THE SOCIAL TRANSFORMATION OF AMERICAN MEDICINE PDF
Title, The social transformation of American medicine: Paul Starr. Author, Starr, Paul, Extent, dpi TIFF G4 page images. E-Distribution Information. In this important work, sociologist Paul Starr analyzes the relations of the medical profession and society. The book has two separate divisions whose titles reveal their contents. The first part Starr calls "A Sovereign Profession: The Rise of Medical Authority and the Shaping of. Editorial Reviews. Review. "The definitive social history of the medical profession in America.
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The Social Transformation of American Medicine. The Rise of a Sovereign Profession I'd love to see a second edition. Don't call me crazy fellow Health Law. The Social Transformation of American Medicine. New York: Basic Books. This content is only available as a PDF. © The American. This important, controversial book traces the rise and early fall of medicine as a “ sovereign profession” from colonial America to the present. It comprehensively.
Klein Open Moments But medicine is also, unmistakably, a world of power where some are more likely to receive the rewards of reason than are others. From a relatively weak, traditional profession of minor economic significance, medicine has become a sprawling system of hospitals, clinics, health plans, insurance companies, and myriad other organizations employing a vast labor force.
This transformation has not been propelled solely by the advance of science and the satisfaction of human needs. The history of medicine has been written as an epic of progress, but it is also a tale of social and economic conflict over the emergence of new hierarchies of power and authority, new markets, and new conditions of belief and experience.
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In America, no one group has held so dominant a position in this new world of rationality and power as has the medical profession. Its rise to sovereignty in the late nineteenth and early twentieth centuries is the first part of the story I have to relate; the emergence in our own time of a bureaucratic and corporate regime is the second.
Goldstein Medical Pluralism Power, at the most rudimentary personal level, originates in dependence, and the power of the professions primarily originates in dependence upon their knowledge and competence.
In some cases, this dependence may be entirely subjective, but no matter: Psychological dependence is as real in its consequences as any other kind.
BOOK ONE: INTRODUCTION: The Social Origins of Professional Sovereignty
Indeed, what makes dependence on the professions so distinctive today is that their interpretations often govern our understanding of the world and our own experience. To most of us, this power seems legitimate: When professionals claim to be authoritative about the nature of reality, whether it is the structure of the atom, the ego, or the universe, we generally defer to their judgment.
Wailoo Science Pescosolido and Martin Cultural Authority The medical profession has had an especially persuasive claim to authority.
Unlike the law and the clergy, it enjoys close bonds with modern science, and at least for most of the last century, scientific knowledge has held a privileged status in the hierarchy of belief. Third was the advent and spread of profit-making hospitals, which are operated by physicians and corporations. As the hospital system has evolved and changed, so has the role of the nurse, physician, surgeon, staff, and patient, which Starr also examines.
In the final chapters of book one, Starr examines dispensaries and their evolvement over time, the three phases of public health and the rise of new specialty clinics, and the resistance to the corporatization of medicine by doctors. He concludes with a discussion of the five major structural changes in the distribution of power that played a major role in the social transformation of American medicine: 1.
The emergence of an informal control system in medical practice resulting from the growth of specialization and hospitals. The profession secured a special dispensation from the burdens of hierarchy of the capitalist enterprise.
The elimination of countervailing power in medical care.
The Social Transformation of American Medicine
The establishment of specific spheres of professional authority. The Struggle for Medical Care The second half of The Social Transformation of American Medicine focuses on the transformation of medicine into an industry and the growing role of corporations and the state in the medical system.
Starr begins with a discussion on how social insurance came about, how it evolved into a political issue, and why America lagged behind other countries with regards to health insurance.
He then examines how the New Deal and the Depression affected and shaped insurance at the time. The birth of Blue Cross in and Blue Shield several years later really paved the way for health insurance in America because it reorganized medical care on a prepaid, comprehensive basis.
Shortly after, health insurance emerged as a benefit received via employment, which reduced the likelihood that only the sick would download insurance and it reduced the large administrative costs of individually sold policies.
Commercial insurance expanded and the character of the industry changed, which Starr discusses. A lot has changed since then, but for a very thorough and well-written look at how medicine has changed throughout history in the United States up until , The Social Transformation of American Medicine is the book to read.An esoteric, intelligent, and scholarly book on how the industry of medicine in the US.
But then medical schools began to emerge and proliferate during the mids and medicine was quickly becoming a profession with licensures, codes of conduct, and professional fees.
The Social Transformation of American Medicine
Multiple, small experiments are the first step. Still, an important example of affirmative govern- ment in an allegedly laissez faire age passes the critical tests of economic efficiency posed by the author.
Sign in via your Institution Sign in. View Metrics. Public aid for seven railroad systems is sub- jected to tests of two sets of hypotheses: the need to subsidize capital expansion and the size of societal returns on the public subsidies. Learn more.
The birth of Blue Cross in and Blue Shield several years later really paved the way for health insurance in America because it reorganized medical care on a prepaid, comprehensive basis.
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