The Involvement of the Behavioral Sciences in American Medicine: A Historical Perspective

1981 ◽  
Vol 11 (4) ◽  
pp. 583-596 ◽  
Author(s):  
Elianne Riska ◽  
Peter Vinten-Johansen
Keyword(s):  
Medical Education ◽  
Behavioral Science ◽  
Care Delivery ◽  
Medical Profession ◽  
The United States ◽  
Theory And Practice ◽  
Physician Patient Relationship ◽  
American Medicine ◽  
Physician Patient ◽  
Existing Structure

This paper discusses the medical profession's underlying motivations in initiating recent changes in medical education in the United States. The first part briefly examines the transition from a holistic to a scientific theory and practice in American medicine. The second part of the paper analyzes and interprets the increasing incorporation of behavioral scientists into medical education in recent decades. A review of the debate on reforms in medical education, appearing in The Journal of the American Medical Association since the 1940s, indicates that the primary function of these behavioral scientists is to provide future physicians with techniques for managing problems in the physician-patient relationship. The concluding interpretation is that behavioral science expertise is actually used to strengthen and legitimize the traditional status of the medical profession in the existing structure of health care delivery.

An Assessment of Simulations on an : International Organization

1985 ◽  
Vol 47 ◽  
pp. 4-5
Author(s):  
Paul F. Diehl ◽  
Michael J. Montgomery
Keyword(s):  
United States ◽  
United Nations ◽  
Political Science ◽  
International Organizations ◽  
Recent Literature ◽  
The United States ◽  
Theory And Practice ◽  
International Organization ◽  
Potential Value ◽  
Existing Structure

Simulation is an increasingly popular pedagogical device; much of the recent literature on the theory and practice of political science instruction attests to this. Probably the most popular simulation device is called model United Nations. In recent articles in Teaching Political Science and NEWS for Teachers of Political Science, William Hazelton and James Jacob have described Model United Nations in glowing terms, focusing on one particular conference and completely ignoring the rest of the 200 or more conferences held annually across the United States.Like Jacob and Hazelton, we recognize the great potential value of United Nations simulations in trying to illuminate the often confusing politics of international organizations. As former participants and directors of these programs, however, we are keenly aware of the shortcomings and difficulties associated with the existing structure of model U.N. programs.

MEDICAL FALLIBILITY

PEDIATRICS ◽  
1977 ◽  
Vol 60 (2) ◽  
pp. 243-243
Author(s):  
Gorovitz ◽  
MacIntyre ◽  
Keyword(s):  
Medical Error ◽  
Medical Profession ◽  
Medical Science ◽  
Medical Problem ◽  
Medical Sciences ◽  
Physician Patient Relationship ◽  
The Public ◽  
Iatrogenic Illness ◽  
The Individual ◽  
Physician Patient

At present, the typical patient is systematically encouraged to believe that his physician will not make a mistake, even though what the physician does may not achieve the desired medical objectives, and even though it cannot be denied that some physicians do make mistakes. The encouragement of this inflated belief in the competence of the physician is of course reinforced by the practice of not keeping systematic and accessible records of medical error. Yet everyone knows that this is a false confidence . . . the current high incidence of iatrogenic illness constitutes a medical problem of enormous proportions, well recognized within government agencies and segments of the medical profession, but only dimly suspected by the public at large. There is still a relatively high probability of a patient suffering from medical error. What patients and the public have to learn is to recognize, accept, and respond reasonably to the necessary fallibility of the individual physician. The physician-patient relationship has to be redefined as one in which necessarily mistakes will be made, sometimes culpably, sometimes because of the state of development of the particular medical sciences at issue, and sometimes, inevitably, because of the inherent limitations in the predictive powers of an enterprise that is concerned essentially with the flourishing of particulars, of individuals. The patient and the public therefore must also understand that medical science is committed to the patient's prospering and flourishing, and that the treatment of the patient is itself a part of that science and not a mere application of it.

The Patient’s Experience

2010 ◽  
Author(s):  
Max Fink MD
Keyword(s):  
Family Members ◽  
The United States ◽  
Physician Patient Relationship ◽  
Electroconvulsive Treatment ◽  
Video Images ◽  
Treatment Room ◽  
Consent Procedure ◽  
The Media ◽  
Popular Images ◽  
Physician Patient

The popular images of electroshock presented in the media reflect practices that were discarded more than 40 years ago. The films One Flew Over the Cuckoo’s Nest and A Beautiful Mind portray imaginative Hollywood images—not reality. The dramatic scene of a pleading patient dragged to a treatment room, forcibly administered electric currents as his jaw clenches, his back arches, and his body shakes while being held down by burly attendants or by foot and wrist restraints, is false. Patients are not coerced into treatment. They may be anxious and reluctant, but they come willingly to the treatment room. They have been told why the treatment is recommended, the procedures have been explained, and many have seen DVD or video images of the procedures. Each patient has consented to the treatment in writing, and in many instances, family members have also agreed. Understandably, the patient may be hesitant about the first treatment. He has seen those movies, so the procedures are explained again, and, except for feeling a needle placed in his vein and electrodes and measuring devices attached to his body, the patient is unaware of the treatment as it occurs. One patient described his treatment this way: “It is a nonentity, a nothing. You go to sleep, and when you wake up, it is all over. It is easier to take than going to the dentist.” Many patients ask to be treated early in the morning so that they can return to the day’s activities as soon as possible. It is not uncommon for patients to reassure family members about the procedure. Doctors frequently ask an experienced patient to explain the procedures and the discomforts to a candidate; patients undergoing ECT have proved to be its best advocates. A consent form, voluntarily signed by each patient, is a necessary part of electroconvulsive treatment in the United States. Such a consent procedure is uncommon in psychiatric practice, and was developed to address concerns about abuse at a time when public distrust of governmental authority was widespread and had affected the physician-patient relationship. In most venues, doctors accept the patient’s cooperation with medication treatment and psychotherapy as consent.

Codification and the Origins of Physician-Patient Privilege

2020 ◽  
Vol 32 (1) ◽  
pp. 78-102
Author(s):  
MILES WILKINSON
Keyword(s):  
Nineteenth Century ◽  
New York ◽  
Medical Profession ◽  
The United States ◽  
Primary Sources ◽  
Professional Status ◽  
Rapid Spread ◽  
American Law ◽  
Judicial Proceedings ◽  
Physician Patient

Abstract:This essay examines the origins of physician-patient privilege in the United States. It concentrates an 1828 New York law that protected medical confidentiality in the courtroom—the first statutory guarantee of physician-patient privilege—as well as the rapid spread of privilege statutes throughout the nineteenth century. Using the published notes of the authors of New York’s influential statute alongside other primary sources, I argue that these early statutes are best explained as the result of nineteenth-century efforts to codify American law. The medical profession took little note of physician-patient privilege until much later, indicating that privilege emerged not as a protection of doctors’ professional status, nor as a means of protecting patients in the courtroom, but rather as an inadvertent offshoot of attempts to streamline and simply judicial proceedings. It is perhaps because of these unsystematic origins that physician-patient privilege still remains such an unevenly applied rule in American courtrooms.

James Herrick (1861–1954): Consultant physician and cardiologist

2018 ◽  
Vol 26 (2) ◽  
pp. 132-136
Author(s):  
Todd M Olszewski
Keyword(s):  
Medical Profession ◽  
Case Reports ◽  
Coronary Thrombosis ◽  
The United States ◽  
Laboratory Evaluation ◽  
American Medicine ◽  
Consultant Physician ◽  
Integral Role ◽  
History Of ◽  
Clinical Description

In 1910, James Bryan Herrick published the first clinical and laboratory description of sickle cell anemia. Two years later, he published a case report on coronary thrombosis. Together, these case reports solidified his reputation as one of the premier diagnosticians of his generation. Now regarded as a central figure in the history of American medicine, Herrick played an integral role in the clinical adoption of the electrocardiograph and the professionalization of cardiology in the United States. Although a full decade passed before the medical profession recognized his clinical description of coronary thrombosis and myocardial infarction, it has had profound implications for cardiovascular medicine and prevention over the past hundred years. As a consultant physician, Herrick advocated in favor of incorporating chemistry and laboratory evaluation into clinical practice.

scholarly journals Az internet hatása az orvos–beteg viszonyra

2016 ◽  
Vol 157 (17) ◽  
pp. 680-684 ◽  
Author(s):  
Ilona Gaal
Keyword(s):  
Communication Skills ◽  
Medical Profession ◽  
Theoretical Models ◽  
The Internet ◽  
Decision Making Process ◽  
Daily Routine ◽  
Patient Relationship ◽  
Physician Patient Relationship ◽  
Necessary Evil ◽  
Physician Patient

Internet became an inevitable phenomenon in the physician–patient relationship. The author analyzes it in two theoretical models: the effects on the medical profession and the interference with the decision making process. These will help to explain why patients search the internet for information about their illness, cure and their doctors. Some physicians dislike this, and they are not just worried about the patient, but about their own position and time. This fear is groundless, even if the internet patient can be hard to tackle in the daily routine. Internet can be seen not only as a necessary evil, but with proper communication skills physicians can benefit from their patients’ passion to internet. Orv. Hetil., 2016, 157(17), 680–684.

Health Promotion in Medical Education

1988 ◽  
Vol 3 (1) ◽  
pp. 37-51 ◽  
Author(s):  
Steven Jonas
Keyword(s):  
Health Promotion ◽  
Medical Education ◽  
Disease Prevention ◽  
Medical School ◽  
Care Delivery ◽  
Medical Science ◽  
Problem Based Learning ◽  
Medical Schools ◽  
The United States ◽  
Care Hospital

A significant portion of the deaths in the United States could have been prevented or postponed using known interventions. One reason this did not occur is because medical science and medical education are disease, not health, oriented. Since physicians are at the center of the health care delivery system, their disease orientation pervades the industry. Historically, there have been calls for physicians to focus more on disease prevention; however, medical education does not teach disease prevention/health promotion. There are several reasons for this: 1) medical school faculty conceptual discordance between “certainty” of curative disease vs. the “probability” of risk factor reduction; 2) gaps in the knowledge of effective interventions; 3) the concept that health promotion/disease prevention are outside the province of physicians; 4) the significant role of biomedical research grants on medical school funding; 5) the close association of medical education and the acute care hospital; and 6) the use of rote memory/lecture based teaching methods of traditional medicine vs. the problem-based learning necessary to teach disease prevention/health promotion. Some medical schools have begun to use problem based learning and to introduce health promotion concepts. Widespread and long-lasting change requires support of the leadership in medical schools and the preventive medicine/public health community, and grant funding from state and federal sources to support research on medical education research and change.

THE PRESIDENT'S PAGE

PEDIATRICS ◽  
1952 ◽  
Vol 10 (3) ◽  
pp. 335-336
Author(s):  
WARREN W. QUILLIAN
Keyword(s):  
Medical Education ◽  
Panel Discussion ◽  
The United States ◽  
The Past ◽  
American Medicine ◽  
History Of ◽  
New Ideas ◽  
Organized Medicine ◽  
The Individual ◽  
School Curricula

WITHIN the past few years American medicine has made tremendous strides in prestige and influence. The Academy has contributed its part to this advance. But, progress has not been gained by accident. Behind the scenes in organized medicine are many conscientious and tireless workers who, by their enthusiasm and consecrated effort, are accomplishing the tasks with which they are confronted. Committee members are often unsung heroes in the solution of problems pertaining to the furtherance of more adequate medical care for children. The individual Academy member occasionally forgets how much so many of us owe to so few in the practical application of our ideals. For example, those of you who attended the Annual Meeting at Toronto last fall heard the panel discussion on Pediatric Education; and saw the exhibit, describing some of the aims and objectives of our Committee on Medical Education. Under the inspired leadership of the Chairman, Dr. Lee F. Hill, this group is making progress in attempting to answer some of the questions posed by the Academy Survey of 1946-48. During the current year, continuation of regional conferences throughout the United States and Canada, with emphasis upon the problems of undergraduate education, has resulted in an intelligent exchange of ideas and an opportunity for discussion unparalleled in the history of North American medical schools. The inevitable result of these discussions will be an improvement of standards for medical education. Interpretation and evaluation of new ideas, inclusion of practical and progressive concepts for the betterment of medical school curricula, requires a great deal of time and effort.

Labor Law and Physicians' Privileged Position: An Example of Structural Interest Influence

1982 ◽  
Vol 12 (2) ◽  
pp. 249-261
Author(s):  
Paul M. Swiercz ◽  
James K. Skipper
Keyword(s):  
Health Care ◽  
Interest Groups ◽  
Political Institutions ◽  
Social Economic ◽  
Care Delivery ◽  
Medical Profession ◽  
Labor Law ◽  
The United States ◽  
Privileged Position ◽  
Group A

Health care delivery in the United States may be characterized as a dynamic system of conflicting interest groups. Since the reorganization of the medical profession in 1910, however, physicians have been able to maintain their position as a dominant structural interest group. A dominant structural interest in one which is served by the structure of social, economic, and political institutions. It does not have to reorganize continuously to protect its privileged position. Although several medical sociologists have noted the privileged position of physicians, few have attempted to explicate the process of status maintenance. This paper examines the development of labor law in health care as one example of structural interest influence. Labor law provides an excellent illustration of this influence in that its development and application are far removed from the physicians' sphere of direct influence. It is demonstrated that the ideology that physicians should hold a privileged position is so ingrained that their interests are protected even in their absence.

The Physician-Patient Relationship and a National Health Information Network

2010 ◽  
Vol 38 (1) ◽  
pp. 36-49 ◽  
Author(s):  
Leslie Pickering Francis
Keyword(s):  
Electronic Health Records ◽  
Health Information ◽  
National Health ◽  
The United States ◽  
Care Quality ◽  
Information Network ◽  
Physician Patient Relationship ◽  
Health Records ◽  
Electronic Health ◽  
Physician Patient

The United States, like other countries facing rising health care costs, is pursuing a commitment to interoperable electronic health records. Electronic records, it is thought, have the potential to reduce the risks of error, improve care coordination, monitor care quality, enable patients to participate more fully in care management, and provide the data needed for research and surveillance. Interoperable electronic health records on a national scale — the ideal of a national health information network (or NHIN) — seem likely to magnify these advantages. Thus, the recent economic stimulus package contains considerable funding for the development of “health information technology architecture that will support the nationwide electronic exchange and use of health information in a secure, private, and accurate manner.”

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