Before World War II, the great majority of practicing doctors in
England and Wales were general practitioners. They performed their
own surgery, and were accustomed to treating a wide variety of
illnesses and symptoms. Specialists were few in number, tended to
practice in large towns, and were often associated with major
hospitals. But rapidly changing medical institutions and services
in the twentieth century have compelled specialization even among
more modest doctors and hospitals. While medical specialization was
not new-for centuries physicians were differentiated from
surgeons-twentieth-century science and technology emphasized and
accelerated this difference rapidly. Medical care began to shift
from services rendered by the general practitioner to the
employment of those doctors with a special interest-for example,
pathology, neurology, or cardiology. Author Rosemary Stevens, an
expert in public health, traces, especially within the last two
centuries, the patterns of English medical practice, institutions,
staffing, and training, and their influence on specialization, the
British National Health Service Act, and post-World War II
developments. Stevens discusses the ever-relevant issues of income
determination, medical education, and the future of the general
practitioner in an age of specialization. Along with its companion
volume, "Medical Practice in Modern England" is a book that will be
of lasting value to scholars of medicine, medical care
organization, economics, and modern social history. It is of
special importance at a time of crisis in the health care systems
of many European Societies. "A fine book. Carefully constructed,
factual, elaborately researched, gracefully written."-George A.
Silver, M.D., professor emeritus of epidemiology and public health,
Yale University. Rosemary Stevens is professor emeritus of history
and sociology of science at the University of Pennsyvlania.
Educated at Oxford, Yale, and Manchester, she has also taught at
Yale University and Tulane University. She is the author of
"American Medicine and the Public Interest" and "In Sickness and in
Wealth: American Hospitals in the Twentieth Century."
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