The Social Transformation Of American Medicine: The Rise Of A Sovereign Profession And The Making Of A Vast Industry / Edition 1

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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

A landmark history of how the entire American health care system has evolved over the last two centuries.

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Editorial Reviews

Charles McGrath
....This important book is written with wit, irony and great style. --The New York Times Books of the Century
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Product Details

  • ISBN-13: 9780465079353
  • Publisher: Basic Books
  • Publication date: 6/5/1984
  • Edition description: Reprint
  • Edition number: 1
  • Pages: 528
  • Sales rank: 179,301
  • Lexile: 1440L (what's this?)
  • Product dimensions: 6.00 (w) x 9.50 (h) x 1.20 (d)

Meet the Author

Paul Starr is Professor of Sociology and Public Affairs at Princeton University and its Woodrow Wilson School of Public Affairs. He is the author of the Pulitzer Prize-winning The Social Transformation of American Medicine and The Creation of the Media. Starr is the co-founder and editor of The American Prospect. He lives in Princeton, New Jersey.

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Table of Contents

Preface ix
Acknowledgments xiii
Book 1 A Sovereign Profession: The Rise of Medical Authority and the Shaping of the Medical System
Introduction: The Social Origins of Professional Sovereignty 3
The Roots of Authority
Dependence and Legitimacy
Cultural Authority and Occupational Control
Steps in a Transformation
The Growth of Medical Authority
From Authority to Economic Power
Strategic Position and the Defense of Autonomy
Chapter 1 Medicine in a Democratic Culture, 1760-1850 30
Domestic Medicine
Professional Medicine
From England to America
Professional Education on an Open Market
The Frustration of Professionalism
The Medical Counterculture
Popular Medicine
The Thomsonians and the Frustration of Anti-Professionalism
The Eclipse of Legitimate Complexity
Chapter 2 The Expansion of the Market 60
The Emerging Market Before the Civil War
The Changing Ecology of Medical Practice
The Local Transportation Revolution
Work, Time, and the Segregation of Disorder
The Market and Professional Autonomy
Chapter 3 The Consolidation of Professional Authority, 1850-1930 79
Physicians and Social Structure in Mid-Nineteenth-Century America
Medicine's Civil War and Reconstruction
The Origins of Medical Sectarianism
Conflict and Convergence
Licensing and Organization
Medical Education and the Restoration of Occupational Control
Reform from Above
Consolidating the System
The Aftermath of Reform
The Retreat of Private Judgment
Authority over Medication
Ambiguity and Competence
The Renewal of Legitimate Complexity
Chapter 4 The Reconstitution of the Hospital 145
The Inner Transformation
Hospitals Before and After 1870
The Making of the Modern Hospital
The Triumph of the Professional Community
The Pattern of the Hospital System
Class, Politics, and Ethnicity
The Peculiar Bureaucracy
Chapter 5 The Boundaries of Public Health 180
Public Health, Private Practice
The Dispensary and the Limits of Charity
Health Departments and the Limits of Government
From Reform to the Checkup
The Modernization of Dirt and the New Public Health
The Prevention of Health Centers
Chapter 6 Escape from the Corporation, 1900-1930 198
Professional Resistance to Corporate Control
Company Doctors and Medical Companies
Consumers' Clubs
The Origins and Limits of Private Group Practice
Capitalism and the Doctors
Why No Corporate Enterprise in Medical Care?
Professionalism and the Division of Labor
The Economic Structure of American Medicine
Book 2 The Struggle for Medical Care: Doctors, the State, and the Coming of the Corporation
Chapter 1 The Mirage of Reform 235
A Comparative Perspective
The Origins of Social Insurance
Why America Lagged
Grand Illusions, 1915-1920
The Democratization of Efficiency
Labor and Capital Versus Reform
Defeat Comes to the Progressives
Evolution in Defeat, 1920-1932
The New Deal and Health Insurance, 1932-1943
The Making of Social Security
The Depression, Welfare Medicine, and the Doctors
A Second Wind
Symbolic Politics, 1943-1950
Socialized Medicine and the Cold War
Three Times Denied
Chapter 2 The Triumph of Accommodation 290
The Birth of the Blues, 1929-1945
The Emergence of Blue Cross
Holding the Line
The Physicians' Shield
The Rise of Private Social Security, 1945-1959
Enter the Unions
A Struggle for Control
The Growth of Prepaid Group Practice
The Commercial Edge
The Accommodation of Insurance
Chapter 3 The Liberal Years 335
Aid and Autonomy, 1945-1960
Public Investment in Science
The Tilt Toward the Hospital
The Structural Impact of Postwar Policy
The New Structure of Opportunity
The New Structure of Power
Redistribution without Reorganization, 1961-1969
The Liberal Opportunity
Redistributive Reform and Its Impact
The Politics of Accommodation
Chapter 4 End of a Mandate 379
Losing Legitimacy, 1970-1974
Discovery of a Crisis
The Contradictions of Accommodation
The Generalization of Rights
The Conservative Assimilation of Reform
Health Policy in a Blocked Society, 1975-1980
An Obstructed Path
The Generalization of Doubt
The Liberal Impasse
The Reprivatization of the Public Household
Chapter 5 The Coming of the Corporation 420
Zero-Sum Medical Practice
The Doctor "Surplus" and Competition
Collision Course
The Growth of Corporate Medicine
Elements of the Corporate Transformation
The Consolidation of the Hospital System
The Decomposition of Voluntarism
The Trajectory of Organization
Doctors, Corporations, and the State
Notes 450
Index 496
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  • Anonymous

    Posted December 14, 2009

    Best book on the evolution of the US healthcare system I've read.

    Clearly demonstrates the growth of the healthcare system and its stakeholders and the complexities in impacting it and making positive change. A must read for anyone in healthcare and those trying to change it for the better.

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