In the tradition of C. Wright Mills, Stephen J. Miller defines
and analyzes the power of the medical elite in American elite. He
describes a group of interns who are becoming the successors of the
physicians who determine the character of medicine in a complex
society. The group is at the Harvard Medical Unit of the Boston
City Hospital, and its members are heirs apparent to the elite of
the medical profession.
Miller spent more than a year living with these interns. He
observed them as they worked on the wards, in clinics, and on the
accident floor. He interviewed interns, administrators, teachers,
researchers, and other personnel at the university-affiliated
hospital. He describes how members of the elite are chosen and
promoted, discusses what makes them elite, and demonstrates how
they maintain their elite status. In the course of his analysis he
describes fully the training of these young physicians and how
their internship prepares them for the future role in medicine. The
thrust of the book is to document the training of interns in a
big-city hospital and to describe the operations and
self-perpetuating tactics of elite.
The best or the elite of the medical profession, explains
Miller, are teachers and researchers at medical schools and
particularly those at "name" schools and their affiliated
hospitals. More than half of those who served in the internship
program went on to become professors, deans, chairmen, and
administrators in those institutions. The author describes how
interns serve the purpose of the elite they may someday join: they
provide the bulk of the medical care at the hospital and, by so
doing, free the researchers so that they are able to spend more
time in the laboratory. While much of what interns do is everyday
tasks of caring for patients, those who serve such internships are
taking the first step on a route that leads to membership in the
medical elite
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