Gesundheitswesen / Arzt / Praxis.

Written by eminent education scholar Thomas Neville Bonner, Becoming A Physician is a groundbreaking, comprehensive history of Western medical education. The only work of its kind, it covers the United States, Great Britain, France, and Germany. Comparative in focus, the narrative unfolds within the context of social, political, and intellectual transformations that occurred in Europe and North America between the Enlightenment and Nazi Germany. Viewing the late eighteenth century as a watershed in the development of medical education, Bonner begins by describing how earlier practices evolved in the 1800s with the introduction of clinical practices. He then traces the growth of laboratory teaching in the nineteenth century and the twentieth-century preoccupation with establishing a university standard of medical education. Throughout, Bonner pays particular attention to the students, chronicling their daily lives and discussing changes in the medical school population and the various biases-- class, gender, racial, and religious--students and prospective students faced.

All advanced health care systems face severe difficulties in financing the delivery of today's sophisticated medical care. In this study David Wilsford compares the health systems in France and the United States to demonstrate that some political systems are considerably more effective at controlling the cost of care than others. He argues that two variables--the autonomy of the state and the strength and cohesiveness of organized medicine--explain this variance. In France, Wilsford shows, the state is strong in the health policy domain, while organized medicine is weak and divided. Consequently, physicians exercise little influence over health care policymaking. By contrast, in the United States the state is weak, the employers and insurers who pay for health care are fragmented, and organized medicine is strong and well financed. As a result, medical professionals are able to exert a greater influence on policymaking, thus making cost control more difficult. Wilsford extends his comparison to health care systems in the United Kingdom, West Germany, Italy, Canada, and Japan. Whether the private or public sector finances health care, he discovers, there is now an important trend in all of the advanced industrial countries toward controlling escalating costs by curbing both the medical profession's clinical autonomy and physicians' incomes.

How did American doctors come to be licensed on the terms we now take for granted? Licensed to Practice begins with an 1891 shooting in Wheeling, West Virginia, that left one doctor dead and another on trial for his life. Formerly close friends, the doctors had fallen out over the issue of medical licensing. Historian James C. Mohr calls the murder “a sorry personal consequence of the far larger and historically significant battle among West Virginia’s physicians over the future of their profession.” Through most of the nineteenth century, anyone could call themselves a doctor and could practice medicine on whatever basis they wished. But an 1889 U.S. Supreme Court case, Dent v. West Virginia, effectively transformed medical practice from an unregulated occupation to a legally recognized profession. The political and legal battles that led up to the decision were unusually bitter—especially among physicians themselves—and the outcome was far from a foregone conclusion. So-called Regular physicians wanted to impose their own standards on the wide-open medical marketplace in which they and such non-Regulars as Thomsonians, Botanics, Hydropaths, Homeopaths, and Eclectics competed. The Regulars achieved their goal by persuading the state legislature to make it a crime for anyone to practice without a license from the Board of Health, which they controlled. When the high court approved that arrangement—despite constitutional challenges—the licensing precedents established in West Virginia became the bedrock on which the modern American medical structure was built. And those precedents would have profound implications. Thus does Dent, a little-known Supreme Court case, influence how Americans receive health care more than a hundred years after the fact.

Traces the development of the healing art with such related factors and facets as hospitals, apothecaries, medicines, equipment, nursing and midwifery.

Published in 1999, the main aim of this text is to examine the nature of professional control, medical practice and the state of health services in a post-colonial state and the medical profession in Zimbabwe since 1980. The text reviews the theories of professions and professional control and medical practice, it concludes by examining the nature of the Zimbabwean state. The chapter on methodology highlights some of the ethical dilemmas of carrying out research in developing countries. The book then goes on to review health services and policies of both the colonial and post-colonial governments in Zimbabwe. Three chapters discuss the nature of medical practice and the constraints encountered by doctors in their work, the terms and conditions of service under which doctors work, and the nature of medical regulation of education, licensing and discipline including issues such as malpractice and litigation. Throughout the book, comparisons are made with situations in other countries, both developed and developing, and the main conclusions of the book are that medical doctors in Zimbabwe have minimal administrative restrictions on the type of treatment which they can carry out but the unavailability and breakdown of essential equipment, shortages of essential drugs and staff limit the doctors' autonomy to carry out the treatment that they consider necessary.

UK. Study of the problems in medical practice resulting from introduction of the national level medicine and health service act and from the trend towards specialisation by physicians. Statistical tables, and bibliography pp. 377 to 381.