Regulating Patient Safety


Book Description

This illuminating study explores the role of professionals, patients, regulation and law in improving patient safety.




The Social Transformation of American Medicine


Book Description

Winner of the 1983 Pulitzer Prize and the Bancroft Prize in American History, this is a landmark history of how the entire American health care system of doctors, hospitals, health plans, and government programs has evolved over the last two centuries. "The definitive social history of the medical profession in America....A monumental achievement."—H. Jack Geiger, M.D., New York Times Book Review




Doctors' Orders


Book Description

The United States does not have enough doctors. Every year since the 1950s, internationally trained and osteopathic medical graduates have been needed to fill residency positions because there are too few American-trained MDs. However, these international and osteopathic graduates have to significantly outperform their American MD counterparts to have the same likelihood of getting a residency position. And when they do, they often end up in lower-prestige training programs, while American-trained MDs tend to occupy elite training positions. Some programs are even fully segregated, accepting exclusively U.S. medical graduates or non-U.S. medical graduates, depending on the program’s prestige. How do international and osteopathic medical graduates end up so marginalized, and what allows U.S.-trained MDs to remain elite? Doctors’ Orders offers a groundbreaking examination of the construction and consequences of status distinctions between physicians before, during, and after residency training. Tania M. Jenkins spent years observing and interviewing American, international, and osteopathic medical residents in two hospitals to reveal the unspoken mechanisms that are taken for granted and that lead to hierarchies among supposed equals. She finds that the United States does not need formal policies to prioritize American-trained MDs. By relying on a system of informal beliefs and practices that equate status with merit and eclipse structural disadvantages, the profession convinces international and osteopathic graduates to participate in a system that subordinates them to American-trained MDs. Offering a rare ethnographic look at the inner workings of an elite profession, Doctors’ Orders sheds new light on the formation of informal status hierarchies and their significance for both doctors and patients.




The Corporate Transformation of Health Care


Book Description

This new volume illuminates the growing corporate in-roads into the health care system and its probable consequences, especially for physicians and other practitioners. Its fourteen contributors examine both the delivery and supply functions in the health sector in America. Ambulatory care, hospitals, health maintenance organizations, and health promotion activities are each critically dissected. A major thrust of the investigations focuses upon implications for the medical profession, principally how the increased scrutiny over clinical decision making by corporate purchasers and payors threatens the traditional role and relative autonomy of physicians. Varying theoretical perspectives are debated, with an additional Canadian perspective offered.




Professional Dominance


Book Description




Institutional Work


Book Description

This book contains a series of essays and empirical case studies exploring the nature of institutional work.




Chinese Local Elites and Patterns of Dominance


Book Description

This important volume affords a panoramic view of local elites during the dramatic changes of late imperial and Republic China. Eleven specialists present fresh, detailed studies of subjects ranging from cultivated upper gentry to twentieth-century militarists, from wealthy urban merchants to village leaders. In the introduction and conclusion the editors reassess the pioneering gentry studies of the 1960s, draw comparisons to elites in Europe, and suggest new ways of looking at the top people in Chinese local social systems. Chinese Local Elites and Patterns of Dominance lays the foundation for future discussions of Chinese elites and provides a solid introduction for non-specialists. Essays are by Stephen C. Averill, Lenore Barkan, Lynda S. Bell, Timothy Brook, Prasenjit Duara, Edward A. McCord, William T. Rowe, Keith Schoppa, David Strand, Rubie S. Watson, and Madeleine Zelin. This title is part of UC Press's Voices Revived program, which commemorates University of California Press’s mission to seek out and cultivate the brightest minds and give them voice, reach, and impact. Drawing on a backlist dating to 1893, Voices Revived makes high-quality, peer-reviewed scholarship accessible once again using print-on-demand technology. This title was originally published in 1990.




The Sociology of the Health Service


Book Description

Until now little attention has been paid by sociologists to health policy issues. The Sociology of the Health Service provides an analysis of current policy and covers such topics as privatisation, health education and management.




Medicine and Morality


Book Description

Medical professionals are expected to act in the interest of patients, the public, and the pursuit of medical knowledge. Their disinterested stance gives them credibility and authority. But what happens when doctors’ supposed impartiality comes under fire? In Medicine and Morality, Helen Kang examines three moments in the history of the medical profession in Canada, spanning more than 150 years, when doctors’ moral and scientific authority was questioned. She shows that, in these moments of crisis, the profession was compelled to re-examine its priorities, strategize in order to regain credibility, and redefine what it means to be a good doctor. Medicine and Morality reveals that professional medicine defines integrity, objectivity, accountability, neutrality, and other ideals according to its social, political, historical, and economic struggles with the state, the media, and even the public. In other words, moral and scientific standards in medicine are determined in direct relation to, not in spite of, conflict of interest.




Australia’s Toxic Medical Culture


Book Description

This book explores dominance in Australia’s medical culture through the positioning of international medical graduates (IMGs). It argues that IMGs are ‘othered’ and ultimately positioned as an underclass, a positioning validated and reinforced by the intersecting inequalities of class, race and nation. It also suggests that the positioning of IMGs is organised through the dimensions of structural power, hegemonic power and interpersonal power, which allow an exploration of power relations between the structures of the health system, the Australian medical profession and the agency of IMGs. The Australian narrative presented to the world espouses a community of social justice and human rights. Instead, an historical lens traces the formation and persistence of difference represented in ethnocentrism, racism and xenophobia from 1788 to the present. The research presented is multidisciplinary in scope. An anti-oppressive theoretical framework enables the voices of lived experience to penetrate throughout and a social justice platform engages the participants and the reader into the interwoven conversations. The data set comprises a focus group, 10 individual interviews with IMGs and a selection of inquiry submissions revealing rich and sometimes shocking evidence to paint a stark picture. Other medical voices join the conversation via media responses to revelations of experiences not only by IMGs but also by Australian-trained doctors. It exposes a toxic culture endemic with bullying and sexual harassment.This book is of interest to practitioners, researchers and administrators in the fields of medical education, human resource management, legal studies, health sciences, social sciences, health services, government departments, universities and hospitals, as well as those tasked with duty of care and the provision of a safe workplace. The voices gifted to this study raise awareness of current issues within medicine in Australia at a very personal level and begin to formulate a policy and practical response to address these disturbing revelations.