The Practice of Uncertainty: Voices of Physicians and Patients in Medical Malpractice Claims

By Stephen L. Fielding | Go to book overview

amounts, and the intense pursuit of industrialism has fostered a greater sense of individualism since the 1970s. People sue because there are no other formalized means of redress. The media also shape the debate by sensationalizing the topic. Stories often focus on physicians and patients as perpetrators or victims, rather than providing thoughtful analyses of the situations that led to the outcomes. Finally, the evidence shows that women have more contacts with the health care system than men; therefore, they are injured more often during medical treatment.

In the next chapter we will see how the background from Chapters 1 and 2 create uncertainty in medicine by increasing the chances of system accidents.


NOTES
1.
C. Wright Mills, The Power Elite ( New York: Oxford University Press, 1956). His central argument is that a triad exists among the government, big corporations (e.g., the Business Roundtable), and the military (i.e., the Pentagon). Many of the leaders from these segments move between each of these groups and are sensitive to the concerns of the others. A shadow governing body results which places the concerns of these elites over those of the public.
2.
Sylvia A. Law, "Blue Cross--What Went Wrong?" in The Sociology of Health and Illness: Critical Perspectives, ed. Peter Conrad and Rochelle Kern ( New York: St. Martin's Press, 1994), 261-69; Paul Starr, "The Commercial Edge and the Accommodation of Insurance," in The Sociology of Health and Illness: Critical Perspectives, ed. Peter Conrad and Rochelle Kern ( New York: St. Martin's Press, 1994), 269-74.
3.
For a more detailed overview of the history of health care policy in the United States, see Kant Patel and Mark E. Rushefsky, Health Care Politics and Policy in America ( New York: M. E. Sharpe, 1995).
4.
In 1946, Congress passed Public Law 79-725, the Hospital Survey and Construction Act, widely known as the Hill-Burton Act, sponsored by Senators Lister Hill and Harold Burton. It was the nation's major health facility construction program under Title VI of the Public Health Service Act. Originally designed to provide federal grants to modernize hospitals that had become obsolete owing to a lack of capital investment throughout the period of the Great Depression and World War II ( 1929 to 1945), the program has changed over time to address other types of infrastructure needs. Since 1946 more than $4.6 billion in Hill- Burton grant funds and $1.5 billion in loans have aided nearly 6,800 health care facilities in over 4,000 communities. In return for federal funds, facilities agree to provide free or reduced charge medical services to persons unable to pay. In 1970 direct loans and loan guarantees with interest subsidies to facilities were authorized, and in 1972 a twenty-year limit was placed on the provision of uncompensated services and specific requirements for providing uncompensated services. (Courtesy of the Federal Bureau of Health Resources Development.)
5.
Stanley Wohl, The Medical-Industrial Complex ( New York: Harmony Books, 1984).

-43-

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The Practice of Uncertainty: Voices of Physicians and Patients in Medical Malpractice Claims
Table of contents

Table of contents

  • Title Page iii
  • Contents vii
  • Illustrations ix
  • Foreword xi
  • Preface and Acknowledgments xv
  • People Interviewed xvii
  • Notes xxiii
  • 1 - Historical and Social Background 1
  • 2 - Setting the Contemporary Stage 25
  • Notes 43
  • 3 - System Accidents 49
  • Notes 66
  • 4 - Uncertainty -- Which Diagnosis and Treatment? 69
  • Summary 81
  • 5 - We Were Going to Be Society's Heroes 83
  • Summary and Discussion 98
  • 6 - Am I the Same? 103
  • 7 - Gender and Telling the Story 123
  • Summary 144
  • 8 - The Defense of Wealth 147
  • Notes 168
  • 9 - Implications 171
  • Notes 196
  • Appendix - Theory and Method 199
  • Notes 208
  • Bibliography 211
  • Index 225
  • About the Author 231
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