Medicine in America, argues Professor Howard Stein, is not merely the product of a biomedical model, but rather an intricate human culture. In this ethnographic study of the American medical system, Dr. Stein uses anthropological, small-group, and psychoanalytic paradigms to interpret diverse and often hidden aspects of medical culture in the United States.Based on two decades of teaching and counseling physicians, Dr. Stein's case studies allow us to hear doctors speak candidly about themselves, their feelings, their fears of failure, their interactions with nurses and other hospital staff, and the ways in which they sometimes internalize the problems of their patients. We also learn how doctors come to label their clients as "good" or "bad" patients, and we see how these labels can affect a patient's care. In addition, Dr. Stein explores the rich symbolism of money in a profession that has great difficulty discussing financial concerns with its clients.Taking the reader on an odyssey through the socialization process of becoming a physician in America, Dr. Stein links the culture of medicine with both the psychodynamics of individual practitioners and the currents of American society at large. He uncovers a rich vein of moralism lying beneath medicine's official position of scientific neutrality and finds that American values such as activism and mastery, and metaphors from competitive sports, warfare, and technology pervade clinical decisionmaking, treatment, and education.This is a fascinating study of a complex culture within our society, a book that will interest scholars, students, and the general reader.
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