Wounded Profession

This important new study explores how American health care evolved in the 1990s, as well as the changes in public support and policy. Birenbaum examines where the interests of consumers and professionals have dovetailed and where they differ. He considers the health care system's future and suggested ways the system must be adjusted to provide better and wider coverage at reasonable costs. This volume is essential reading for scholars, students, and professionals in the medical field, as well as general readers concerned with health care issues. The 90s saw the country moving toward a realization that health care had become unaffordable-or an enormous financial burden for people with otherwise adequate incomes. Health care providers and consumers alike worried that the problem was becoming uncontrollable. Doctors saw their autonomy and control eroded, employers saw their costs rising significantly, the costs began shifting to employees, and alternative approaches to cost containment were explored.

ARNOLD BIRENBAUM is Professor in the Pediatrics Department of the Albert Einstein College of Medicine and Associate Director of the Rose F. Kennedy University Center for Excellence in Developmental Disability Education, Research, and Service.

Preface Introduction Health Care on the National Agenda What's Behind the Changing Doctor-Patient Relationship Driving Down Costs and Professional Autonomy The Reorganization of Health Care Delivery Managed Care and the Profession's Tarnished Jewels in the Crown--Academic Health Centers Doctors Respond to the Dark Side of Managed Care How Managed Care Is Shaping Medical Practice Hopes for Reform The Future of American Medicine Index