Technology, Bureaucracy, and Healing in America
"A nice application of philosophy, sociology, anthropology, knowledge of science and clinical medicine to a major contemporary problem…Its brevity, lucidity, and, often, home-spun wisdom make reading this a few hours well spent."—Robert G. Petersdorf, M.D.
"Technology, Bureaucracy, and Healing in America is well written in a clear, flowing, and personal style. It is thought-provoking and should stir wide public interest."—Charles E. Odegaard, professor emeritus of biomedical history, University of Washington
Just when scientists have achieved almost unimaginable technologic advances in extending human lives, many people are experiencing doubts about the value of technology and the physician's role in caring for patients. Along with the great advancements in prolonging life have come the inevitable questions about the quality of life, about equal treatment for all people, including the elderly and the poor, and about the hospital's role in providing a place for such care.
Drawing on his years of experience as both physician and administrator, Roger J. Bulger addresses these and other pressing questions about the state of modern health care. Bulger examines societal values and the inherent expectations built into the American system, which he compares to British policies that assure equal medical care for all. He then discusses the Hippocratic oath and the basic and implied beliefs of working physicians, especially in contrast to those of major medical centers, which must often limit expensive treatments to only a handful of patients.
In writing this volume, Bulger reintegrates the three strands of technology, bureaucracy, and healing into a new, more humane, and more effective approach to health care. He considers HMOs, employee health care benefits, the bottom-line mentality of some hospital chains, the seductive quality of technology, and the psychologic cost of lawsuits on the patient-physician relationship. Though he does not condemn for-profit hospitals and the managerial thinking that often accompanies their operation, he does offer an alternate view toward merging them with more patient-centered policies and care.