a legislator's stories of government and health care
Author: McDonough, John E. (John Edward)
Published: University of California Press,  2000
Subjects: Politics | Public Policy | Medicine
Publisher's Description: John E. McDonough affords a rare glimpse into the practice of state politics in this insider's account of the fascinating interface between political science and real-life politics. A member of the Massachusetts House of Representatives for thirteen years and a skilled storyteller, McDonough eloquently weaves together stories of politics and policy with engaging theoretical models in a way that illuminates both the theory and the practice. By providing a link between scholarship and the world of experience, he communicates much about the essence of representative democracy. In the process, he demonstrates how politics extend beyond the public sphere into many aspects of life involving diverse values and interests. McDonough describes the nature of conflict, the role of interests, agenda setting, the nature and pace of change, the use of language, and more. Accessible, insightful, and original, his stories touch on a broad range of issues - including health care politics, campaigns, and elections; a street gang called the X-men; the death penalty; campaign finance reform, and tenants versus landlords. To the author, politics is everywhere and political dynamics are universal. While the setting for this book is one legislature, the lessons and insights are intended for everyone.   [brief]
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Title: Just doctoring: medical ethics in the liberal state 
Author: Brennan, Troyen A
Published: University of California Press,  1991
Subjects: Philosophy | Ethics | Medicine
Publisher's Description: Just Doctoring draws the doctor-patient relationship out of the consulting room and into the middle of the legal and political arenas where it more and more frequently appears. Traditionally, medical ethics has focused on the isolated relationship of physician to patient in a setting that has left the physician virtually untouched by market constraints or government regulation. Arguing that changes in health care institutions and legal attention to patient rights have made conventional approaches obsolete, Troyen Brennan points the way to a new, more aware and engaged medical ethics.The medical profession is no longer isolated, even theoretically, from the liberal, market-dominated state. Old ideas of physician beneficence and altruism must make way for a justice-based medical ethics, assuming a relationship between equals more compatible with liberal political philosophy. Brennan offers clinical examples of many of today's most challenging medical problems - from informed consent to care rationing and the repercussions of the HIV epidemic - and gives his recommendation for a new ethical perspective. This lively and controversial plea for a rethinking of medical ethics goes right to the heart of medical care at the end of the twentieth century.   [brief]
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Title: Inventing home: emigration, gender, and the middle class in Lebanon, 1870-1920 
Author: Khater, Akram Fouad 1960-
Published: University of California Press,  2001
Subjects: History | Middle Eastern History | Women's Studies | Sociology | Middle Eastern Studies
Publisher's Description: Between 1890 and 1920 over one-third of the peasants of Mount Lebanon left their villages and traveled to the Americas. This book traces the journeys of these villagers from the ranks of the peasantry into a middle class of their own making. Inventing Home delves into the stories of these travels, shedding much needed light on the impact of emigration and immigration in the development of modernity. It focuses on a critical period in the social history of Lebanon--the "long peace" between the uprising of 1860 and the beginning of the French mandate in 1920. The book explores in depth the phenomena of return emigration, the questioning and changing of gender roles, and the rise of the middle class. Exploring new areas in the history of Lebanon, Inventing Home asks how new notions of gender, family, and class were articulated and how a local "modernity" was invented in the process.Akram Khater maps the jagged and uncertain paths that the fellahin from Mount Lebanon carved through time and space in their attempt to control their future and their destinies. His study offers a significant contribution to the literature on the Middle East, as well as a new perspective on women and on gender issues in the context of developing modernity in the region.   [brief]
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Title: Rethinking home: a case for writing local history
Author: Amato, Joseph Anthony
Published: University of California Press,  2002
Subjects: History | Intellectual History | United States History | Writing
Publisher's Description: Joseph A. Amato proposes a bold and innovative approach to writing local history in this imaginative, wide-ranging, and deeply engaging exploration of the meaning of place and home. Arguing that people of every place and time deserve a history, Amato draws on his background as a European cultural historian and a prolific writer of local history to explore such topics as the history of cleanliness, sound, anger, madness, the clandestine, and the environment in southwestern Minnesota. While dedicated to the unique experiences of a place, his lively work demonstrates that contemporary local history provides a vital link for understanding the relation between immediate experience and the metamorphosis of the world at large. In an era of encompassing forces and global sensibilities, Rethinking Home advocates the power of local history to revivify the individual, the concrete, and the particular. This singular book offers fresh perspectives, themes, and approaches for energizing local history at a time when the very notion of place is in jeopardy. Amato explains how local historians shape their work around objects we can touch and institutions we have directly experienced. For them, theory always gives way to facts. His vivid portraits of individual people, places, situations, and cases (which include murders, crop scams, and taking custody of the law) are joined to local illustrations of the use of environmental and ecological history. This book also puts local history in the service of contemporary history with the examination of recent demographic, social, and cultural transformations. Critical concluding chapters on politics and literature--especially Sinclair Lewis's Main Street and Longfellow's Hiawatha --show how metaphor and myth invent, distort, and hold captive local towns, peoples, and places.   [brief]
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Title: Apartment stories: city and home in nineteenth-century Paris and London
Author: Marcus, Sharon 1966-
Published: University of California Press,  1999
Subjects: Literature | European History | Urban Studies | Women's Studies
Publisher's Description: In urban studies, the nineteenth century is the "age of great cities." In feminist studies, it is the era of the separate domestic sphere. But what of the city's homes? In the course of answering this question, Apartment Stories provides a singular and radically new framework for understanding the urban and the domestic. Turning to an element of the cityscape that is thoroughly familiar yet frequently overlooked, Sharon Marcus argues that the apartment house embodied the intersections of city and home, public and private, and masculine and feminine spheres.Moving deftly from novels to architectural treatises, legal debates, and popular urban observation, Marcus compares the representation of the apartment house in Paris and London. Along the way, she excavates the urban ghost tales that encoded Londoners' ambivalence about city dwellings; contends that Haussmannization enclosed Paris in a new regime of privacy; and locates a female counterpart to the flâneur and the omniscient realist narrator - the portière who supervised the apartment building.   [brief]
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Title: Working families: the transformation of the American home
Author: Hertz, Rosanna
Published: University of California Press,  2001
Subjects: Gender Studies | Women's Studies | Sociology | Social Problems | Anthropology | Economics and Business | Urban Studies | Ethnic Studies | Politics | Politics
Publisher's Description: The dynamics of work and parenthood are in the midst of a revolutionary shift in the United States. Focused around a major factor in this shift - the rise of dual-income families - this groundbreaking volume provides a highly informative snapshot of the intricate fabric of work and family in the United States. With selections written by leading scholars both inside and outside academia, Working Families offers intimate stories of how families manage and how children respond to the rigors of their parents' lives, as well as broad overviews developed from survey and census data. Taken together, these essays present an updated and integral view of the revolutionary changes in patterns of work and family life occurring today. Using a broad range of methodologies, the contributors reach across gender, age, and class differences. They discuss working-class as well as affluent dual-career couples and work sites ranging from factories to offices. Straddling racial divides, the essays range from studies of white day care providers to a close look at a Mexican maid's daughter. The collection as a whole refutes the assumption that there is one normal type of family or workplace. These readable essays capture our attention as they build, cumulatively, to an absorbing picture of today's families and workplaces.   [brief]
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Title: Home bound: Filipino lives across cultures, communities, and countries
Author: Espiritu, Yen Le 1963-
Published: University of California Press,  2003
Subjects: Ethnic Studies | American Studies | Sociology | Cultural Anthropology | Asian American Studies | Gender Studies | United States History | Postcolonial Studies | Immigration
Publisher's Description: Filipino Americans, who experience life in the United States as immigrants, colonized nationals, and racial minorities, have been little studied, though they are one of our largest immigrant groups. Based on her in-depth interviews with more than one hundred Filipinos in San Diego, California, Yen Le Espiritu investigates how Filipino women and men are transformed through the experience of migration, and how they in turn remake the social world around them. Her sensitive analysis reveals that Filipino Americans confront U.S. domestic racism and global power structures by living transnational lives that are shaped as much by literal and symbolic ties to the Philippines as they are by social, economic, and political realities in the United States. Espiritu deftly weaves vivid first-person narratives with larger social and historical contexts as she discovers the meaning of home, community, gender, and intergenerational relations among Filipinos. Among other topics, she explores the ways that female sexuality is defined in contradistinction to American mores and shows how this process becomes a way of opposing racial subjugation in this country. She also examines how Filipinos have integrated themselves into the American workplace and looks closely at the effects of colonialism.   [brief]
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Title: Power and illness: the failure and future of American health policy 
Author: Fox, Daniel M
Published: University of California Press,  1993
Subjects: Sociology | Medicine | History | American Studies | United States History
Publisher's Description: During most of this century, American health policy has emphasized caring for acute conditions rather than preventing and managing chronic illness - even though chronic illness has caused most sickness and death since the 1920s. In this provocative and wide-ranging book, Daniel Fox explains why this has been so and offers a forceful argument for fundamental change in national health care priorities.Fox discusses how ideas about illness and health care, as well as the power of special interest groups, have shaped the ways in which Americans have treated illness. Those who make health policy decisions have increased support for hospitals, physicians, and medical research, believing that people then would become healthier. This position, implemented at considerable cost, has not adequately taken into account the growing burden of chronic disabling illness. While decision makers may have defined chronic disease as a high priority in research, they have not given it such a priority in the financing of health services.The increasing burden of chronic illness is critical. Fox suggests ways to solve this problem without increasing the already high cost of health care - but he does not underestimate the difficulties in such a strategy. Advocating the redistribution of resources within hospital and medical services, he targets those that are redundant or marginally effective.There could be no more timely subject today than American health care. And Daniel Fox is uniquely able to address its problems. A historian of medicine, with knowledge of how hospitals and physicians behave and how health policy is made at government levels, he has extensively researched published and unpublished documents on health care. What he proposes could profoundly affect all Americans.   [brief]
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Title: Immigration and the political economy of home: West Indian Brooklyn and American Indian Minneapolis, 1945-1992 
Author: Buff, Rachel 1961-
Published: University of California Press,  2001
Subjects: Ethnic Studies | American Studies | Native American Studies | Native American Ethnicity | United States History
Publisher's Description: Rachel Buff's innovative study of festivals in two American communities launches a substantive inquiry into the nature of citizenship, race, and social power. Drawing on ethnographic fieldwork as well as archival research, Buff compares American Indian powwows in Minneapolis with the West Indian American Day Carnival in New York. She demonstrates the historical, theoretical, and cultural links between two groups who are rarely thought of together and in so doing illuminates our understanding of the meaning of home and citizenship in the post-World War II period. The book also follows the history of federal Indian and immigration policy in this period, tracing the ways that migrant and immigrant identities are created by both national boundaries and transnational cultural memory. In addition to offering fascinating discussions of these lively and colorful festivals, Buff shows that their importance is not just as a form of performance or entertainment, but also as crucial sites for making and remaking meanings about group history and survival. Cultural performances for both groups contain a history of resistance to colonial oppression, but they also change and creatively respond to the experiences of migration and the forces of the global mass-culture industry. Accessible and engaging, Immigration and the Political Economy of Home addresses crucial contemporary issues. Powwow culture and carnival culture emerge as vital, dynamic sites that are central not only to the formation of American Indian and West Indian identities, but also to the understanding modern America itself: the history of its institution of citizenship, its postwar cities, and the nature of metropolitan culture.   [brief]
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Title: American medicine: the quest for competence
Author: Good, Mary-Jo DelVecchio
Published: University of California Press,  1995
Subjects: Medicine | Science | Medical Anthropology | Public Policy
Publisher's Description: What does it mean to be a good doctor in America today? How do such challenges as new biotechnologies, the threat of malpractice suits, and proposed health-care reform affect physicians' ability to provide quality care?These and many other crucial questions are examined in this book, the first to fully explore the meaning and politics of competence in modern American medicine. Based on Mary-Jo DelVecchio Good's recent ethnographic studies of three distinct medical communities - physicians in rural California, academics and students involved in Harvard Medical School's innovative "New Pathway" curriculum, and oncologists working on breast cancer treatment - the book demonstrates the centrality of the issue of competence throughout the medical world. Competence, it shows, provides the framework for discussing the power struggles between rural general practitioners and specialists, organizational changes in medical education, and the clinical narratives of high-technology oncologists. In their own words, practitioners, students, and academics describe what competence means to them and reveal their frustration with medical-legal institutions, malpractice, and the limitations of peer review and medical training.Timely and provocative, this study is essential reading for medical professionals, academics, anthropologists, and sociologists, as well as health-care policymakers.   [brief]
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