Practice Of Uncertainty

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Overview

Incorporating in-depth interviews, statistical data, and prior studies, Fielding illustrates how modern medicine is a victim of its own success. The historical record since the early 19th century shows that the rate of malpractice claims has increased as medicine developed new and more complex procedures. Fielding integrates macro- and micro-levels of analysis to explain how scientific medicine is inherently prone to adverse outcomes no matter how competent medical provides are and how patients often feel their personal experiences and views are marginalized during the course of their medical care. This combination makes it more likely that patients will sue when something goes wrong.

The so-called medical practice crisis is mostly the result of a system of health care that has promoted professional dominance and high-tech care. This system both shapes and is shaped by the daily clinical context in which patients, physicians, and other providers interact. The key policy implication would be to place greater emphasis on primary care and prevention rather than curative or high-tech interventions. For example, aggressive programs to ensure primary care for all, public health, occupational health, and accident reduction would go a long way to improve both the health of the population and reduce the rate of medical malpractice claims.

This book shows how the rate of malpractice claims increases as medicine develops new and more complex procedures.

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Editorial Reviews

Booknews
Incorporates in-depth interviews, statistical data, and prior studies to illustrate how modern medicine is a victim of its own success. Integrates macro- and micro-levels of analysis to explain how scientific medicine is prone to adverse outcomes no matter how competent medical providers are, and discusses how patients feel their personal experiences and views are marginalized during the course of their medical care. Recommends greater emphasis be placed on primary care rather than curative or high-tech interventions. Distributed by Greenwood Publishing Group. Annotation c. by Book News, Inc., Portland, Or.
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Product Details

  • ISBN-13: 9780865692848
  • Publisher: ABC-Clio, LLC
  • Publication date: 4/30/1999
  • Pages: 256
  • Lexile: 1350L (what's this?)
  • Product dimensions: 6.14 (w) x 9.21 (h) x 0.63 (d)

Meet the Author

STEPHEN L. FIELDING is Research Assistant Professor in the Department of Family Medicine at the University of Rochester School of Medicine and Dentistry where he is managing several research projects on women's reproductive health.

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Table of Contents

Illustrations
Foreword
Preface and Acknowledgments
People Interviewed
1 Historical and Social Background 1
2 Setting the Contemporary Stage 25
3 System Accidents 49
4 Uncertainty - Which Diagnosis and Treatment? 69
5 We Were Going to Be Society's Heroes 83
6 Am I the Same? 103
7 Gender and Telling the Story 123
8 The Defense of Wealth 147
9 Implications 171
Afterword: The Limitations of Science and Technology 189
Appendix: Theory and Method 199
Bibliography 211
Index 225
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