We need good data to practise good medicine. However, if a system becomes dominated by electronic health records (EHRs), computerized decision-making programs, and excessive guidelines and protocols, physicians can become pawns in “the silicon cage.” Arnold Eiser, professor of medicine and associate dean at Drexel University College of Medicine, is concerned about the erosion of both the patient-physician relationship and professionalism in the corporate world of American medicine. This postmodern world is characterized by what he calls “the three big C’s” of American medicine: consumerism, computerization, and corporatization. He notes that it is difficult to gain a broad perspective of the changes in health care when you are living through it. To provide an overview, he employs a wide-angle lens that includes postmodern philosophers, contemporary commentators, bioethicists, policy makers, and experiences from other countries (although this final aspect is relatively thin). Eiser begins by recounting the changes since 1970, when the health care system became more corporate. This business model increasingly viewed health care as marketable services and commodities, which was aided by challenges to the tradition of physician power and paternalism, coupled with social trends that favoured individualism, autonomy, and entitlements.
The Racial Divide in American Medicine: Black Physicians and the Struggle for Justice in Health Care
