As the journey continues into the history of American medicine, Paul Starr offers elegant an elegant summation of very through book, he also paints a detailed picture of today’s health care sector--even if his ‘today’ was thirty years ago. The observations he made and prediction of the pattern of growth of corporation in the healthcare sector are as valid today as they were in 1980s.
Foreign-Trained doctors (aka Foreign Medical Graduates).
Presumably a product of the shortage of doctors, but in reality a way to bridge access disparities in less fortunate populations, foreign-trained doctors, who came to be affectionately called FMG, found America to be a medical haven. It was common knowledge among medical graduates that as a doctor in America you will either be rich or live comfortably trying. As Starr pointed out, this has created remarkable ethnic diversity in the medical field and perhaps was also to the immediate advantage of immigrant populations who may reside in the same practice area as the physician, which often naturally happens because of the way immigrants tend to ‘group’ themselves in certain districts, cities, or around major religious establishment.
Presumably a product of the shortage of doctors, but in reality a way to bridge access disparities in less fortunate populations, foreign-trained doctors, who came to be affectionately called FMG, found America to be a medical haven. It was common knowledge among medical graduates that as a doctor in America you will either be rich or live comfortably trying. As Starr pointed out, this has created remarkable ethnic diversity in the medical field and perhaps was also to the immediate advantage of immigrant populations who may reside in the same practice area as the physician, which often naturally happens because of the way immigrants tend to ‘group’ themselves in certain districts, cities, or around major religious establishment.
The Breakdown of the Doctor-Patient Relationship.
Medicine’s “authority and strategic position” have indeed slowly “eroded” over time. And I believe that the breakdown and weakening of the relationship between the doctor and his patients, partially because of increasing specialization, has contributed to this erosion of position of authority. The doctor went from a confidante who knew all family members by name, who frequently has seen the inside of their home on many occasions, and who took phone calls from concerned patients to a person simply doing their job. Doctors became more entrepreneurial and patients sensed it. This air of business about doctors made them seem all the less trustworthy, and all the more potentially adversaries; hence, as Paul Starr noted, the increase in medical malpractice suits.
Medicine’s “authority and strategic position” have indeed slowly “eroded” over time. And I believe that the breakdown and weakening of the relationship between the doctor and his patients, partially because of increasing specialization, has contributed to this erosion of position of authority. The doctor went from a confidante who knew all family members by name, who frequently has seen the inside of their home on many occasions, and who took phone calls from concerned patients to a person simply doing their job. Doctors became more entrepreneurial and patients sensed it. This air of business about doctors made them seem all the less trustworthy, and all the more potentially adversaries; hence, as Paul Starr noted, the increase in medical malpractice suits.
The Culture of Medicine.
At the end of the chapter, Paul Starr makes an excellent summation: the culture of medicine has shifted from domination by ideals like professionalism and voluntarism, to a profit centered focus. The shift, once happens, is irreversible but its effects can be mitigated. With the age of corporate medicine here to stay, the biggest challenge is equitable access, I agree with Starr, because corporations are not charities. I looked up recent articles and editorials by the author to note how he had viewed the health care reform efforts, not necessarily the mandate or the individual items on the bill, but rather the efforts themselves. I came across this article here .While he has a lot to say about the reform, he lauds the attempt of the organization of health care around justice and efficiency. In my follow up of issues pertaining to health care reform, Paul Starr will definitely be on my list of authors to consult.
And as Paul Starr suggests, “a trend is not necessarily fate.” The choice, and with it the future, lies in America’s hands.
At the end of the chapter, Paul Starr makes an excellent summation: the culture of medicine has shifted from domination by ideals like professionalism and voluntarism, to a profit centered focus. The shift, once happens, is irreversible but its effects can be mitigated. With the age of corporate medicine here to stay, the biggest challenge is equitable access, I agree with Starr, because corporations are not charities. I looked up recent articles and editorials by the author to note how he had viewed the health care reform efforts, not necessarily the mandate or the individual items on the bill, but rather the efforts themselves. I came across this article here .While he has a lot to say about the reform, he lauds the attempt of the organization of health care around justice and efficiency. In my follow up of issues pertaining to health care reform, Paul Starr will definitely be on my list of authors to consult.
And as Paul Starr suggests, “a trend is not necessarily fate.” The choice, and with it the future, lies in America’s hands.
No comments:
Post a Comment