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

By Stephen L. Fielding | Go to book overview

8
THE DEFENSE OF WEALTH

We have seen how physician-patient interaction within the clinical setting is influenced by historical, organizational, legal, and cultural factors. These factors shape how patients and physicians act and react as conditions change. Central to this change are the development and implementation of medical technology. As physicians become more dependent on technology, they become more like technicians. For example, Robert Zussman has shown in his study of intensive care units (ICUS) that ICU physicians become so much like technicians that their focus on patients is reduced to quantifiable readouts on the patients' physiological status. Curing patients is not the goal. 1 ICU physicians attempt to stabilize their patients' physiological systems so they can be returned to their regular attending physicians.

Although ICU patients and their families accept the fact that technical expertise is more important than humanism, they greatly miss the humanistic touch. Under these circumstances, when something goes wrong (from the perspective of the patient or her family), they are more likely to believe that the physician(s) did not act properly. The interviews here show that patients are then more likely to feel that they did not receive quality service and are more likely to sue in order to receive compensation, among other things.

Physicians and patients thus shape their world while they are also shaped by it. In much the same way, the people running institutions

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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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