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: 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: Lives at risk: public health in nineteenth-century Egypt 
Author: Kuhnke, LaVerne
Published: University of California Press,  1990
Subjects: Anthropology | Medical Anthropology
Publisher's Description: Lives at Risk describes the introduction of Western medicine into Egypt. The two major innovations undertaken by Muhammad Ali in the mid-nineteenth century were a Western-style school of medicine and an international Quarantine Board. The ways in which these institutions succeeded and failed will greatly interest historians of medicine and of modern Egypt. And because the author relates her narrative to twentieth-century health issues in developing countries, Lives at Risk will also interest medical and social anthropologists.The presence of the quarantine establishment and the medical school in Egypt resulted in a rudimentary public health service. Paramedical personnel were trained to provide primary health care for the peasant population. A vaccination program effectively freed the nation from smallpox. But the disease-oriented, individual-care practice of medicine derived from the urban hospital model of industrializing Europe was totally incompatible with the health care requirements of a largely rural, agrarian population.   [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: 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: 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: 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: Public health law and ethics: a reader
Author: Gostin, Larry O. (Larry Ogalthorpe)
Published: University of California Press,  2002
Subjects: Law | Medicine | Health Care
Publisher's Description: This incisive selection of government reports, scholarly articles, and court cases is designed to illuminate the ethical, legal, and political issues in the theory and practice of public health. A companion to the internationally acclaimed Public Health Law: Power, Duty, Restraint, this collection encourages debate and discourse about how courts, scholars, and policy makers respond to the salient legal and ethical dilemmas. The excerpts and commentaries in the reader analyze the legal and constitutional foundations of public health, juxtaposing them with the emerging importance of public health ethics and human rights. The book offers a systematic account of public health law, ethics, and human rights in promoting the common good. Gostin provides thoughtful commentary on the field of public health and carefully explains the meaning and importance of each selection. Scholars, legislators, and public health professionals, as well as faculty and students in schools of law, public health, medicine, nursing, government, and health administration, will benefit from the contemporary case studies covering a wide range of topics from bioterrorism to public health genetics.   [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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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: Policies, plans, & people: foreign aid and health development
Author: Justice, Judith
Published: University of California Press,  1989
Subjects: Anthropology | Art and Architecture
Publisher's Description: Judith Justice uses an interdisciplinary approach to show how anthropologists and planners can combine their expertise to make health care programs culturally compatible with the populations they serve.
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Title: The blood of strangers: stories from emergency medicine
Author: Huyler, Frank 1964-
Published: University of California Press,  1999
Subjects: Medicine | American Literature | Autobiography
Publisher's Description: Reminiscent of Chekhov's stories, The Blood of Strangers is a visceral portrayal of a physician's encounters with the highly charged world of an emergency room. In this collection of spare and elegant stories, Dr. Frank Huyler reveals a side of medicine where small moments - the intricacy of suturing a facial wound, the bath a patient receives from her husband and daughter - interweave with the lives and deaths of the desperately sick and injured. The author presents an array of fascinating characters, both patients and doctors - a neurosurgeon who practices witchcraft, a trauma surgeon who unexpectedly commits suicide, a wounded murderer, a man chased across the New Mexico desert by a heat-seeking missile. At times surreal, at times lyrical, at times brutal and terrifying, The Blood of Strangers is a literary work that emerges from one of the most dramatic specialties of modern medicine. This deeply affecting first book has been described by one early reader as "the best doctor collection I have seen since William Carlos Williams's The Doctor Stories ."   [brief]
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Title: Who survives cancer? 
Author: Greenwald, Howard P
Published: University of California Press,  1992
Subjects: Sociology | Environmental Studies | Medicine
Publisher's Description: FACT OR FICTION? *A white male earning over $35,000 a year has a better chance of surviving most types of cancer than an unemployed African-American male.*Psychological factors predispose people to contracting cancer and improved emotional health promotes recovery.*Early detection is useless in curing cancer.*Experimental, not conventional, treatments offer the most benefits and longer survival rates to cancer patients.*A scientific breakthrough of practical and immediate significance in cancer treatment is imminent.*Cancer prevention is ineffective in many areas and campaigns will probably never achieve a reduction of cancer mortality approaching 50 percent.*Health Maintenance Organizations (HMOs) increase survival chances for most cancer patients.Howard Greenwald takes an incisive new look at how class, race, sex, psychological state, type of health care and available treatments affect one's chance of surviving cancer. Drawing on an original ten-year survival study of cancer patients, he synthesizes medical, epidemiological, and psychosocial research in a uniquely interdisciplinary and eye-opening approach to the question of who survives cancer and why.Scientists, health care professionals, philanthropists, government agencies, and ordinary people all agree that significant resources must be allocated to fight this dreaded disease. But what is the most effective way to do it? Greenwald argues that our priorities have been misplaced and calls for a fundamental rethinking of the way the American medical establishment deals with the disease. He asserts that the emphasis on prevention and experimental therapy has only limited value, whereas the availability of conventional medical care is very important in influencing cancer survival. Class and race become strikingly significant in predicting who has access to health care and can therefore obtain medical treatment in a timely, effective manner. Greenwald counters the popular notion that personality and psychological factors strongly affect survival, and he underscores the importance of early detection. His research shows that Health Maintenance Organizations, while sometimes prone to delays, offer low-income patients a better chance of ultimate survival. Greenwald pleads for immediate attention to the inadequacies and inequalities in our health care delivery system that deter patients from seeking regular medical care.Instead of focusing on research and the hope for a breakthrough cure, Greenwald urges renewed emphasis on ensuring available health care to all Americans. In its challenge to the thrust of much biomedical research and its critique of contemporary American health care, as well as in its fresh and often counterintuitive look at cancer survival, Who Survives Cancer? is invaluable for policymakers, health care professionals, and anyone who has survived or been touched by cancer.   [brief]
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Title: Should I be tested for cancer?: maybe not and here's why
Author: Welch, H. Gilbert
Published: University of California Press,  2004
Subjects: Medicine | Health Care | Disease
Publisher's Description: Getting tested to detect cancer early is one of the best ways to stay healthy - or is it? In this lively, carefully researched book, a nationally recognized expert on early cancer detection challenges one of medicine's most widely accepted beliefs: that the best defense against cancer is to always try to catch it early. Read this book and you will think twice about common cancer screening tests such as total body scans, mammograms, and prostate-specific antigen (PSA) tests. Combining patient stories and solid data on common cancers, Dr. H. Gilbert Welch makes the case that testing healthy people for cancer is really a double-edged sword: while these tests may help, they often have surprisingly little effect and are sometimes even harmful. Bringing together a body of little-known medical research in an engaging and accessible style, he discusses in detail the pitfalls of screening tests, showing how they can miss some cancers, how they can lead to invasive, unnecessary treatments, and how they can distract doctors from other important issues. Welch's conclusions are powerful, counterintuitive, and disturbing: the early detection of cancer does not always save lives, it can be hard to know who really has early cancer, and there are some cancers better left undiscovered. Should I Be Tested for Cancer? is the only book to clearly and simply lay out the pros and cons of cancer testing for the general public. It is indispensable reading for the millions of Americans who repeatedly face screening tests and who want to make better-informed decisions about their own health care.   [brief]
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Title: Promoting human wellness: new frontiers for research, practice, and policy 
Author: Jamner, Margaret Schneider
Published: University of California Press,  2001
Subjects: Medicine | Public Policy | Anthropology | Aging | Education
Publisher's Description: This book is a state-of-the-art educational resource on the latest research and public-policy developments in the fields of wellness promotion and disease prevention. Based on award-winning lectures by University of California faculty on nine campuses as part of the Wellness Lectures Program jointly funded by The California Wellness Foundation, Health Net, and the University of California, the volume aims to widen the scope of health care research and policy to promote wellness rather than focus on illness and disease, and to incorporate proactive, interdisciplinary approaches to health care. The volume also contains chapters by distinguished scholars inthe fields of wellness promotion and disease prevention. Many of these articles fall outside the scope of what we conventionally call health promotion, bringing new perspectives to research and policy possibilities. Promoting Human Wellness is organized around core themes such as the importance of disease prevention programs that address multiple health risks, the link between poverty and minority status and disease susceptibility, and the challenge of evaluating health benefits and cost-effectiveness. The articles discuss such timely issues as genetic determinism as a paradigm in wellness promotion, adolescent health promotion and teen pregnancy prevention strategies, racial differences in cancer epidemiology, the California smokers' helpline, strategies for reducing youth violence, HIV/AIDS prevention, domestic violence education and prevention srategies, and the future of women's health research. Presented within the framework of social ecology, several of the chapters in this volume address new ideas and approaches in the wellness field that are only now beginning to be understood such as the social construction of variables including race, class, and gender. Promoting Human Wellness will be essential reading for health practitioners, policymakers, and others seeking to expand the ways we define and achieve health. Keywords: Public health, community health, medicine, nursing, social welfare, health education, health psychology, social ecology, public policy, aging, health promotion.   [brief]
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Title: The caregiving dilemma: work in an American nursing home
Author: Foner, Nancy 1945-
Published: University of California Press,  1994
Subjects: Anthropology | Medical Anthropology | Social Problems | Medicine | Women's Studies
Publisher's Description: Along with increasing life expectancy comes the knowledge that many Americans will one day enter nursing homes. Who are the people who will care for us or for our relatives? Nancy Foner provides a major study of institutional care that focuses on nursing aides, who are the backbone of American nursing homes. She examines the strains and paradoxes facing nursing aides - asked, on the one hand, to provide compassionate care and, on the other, to cope with the pressures of the workplace and the institution.Aides are expected to look after patients, who are predominantly older women, with kindness and consideration, but nursing home regulations and bureaucratic forces often hinder even the best efforts to offer consistently supportive care. Positioned at the bottom of the nursing hierarchy, aides must cope with the needs of frail, dependent residents, pressures from patients' relatives and from their own families, and demands of supervisors and coworkers.Foner's detailed description and analysis of caregiving dilemmas, based on intensive field research in a New York facility, brings the perspective of the nursing aides to the fore. This is a timely contribution to the study of work, bureaucracy, and the future of an aging American population.   [brief]
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Title: What I learned in medical school: personal stories of young doctors
Author: Takakuwa, Kevin M
Published: University of California Press,  2004
Subjects: Medicine | Sociology | Ethnic Studies | Gender Studies | Anthropology | Health Care
Publisher's Description: Like many an exclusive club, the medical profession subjects its prospective members to rigorous indoctrination: medical students are overloaded with work, deprived of sleep and normal human contact, drilled and tested and scheduled down to the last minute. Difficult as the regimen may be, for those who don't fit the traditional mold - white, male, middle-to-upper class, and heterosexual - medical school can be that much more harrowing. This riveting book tells the tales of a new generation of medical students - students whose varied backgrounds are far from traditional. Their stories will forever alter the way we see tomorrow's doctors. In these pages, a black teenage mother overcomes seemingly insurmountable odds, an observant Muslim dons the hijab during training, an alcoholic hides her addiction. We hear the stories of an Asian refugee, a Mexican immigrant, a closeted Christian, an oversized woman - these once unlikely students are among those who describe their medical school experiences with uncommon candor, giving a close-up look at the inflexible curriculum, the pervasive competitive culture, and the daunting obstacles that come with being "different" in medical school. Their tales of courage are by turns poignant, amusing, eye-opening - and altogether unforgettable.   [brief]
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Title: When walking fails: mobility problems of adults with chronic conditions
Author: Iezzoni, Lisa I
Published: University of California Press,  2003
Subjects: Medicine | Health Care | Sociology | Public Policy
Publisher's Description: Roughly one in ten adult Americans find their walking slowed by progressive chronic conditions like arthritis, back problems, heart and lung diseases, and diabetes. In this passionate and deeply informed book, Lisa I. Iezzoni describes the personal experiences of and societal responses to adults whose mobility makes it difficult for them to live as they wish - partly because of physical and emotional conditions and partly because of persisting societal and environmental barriers. Basing her conclusions on personal experience, a wealth of survey data, and extensive interviews with dozens of people from a wide social spectrum, Iezzoni explains who has mobility problems and why; how mobility difficulties affect people's physical comfort, attitudes, daily activities, and relationships with family and friends throughout their communities; strategies for improving mobility; and how the health care system addresses mobility difficulties, providing and financing services and assistive technologies. Iezzoni claims that, although strategies exist to improve mobility, many people do not know where to turn for advice. She addresses the need to inform policymakers about areas where changes will better accommodate people with difficulty walking. This straightforward and engaging narrative clearly demonstrates that improving people's ability to move freely and independently will enhance overall health and quality of life, not only for these persons, but also for society as a whole.   [brief]
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Title: Voting at the political fault line: California's experiment with the blanket primary 
Author: Cain, Bruce E
Published: University of California Press,  2002
Subjects: Politics | California and the West
Publisher's Description: California's adoption of the blanket primary in 1996 presented a unique natural experiment on the impact that election rules have on politics. Billed as a measure that would increase voter participation and end ideological polarization, Proposition 198 placed California voters once again on the frontier of political reform. Employing a variety of data sources and methodologies, the contributors to Voting at the Political Fault Line apply their wide-ranging expertise to understand how this change in political institutions affected electoral behavior and outcomes. This authoritative study analyzes the consequences of California's experiment with the blanket primary, including the incidence of, motivations behind, and persistence of crossover voting; the behavior of candidates and donors; the effects on candidate positions and party platforms; and the consequences for women, minorities, and minor-party candidates. Published in association with the Institute of Governmental Studies, University of California, Berkeley   [brief]
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Title: Under the medical gaze: facts and fictions of chronic pain
Author: Greenhalgh, Susan
Published: University of California Press,  2001
Subjects: Anthropology | Folklore and Mythology | Medical Anthropology | Physical Anthropology | Cultural Anthropology | Medicine | Gender Studies | Sociology | Social Problems | Social Problems
Publisher's Description: This compelling account of the author's experience with a chronic pain disorder and subsequent interaction with the American health care system goes to the heart of the workings of power and culture in the biomedical domain. It is a medical whodunit full of mysterious misdiagnosis, subtle power plays, and shrewd detective work. Setting a new standard for the practice of autoethnography, Susan Greenhalgh presents a case study of her intense encounter with an enthusiastic young specialist who, through creative interpretation of the diagnostic criteria for a newly emerging chronic disease, became convinced she had a painful, essentially untreatable, lifelong muscle condition called fibromyalgia. Greenhalgh traces the ruinous effects of this diagnosis on her inner world, bodily health, and overall well-being. Under the Medical Gaze serves as a powerful illustration of medicine's power to create and inflict suffering, to define disease and the self, and to manage relationships and lives. Greenhalgh ultimately learns that she had been misdiagnosed and begins the long process of undoing the physical and emotional damage brought about by her nearly catastrophic treatment. In considering how things could go so awry, she embarks on a cogent and powerful analysis of the sociopolitical sources of pain through feminist, cultural, and political understandings of the nature of medical discourse and practice in the United States. She develops fresh arguments about the power of medicine to medicalize our selves and lives, the seductions of medical science, and the deep, psychologically rooted difficulties women patients face in interactions with male physicians. In the end, Under the Medical Gaze goes beyond the critique of biomedicine to probe the social roots of chronic pain and therapeutic alternatives that rely on neither the body-cure of conventional medicine nor the mind-cure of some alternative medicines, but rather a broader set of strategies that address the sociopolitical sources of pain.   [brief]
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