The State Of Medicine

"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.

The NHS is 'the closest thing the UK has to a national religion'. No wonder: it has worked secular miracles. Before the NHS, sick children could not see a doctor before a sixpence was handed over. People died of whooping cough and tuberculosis, illnesses we now scarcely see. When the NHS was founded, almost 70 years ago, people in the UK lived less than 50 years on average - a lifespan which has almost doubled. No matter how poor we are, our health care is included with British citizenship. But the NHS has also been accused of high death rates, lazy and uncaring staff, dirty hospitals and unbridgeable funding gaps. Every politician claims to know how to save the NHS. Margaret McCartney argues differently. She believes that the NHS is world class: but politicians have to stop micromanaging based on faith in their own political beliefs and instead base decisions on evidence. Patients and professionals working together to deliver an evidence-based NHS is the only future - if we want our NHS to survive.

Integration of complementary and alternative medicine therapies (CAM) with conventional medicine is occurring in hospitals and physicians offices, health maintenance organizations (HMOs) are covering CAM therapies, insurance coverage for CAM is increasing, and integrative medicine centers and clinics are being established, many with close ties to medical schools and teaching hospitals. In determining what care to provide, the goal should be comprehensive care that uses the best scientific evidence available regarding benefits and harm, encourages a focus on healing, recognizes the importance of compassion and caring, emphasizes the centrality of relationship-based care, encourages patients to share in decision making about therapeutic options, and promotes choices in care that can include complementary therapies where appropriate. Numerous approaches to delivering integrative medicine have evolved. Complementary and Alternative Medicine in the United States identifies an urgent need for health systems research that focuses on identifying the elements of these models, the outcomes of care delivered in these models, and whether these models are cost-effective when compared to conventional practice settings. It outlines areas of research in convention and CAM therapies, ways of integrating these therapies, development of curriculum that provides further education to health professionals, and an amendment of the Dietary Supplement Health and Education Act to improve quality, accurate labeling, research into use of supplements, incentives for privately funded research into their efficacy, and consumer protection against all potential hazards.

This anthology unites articles about different aspects of scientific human experiments in the course of World War I to the 1960s. The majority of them deals with the development of medicine and life sciences as well as the national research promotion under the Nazi regime and during World War II. Studies on human experiments of French, Japanese, and US-American research enlarge the perspective on a problem of obviously international range. These empirical studies are supplemented by articles on the legal evaluation of this behaviour of scientists, as well as on the resulting movement to formulate binding transnational ethical codes on behalf of human experiments.

Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine

Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.

Traces medicare's roots around the world--to the New Deal in the US, the October Revolution in Russia and the British Labour movement. From the 1930s to the early 1950s radical health advocates from around the Atlantic world debated how to achieve socialized medicine. Out of these debates, there emerged on the medical left a specific model for health equality--the health centre. Jones uses the personal histories of international health advocates, the history of ideas, policy debates, political insights as well as the role of emotion as a central force in social movements. Challenging dominant historical narratives that often depoliticize medicare's origins by treating it a simple manifestation of primordial prairie politics, the author shows that, although medicare was shaped fundamentally by local forces and cultures, we can only understand its history in a world-historical context. --From publisher description.