Remaking the American Patient: How Madison Avenue and Modern Medicine Turned Patients into Consumers

Remaking the American Patient: How Madison Avenue and Modern Medicine Turned Patients into Consumers

Remaking the American Patient: How Madison Avenue and Modern Medicine Turned Patients into Consumers

Remaking the American Patient: How Madison Avenue and Modern Medicine Turned Patients into Consumers

Synopsis

In a work that spans the twentieth century, Nancy Tomes questions the popular--and largely unexamined--idea that in order to get good health care, people must learn to shop for it. Remaking the American Patient explores the consequences of the consumer economy and American medicine having come of age at exactly the same time. Tracing the robust development of advertising, marketing, and public relations within the medical profession and the vast realm we now think of as "health care," Tomes considers what it means to be a "good" patient. As she shows, this history of the coevolution of medicine and consumer culture tells us much about our current predicament over health care in the United States. Understanding where the shopping model came from, why it was so long resisted in medicine, and why it finally triumphed in the late twentieth century helps explain why, despite striking changes that seem to empower patients, so many Americans remain unhappy and confused about their status as patients today.

Excerpt

A few years ago, while cleaning out the bathroom closet of my childhood home, I found an old prescription bottle. Its label carried simply the date, March 6, 1965, the name and telephone number of the drugstore, my name (misspelled), my home address (correct), my doctor’s name, and these cryptic directions: “One every four hours until relieved.” Unlike a prescription I recently filled at my supermarket pharmacy, there was no drug name with its generic equivalent, no number of allotted refills, no patient information leaflet explaining the conditions that the drug might remedy and the list of side effects I might expect.

Through the long labor of writing this book, I have kept that old bottle in front of me as a reminder of the past landscape of patienthood that I have tried to capture. My 1965 prescription came from Dr. William J. Moore, a Norman Rockwell–style general practitioner who still made house calls and had my family’s worshipful respect. The medication was prepared at FrankelKlapheke’s, a tiny, dark drugstore that sold almost nothing except medicine. At that time, patients were to be seen and not heard, and no one—in my family at least—thought to second-guess the doctor’s recommendations. At my local public library, the Physicians’ Desk Reference—that Bible of all things prescription-drug-related—was likely kept behind the librarians’ desk, along with the sex books, safe from inquisitive patient eyes. I saw plenty of drug ads on TV, but only for over-the-counter remedies; my generation grew up hearing about the plop, plop, fizz, fizz of Alka Seltzer and the fast, fast pain relief of Excedrin. But in my youth, ads did not invoke the magic of the lifesaving operation and miracle drug. Those seemed to be sacred goods, set apart from the commercial frenzy associated with hula hoops, cars with fins, and avocado green refrigerators. In those days, medicine seemed more protected from the unsavory aspects of modern capitalism.

As I have learned in writing this book, that image of separateness was in many ways illusory: already by the 1960s, the changes were under way that would turn my doctor’s office and Frankel-Klapheke’s drugstore into relics of a bygone age. But like most Americans, my awareness of that sweeping . . .

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