The Company Doctor


Book Description

To limit the skyrocketing costs of their employees' health insurance, companies such as Dow, Chevron, and IBM, as well as many large HMOs, have increasingly hired physicians to supervise the medical care they provide. As Elaine Draper argues in The Company Doctor, company doctors are bound by two conflicting ideals: serving the medical needs of their patients while protecting the company's bottom line. Draper analyzes the advent of the corporate physician both as an independent phenomenon, and as an index of contemporary culture, reaching startling conclusions about the intersection of corporate culture with professional autonomy. Drawing on over 100 interviews with company physicians, scientists, and government and labor officials, as well as historical, legal, and statistical sources and medical trade association data, Draper presents an illuminating overview of the social context and meaning of professional work in corporations. Draper finds that while medical journals, speeches, and ethical codes proclaim the independent professional judgment of corporate physicians, the company doctors she interviewed often expressed anguish over the tightrope they must walk between their patients' health and the corporate oversight they face at every turn. Draper dissects the complex position occupied by company doctors to explore broad themes of doctor-patient trust, employee loyalty, privacy issues, and the future direction of medicine. She addresses such controversial topics as drug screening and the difficult position of company doctors when employees sue companies for health hazards in the workplace. Company doctors are but one example of professionals who have at times ceded their autonomy to corporate management. Physicians provide the prototypical professional case for exploring this phenomenon, due to their traditional independence, extensive training, and high levels of prestige. But Draper expands the scope of the book—tracing parallel developments in the law, science, and technology—to draw insightful conclusions about changing conditions in the professional workplace, as corporate cultures everywhere adapt to the new realities of the global economy. The Company Doctor provides a compelling examination of the corporatization of American medicine with far-reaching implications for professionals in many other fields.




Safe Work in the 21st Century


Book Description

Despite many advances, 20 American workers die each day as a result of occupational injuries. And occupational safety and health (OSH) is becoming even more complex as workers move away from the long-term, fixed-site, employer relationship. This book looks at worker safety in the changing workplace and the challenge of ensuring a supply of top-notch OSH professionals. Recommendations are addressed to federal and state agencies, OSH organizations, educational institutions, employers, unions, and other stakeholders. The committee reviews trends in workforce demographics, the nature of work in the information age, globalization of work, and the revolution in health care deliveryâ€"exploring the implications for OSH education and training in the decade ahead. The core professions of OSH (occupational safety, industrial hygiene, and occupational medicine and nursing) and key related roles (employee assistance professional, ergonomist, and occupational health psychologist) are profiled-how many people are in the field, where they work, and what they do. The book reviews in detail the education, training, and education grants available to OSH professionals from public and private sources.




Taking Action Against Clinician Burnout


Book Description

Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.







Conflict of Interest in Medical Research, Education, and Practice


Book Description

Collaborations of physicians and researchers with industry can provide valuable benefits to society, particularly in the translation of basic scientific discoveries to new therapies and products. Recent reports and news stories have, however, documented disturbing examples of relationships and practices that put at risk the integrity of medical research, the objectivity of professional education, the quality of patient care, the soundness of clinical practice guidelines, and the public's trust in medicine. Conflict of Interest in Medical Research, Education, and Practice provides a comprehensive look at conflict of interest in medicine. It offers principles to inform the design of policies to identify, limit, and manage conflicts of interest without damaging constructive collaboration with industry. It calls for both short-term actions and long-term commitments by institutions and individuals, including leaders of academic medical centers, professional societies, patient advocacy groups, government agencies, and drug, device, and pharmaceutical companies. Failure of the medical community to take convincing action on conflicts of interest invites additional legislative or regulatory measures that may be overly broad or unduly burdensome. Conflict of Interest in Medical Research, Education, and Practice makes several recommendations for strengthening conflict of interest policies and curbing relationships that create risks with little benefit. The book will serve as an invaluable resource for individuals and organizations committed to high ethical standards in all realms of medicine.




The Physician in Industry


Book Description




Medical Monopoly


Book Description

During most of the nineteenth century, physicians and pharmacists alike considered medical patenting and the use of trademarks by drug manufacturers unethical forms of monopoly; physicians who prescribed patented drugs could be, and were, ostracized from the medical community. In the decades following the Civil War, however, complex changes in patent and trademark law intersected with the changing sensibilities of both physicians and pharmacists to make intellectual property rights in drug manufacturing scientifically and ethically legitimate. By World War I, patented and trademarked drugs had become essential to the practice of good medicine, aiding in the rise of the American pharmaceutical industry and forever altering the course of medicine. Drawing on a wealth of previously unused archival material, Medical Monopoly combines legal, medical, and business history to offer a sweeping new interpretation of the origins of the complex and often troubling relationship between the pharmaceutical industry and medical practice today. Joseph M. Gabriel provides the first detailed history of patent and trademark law as it relates to the nineteenth-century pharmaceutical industry as well as a unique interpretation of medical ethics, therapeutic reform, and the efforts to regulate the market in pharmaceuticals before World War I. His book will be of interest not only to historians of medicine and science and intellectual property scholars but also to anyone following contemporary debates about the pharmaceutical industry, the patenting of scientific discoveries, and the role of advertising in the marketplace.