Handel Reynolds
- Published in print:
- 2012
- Published Online:
- August 2016
- ISBN:
- 9780801450938
- eISBN:
- 9780801466007
- Item type:
- book
- Publisher:
- Cornell University Press
- DOI:
- 10.7591/cornell/9780801450938.001.0001
- Subject:
- Public Health and Epidemiology, Public Health
In 2009, an influential panel of medical experts ignited a controversy when they recommended that most women should not begin routine mammograms to screen for breast cancer until the age of fifty, ...
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In 2009, an influential panel of medical experts ignited a controversy when they recommended that most women should not begin routine mammograms to screen for breast cancer until the age of fifty, reversing guidelines they had issued just seven years before when they recommended forty as the optimal age to start getting mammograms. While some praised the new recommendation as sensible given the smaller benefit women under fifty derive from mammography, many women's groups, health care advocates, and individual women saw the guidelines as privileging financial considerations over women's health and a setback to decades-long efforts to reduce the mortality rate of breast cancer. This book notes that this episode was only the most recent controversy in the turbulent history of mammography since its introduction in the early 1970s. The book shows how pivotal decisions made during mammography's initial launch made it all but inevitable that the test would be contentious. It describes how, at several key points in its history, the emphasis on mammography screening as a fundamental aspect of women's preventive health care coincided with social and political developments, from the women's movement in the early 1970s to breast cancer activism in the 1980s and 1990s. At the same time, aggressive promotion of mammography made the screening tool the cornerstone of a huge new industry. The book addresses both the benefits and risks of mammography, charting debates that have weighed the early detection of aggressively malignant tumors against unnecessary treatments resulting from the identification of slow-growing and non-life-threatening cancers.Less
In 2009, an influential panel of medical experts ignited a controversy when they recommended that most women should not begin routine mammograms to screen for breast cancer until the age of fifty, reversing guidelines they had issued just seven years before when they recommended forty as the optimal age to start getting mammograms. While some praised the new recommendation as sensible given the smaller benefit women under fifty derive from mammography, many women's groups, health care advocates, and individual women saw the guidelines as privileging financial considerations over women's health and a setback to decades-long efforts to reduce the mortality rate of breast cancer. This book notes that this episode was only the most recent controversy in the turbulent history of mammography since its introduction in the early 1970s. The book shows how pivotal decisions made during mammography's initial launch made it all but inevitable that the test would be contentious. It describes how, at several key points in its history, the emphasis on mammography screening as a fundamental aspect of women's preventive health care coincided with social and political developments, from the women's movement in the early 1970s to breast cancer activism in the 1980s and 1990s. At the same time, aggressive promotion of mammography made the screening tool the cornerstone of a huge new industry. The book addresses both the benefits and risks of mammography, charting debates that have weighed the early detection of aggressively malignant tumors against unnecessary treatments resulting from the identification of slow-growing and non-life-threatening cancers.
Frederick M. MD Barken
- Published in print:
- 2011
- Published Online:
- August 2016
- ISBN:
- 9780801449765
- eISBN:
- 9780801460609
- Item type:
- book
- Publisher:
- Cornell University Press
- DOI:
- 10.7591/cornell/9780801449765.001.0001
- Subject:
- Public Health and Epidemiology, Public Health
Primary care medicine is in crisis. While policymakers, government administrators, and the health insurance industry pay lip service to the personal relationship between physician and patient, ...
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Primary care medicine is in crisis. While policymakers, government administrators, and the health insurance industry pay lip service to the personal relationship between physician and patient, dissatisfaction and disaffection run rampant among primary care doctors, and medical students steer clear in order to pursue more lucrative specialties. Patients feel helpless, well aware that they are losing a valued close connection as health care steadily becomes more transactional than relational. The thin-margin efficiency, rapid pace, and high volume demanded by the new health care economics do not work for primary care, an inherently slower, more personal, and uniquely tailored service. This book offers a cool critique of the “market model of medicine” while vividly illustrating how the seemingly inexorable trend toward specialization in the last few decades has shifted emphasis away from what was once the foundation of medical practice. It addresses the complexities of modern practice—overuse of diagnostic studies, fragmentation of care, increasing reliance on an array of prescription drugs, and the practice of defensive medicine. The book shows how changes in medicine, the family, and society have left physicians to deal with a wide range of geriatric issues, from limited mobility to dementia, that are not addressed by health care policy and are not entirely amenable to a physician's prescription. It contends that the very survival of primary care is in jeopardy at a time when its practitioners are needed more than ever.Less
Primary care medicine is in crisis. While policymakers, government administrators, and the health insurance industry pay lip service to the personal relationship between physician and patient, dissatisfaction and disaffection run rampant among primary care doctors, and medical students steer clear in order to pursue more lucrative specialties. Patients feel helpless, well aware that they are losing a valued close connection as health care steadily becomes more transactional than relational. The thin-margin efficiency, rapid pace, and high volume demanded by the new health care economics do not work for primary care, an inherently slower, more personal, and uniquely tailored service. This book offers a cool critique of the “market model of medicine” while vividly illustrating how the seemingly inexorable trend toward specialization in the last few decades has shifted emphasis away from what was once the foundation of medical practice. It addresses the complexities of modern practice—overuse of diagnostic studies, fragmentation of care, increasing reliance on an array of prescription drugs, and the practice of defensive medicine. The book shows how changes in medicine, the family, and society have left physicians to deal with a wide range of geriatric issues, from limited mobility to dementia, that are not addressed by health care policy and are not entirely amenable to a physician's prescription. It contends that the very survival of primary care is in jeopardy at a time when its practitioners are needed more than ever.