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Book ChapterDOI

The American Health Care System: Beginning the Twenty‐First Century with High Risk, Major Challenges, and Great Opportunities

11 Nov 2009-pp 391-411
About: The article was published on 2009-11-11. It has received 12 citations till now. The article focuses on the topics: Health care reform & Health care.
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Journal ArticleDOI
TL;DR: Although SES health differences are observed among the elderly in both countries, they are more pronounced in Germany than in the United States where effects are restricted to younger old age.

216 citations

Journal ArticleDOI
TL;DR: This work examines individuals' evaluations of the way physicians do their work and their ability to confront health problems, and finds support for a general public response to social institutions and confidence in medicine tracking closely with confidence in science in level, and education in pattern.
Abstract: Recent work on the sociology of the professions, in general, and on the profession of medicine, in particular, target dramatic changes in the organization of social institutions, "boundary work" among professionals, and the implications of both for professional power. However, public attitudes cited in theories as a critical linchpin of professional status remain relatively unexplored in the face of these changes and widespread contentions of public dissatisfaction. Using data from the 1976 National Survey of Access to Care (Aday, Andersen, and Fleming 1980) and the 1998 General Social Survey (Davis, Smith, and Mardsen 1998), we take advantage of a unique opportunity to compare the public's attitudes across a 20-year period. We examine individuals' evaluations of the way physicians do their work and their ability to confront health problems. Three findings support a complex view of public sentiments. First, while public confidence in physicians remains relatively high, we document a crystallization of attitudes reflecting greater negative and fewer positive sentiments. Second, while neither the structure of attitudes nor the role of sociodemographic characteristics in explaining attitudes has significantly shifted over time, in 1998 health status and insurance status are correlated with negative attitudes. Third, using General Social Survey time trend data on the confidence in medicine compared to other professions (science and education), we find support for a general public response to social institutions, with confidence in medicine tracking closely with confidence in science in level, and education in pattern. We end with four possible explanations of our findings, including and a general discussion of the role of the public in the professional status of physicians and its implications for social change in the institution of medicine.

106 citations

Journal ArticleDOI
TL;DR: Content analysis of a sample of documents shows the medical profession responded to the growth of CAM in three distinct phases, demonstrating the evolutionary process of professionalization, in which dominance is sustained through adaptation to structural change.
Abstract: This research examines trends in coverage of complementary and alternative medicine (CAM) in five prestigious medical journals during a period of intense reorganization within medicine (1965–1999). Content analysis of a sample of documents ( N = 102) shows the medical profession responded to the growth of CAM in three distinct phases. During each phase, changes in the medical marketplace–such as relaxed medical licensing, the development of managed care, rising consumerism, and the establishment of the Office of Alternative Medicine–influenced the type of response in the journals. From the late 1960s to the early 1970s, during the condemnation phase, authors ridiculed, exaggerated the risks, and petitioned the state to contain CAM. In the reassessment phase (mid-1970s through early 1990s), increased consumer utilization of CAM prompted concern, and authors pondered whether patient dissatisfaction and shortcomings in conventional care contributed to this trend. Throughout the 1990s, in the integration phase, struggles to outlaw CAM were abandoned, physicians began learning to work around or administer CAM, and the subjugation of CAM to scientific scrutiny became the primary means of control. This analysis demonstrates the evolutionary process of professionalization, a process in which dominance is sustained through adaptation to structural change.

75 citations

Journal ArticleDOI
18 Dec 2019-PLOS ONE
TL;DR: The need to develop culturally appropriate public health interventions targeting healthcare professionals in order to address stigma and eliminate health disparities among Latinos/as with SMI is supported.
Abstract: Background People living with a Serious Mental Illness (SMI) die earlier than the general population due to preventable medical conditions. Latinos living with SMI are a particularly vulnerable population with higher prevalence of chronic medical conditions. Stigma has been identified as a factor that fosters health inequities for Latinos/as with SMI, particularly Puerto Ricans. Although personal and social consequences of stigmatization have been well documented, research regarding the role of cultural factors on healthcare interactions is scarce. Furthermore, little research has focused on addressing stigma from the perspective of healthcare professionals. Methods We investigated this process through a qualitative design using semi-structured individual interviews with 11 healthcare professionals (8 physicians and 3 nurses) in Puerto Rico. We conducted a thematic analysis to analyze the data. Results Following a thematic analysis, we found three main themes and nine sub-themes related to the stigmatization process. Some participants reported perceptions of dangerousness and uneasiness, social distance and inadequate care. Participants also emphasized a lack of medical training regarding SMI within the Puerto Rican context. Conclusions These findings support the need to develop culturally appropriate public health interventions targeting healthcare professionals in order to address stigma and eliminate health disparities among Latinos/as with SMI.

17 citations

Journal ArticleDOI
01 Jul 2007-Health
TL;DR: Results indicate that coverage of CAM is related to a proportionately older population, disability, innovation in health care financing and expanded licensing for non-physician health care providers, which point to a profession actively monitoring its competitors in a rapidly changing medical marketplace.
Abstract: For decades, complementary and alternative medicine (CAM) has been a topic of discussion within American medical journals. This research examines trends in the amount of coverage CAM receives in top professional journals in US medicine in order to ascertain if the timing of this discussion is linked to demographic, economic or political changes occurring in US society and affecting organized medicine. Pooled time series analyses of the number of published documents in five prestigious American medical journals between 1965 and 1999 were conducted, and findings of models with unlagged and lagged variables are presented. Results indicate that coverage of CAM is related to a proportionately older population, disability, innovation in health care financing and expanded licensing for non-physician health care providers. These associations point to a profession actively monitoring its competitors in a rapidly changing medical marketplace.

12 citations