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Books > Social sciences > Sociology, social studies > Social issues > Illness & addiction: social aspects
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Conflicted Care - Doctors Navigating Patient Welfare, Finances, and Legal Risk (Hardcover)
Loot Price: R1,795
Discovery Miles 17 950
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Conflicted Care - Doctors Navigating Patient Welfare, Finances, and Legal Risk (Hardcover)
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An eye-opening and compelling ethnography about how doctors make
decisions The oath that doctors take to "do no harm" suggests that
patient welfare is at the center of what it means to be a
successful medical professional. It is also understood, however,
that hospitals are not only vessels for medical care-they are
businesses, educational institutions, and complex bureaucracies
with intricate codes of etiquette that dictate how each staff
member should approach situations with patients. In Conflicted
Care, Hyeyoung Oh Nelson provides an in-depth look at the
decision-making processes of physicians at a large, prestigious
academic medical center-that she calls Pacific Medical Center-and
finds that more often than not patient wellbeing is only one of
several factors governing day-to-day decisions. The steps
physicians take reveal a kind of hidden curriculum of the medical
world, one that is guided by status and hierarchy, bureaucracy,
norms for consulting with third-parties, regulations for
interactions with patients, and medical uncertainty. While at an
institutional and individual level patient care continues to be
integral to everything the physicians do, they are forced to
reconcile that vow with these other, often-conflicting internal
logics. Harm, Nelson argues, is thus built into the practice of
medicine in the United States. This harm can take the form of
unnecessary treatments and consultations or inadequate treatment
for pain to motivate specialist intervention that would otherwise
be resisted. These and other practices have the overall consequence
of significantly driving up inpatient care costs, which then
results in patients forgoing needed, ongoing treatment once they
receive their medical bills. Drawing on a deep ethnography of
physicians in the Internal Medicine Service unit, Nelson offers a
sharp assessment of current policies aimed at alleviating medical
costs and explains why they are ineffective. She concludes by
offering novel policy and practice recommendations for health care
practitioners, policy makers, and healthcare institutions.
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