Catalogue


Big doctoring in America : profiles in primary care /
by Fitzhugh Mullan.
imprint
Berkeley : University of California Press, c2002.
description
xx, 255 p. : ill. ; 24 cm.
ISBN
0520226704 (cloth : alk. paper)
format(s)
Book
Holdings
More Details
imprint
Berkeley : University of California Press, c2002.
isbn
0520226704 (cloth : alk. paper)
contents note
Primary care roots -- The new GPs, the family physician comes of age -- Eugene McGregor, M.D., a legacy of general practice -- Connie Adler, M.D., living rural medicine -- Neil Calman, M.D., urban warrior -- Roots rediscovered, the internist and the pediatrician as generalists -- Beach Conger, M.D., caretaker and contrartian -- Linda Headrick, M.D., seeking a common language in primary care -- Selma Deitch, M.D., M.P.H., children first -- The new clinicians, nurse practitioners and physician assistants -- Therese Hidalgo, R.N., F.N.P., proud to be a nurse -- Carl Toney, P.A., building a new profession -- Holly Gerlaugh, F.N.P./P.A.-C., a one woman merger -- The system doctors, managed care and primary care -- Sam Ho, M.D., idealist, innovator, entrepreneur -- Sallyann Bowman, M.D., a Philadelphia story -- Gwen Wagstrom Halaas, M.D., M.B.A., evidence based doctoring -- The quixote factor, generalists doing special battle -- William Kapla, M.D., life and death in San Francisco -- Barbara Ross-Lee, D.O., ground breaker -- Janelle Goetcheus, M.D., doctor succor -- Building a better future, the case for primary care.
catalogue key
4718646
 
Includes bibliographical references and index.
A Look Inside
About the Author
Author Affiliation
Fitzhugh Mullan is Professor of Pediatrics and Public Health at George Washington University.
Excerpts
Flap Copy
"Mullan gets it right! His 'big doctors' are the unsung heroes of American medicine. Their stories --and they are great stories--tell us where we have to go to build a medical system that will work for everybody. And I mean everybody - the CEO, the family on welfare, you, and me."--Studs Terkel, author of Working, The Good War, and Coming of Age " Big Doctoring is a unique undertaking. We hear people in the frontlines of medicine tell us their story, and tell it in their own voices. In these pages, which are a joy to read, we find proof that medicine is, and always will be, both art and science."--Abraham Verghese, M.D., author of The Tennis Partner " Big Doctoring is an extraordinarily compelling effort by a dedicated and idealistic physician -- who offers us, through the voices of his informants, a clearly written narrative that tells of a profession's contemporary challenges and difficulties. Here is documentary work of the most instructive and telling kind -- a nation's healers become witnesses and teachers for us readers."--Robert Coles, M.D. "At a time when both doctors and patients in record numbers abhor the shadowy mass of gloomy economics and gruesome bureaucracy that has overtaken American medicine, Mullan shows us a path out of the darkness. And his is a desperately needed map, as physicins and nurses are now quitting in droves, tens of millions of Americans are losing their health insurance, and millions more, though insured, are forbidden treatments and primary care that could save their lives. Bravo!"--Laurie Garrett, author of The Coming Plague and Betrayal of Trust
Flap Copy
"Mullan gets it right! His 'big doctors' are the unsung heroes of American medicine. Their stories --and they are great stories--tell us where we have to go to build a medical system that will work for everybody. And I mean everybody - the CEO, the family on welfare, you, and me."--Studs Terkel, author ofWorking, The Good War,andComing of Age "Big Doctoringis a unique undertaking. We hear people in the frontlines of medicine tell us their story, and tell it in their own voices. In these pages, which are a joy to read, we find proof that medicine is, and always will be, both art and science."--Abraham Verghese, M.D., author ofThe Tennis Partner "Big Doctoringis an extraordinarily compelling effort by a dedicated and idealistic physician -- who offers us, through the voices of his informants, a clearly written narrative that tells of a profession's contemporary challenges and difficulties. Here is documentary work of the most instructive and telling kind -- a nation's healers become witnesses and teachers for us readers."--Robert Coles, M.D. "At a time when both doctors and patients in record numbers abhor the shadowy mass of gloomy economics and gruesome bureaucracy that has overtaken American medicine, Mullan shows us a path out of the darkness. And his is a desperately needed map, as physicins and nurses are now quitting in droves, tens of millions of Americans are losing their health insurance, and millions more, though insured, are forbidden treatments and primary care that could save their lives. Bravo!"--Laurie Garrett, author ofThe Coming PlagueandBetrayal of Trust
Full Text Reviews
Appeared in Library Journal on 2002-09-15:
By the mid-20th century, the sophistication and escalation of medical knowledge led to a proliferation of medical specialists and the near extinction of the general practitioner (GP). Despite the recent advent of the primary-care physician, Mullan (pediatrics and public health, George Washington Univ.; Plagues and Politics), a contributing editor at Health Affairs, fears that the principles of "big doctoring" (coordinated, comprehensive care over time) are in danger of disappearing. Compiling and expanding the 1998-99 "Profiles in Primary Care" series of articles and interviews that appeared in the Journal of American Medicine, he maintains that general practice is an important and needed calling. In the words of GPs and other generalized caregivers, the author identifies the rewards and hassles of this type of practice. This theme has been treated in a more scholarly manner in several other publications, such as Promoting Human Wellness; however, Mullan's work, aimed at the general reader, underscores an important issue in American healthcare and makes a compelling statement. For larger public libraries.-Margaret K. Norden, Marymount Univ. Lib., Arlington, VA (c) Copyright 2010. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
Appeared in Choice on 2003-02-01:
"Big doctoring" refers to the kind of personalized total care once provided by general practitioners, a service that changed dramatically with the advent of specialty medicine in the first half of the past century. The coordinated, inclusive care provided by the general practitioner, now almost extinct, was gradually replaced by better trained primary care providers in family medicine and generalists in pediatrics and internal medicine, complemented by the newer disciplines of nurse practitioners and physician assistants. Mullan (pediatrics and public health, George Washington Univ.) chronicles the emergence of this new generation of "big doctors" through the lives and work of 15 men and women from these new disciplines to narrate the evolution of primary care in the US. Using edited interviews of selected colorful individuals, he presents an engrossing collection of mini-autobiographies that tell the passions, achievements, frustrations, and experiences of this new generation of doctors and illustrates how each discipline emerged and the difficulties they faced. Especially valuable are the opening and concluding chapters with brief but insightful histories of the roots of primary care and its future in medicine. This jewel of a book, well written and sensitively narrated, is an eloquently articulated history of the important role of primary care in the US. All levels. G. Eknoyan Baylor College of Medicine
Reviews
This item was reviewed in:
Booklist, September 2002
Library Journal, September 2002
Choice, February 2003
New York Times Book Review, March 2003
To find out how to look for other reviews, please see our guides to finding book reviews in the Sciences or Social Sciences and Humanities.
Summaries
Main Description
The general practitioner was once America's doctor. The GP delivered babies, removed gallbladders, and sat by the bedsides of the dying. But as the twentieth century progressed, the pattern of medical care in the United States changed dramatically. By the 1960s, the GP was almost extinct. The later part of the twentieth century, however, saw a rebirth of the idea of the GP in the form of primary care practitioners. In this engrossing collection of oral histories and provocative essays about the past and future of generalism in health care, Fitzhugh Mullan--a pediatrician, writer, and historian--argues that primary care is a fascinating, important, and still endangered calling. In conveying the personal voices of primary care practitioners, Mullan sheds light on the political and economic contradictions that confront American medicine. Mullan interviewed dozens of primary care practitioners--family physicians, internists, pediatricians, nurse practitioners, and physician assistants--asking them about their lives and their work. He explains how, during the last forty years, the primary care movement has emerged built on the principles of "big doctoring"--coordinated, comprehensive care over time. This book is essential reading for understanding core issues of the current health care dilemma. As our country struggles with managed care, market reforms, and cost containment strategies in medicine, Big Doctoring in America provides an engrossing and illuminating look at those in the trenches of the profession.
Main Description
A pediatrician and writer who has moved into the health policy field makes the case for the importance of primary care by telling the stories of 15 professionals on the front lines of health care--doctors, nurse practitioners, and physicians' assitants--working in settings from urban HMOs to small-town solo practices.
Long Description
The general practitioner was once America's doctor. The GP delivered babies, removed gallbladders, and sat by the bedsides of the dying. But as the twentieth century progressed, the pattern of medical care in the United States changed dramatically. By the 1960s, the GP was almost extinct. The later part of the twentieth century, however, saw a rebirth of the idea of the GP in the form of primary care practitioners. In this engrossing collection of oral histories and provocative essays about the past and future of generalism in health care, Fitzhugh Mullan--a pediatrician, writer, and historian--argues that primary care is a fascinating, important, and still endangered calling. In conveying the personal voices of primary care practitioners, Mullan sheds light on the political and economic contradictions that confront American medicine. Mullan interviewed dozens of primary care practitioners--family physicians, internists, pediatricians, nurse practitioners, and physician assistants--asking them about their lives and their work. He explains how, during the last forty years, the primary care movement has emerged built on the principles of "big doctoring"--coordinated, comprehensive care over time. This book is essential reading for understanding core issues of the current health care dilemma. As our country struggles with managed care, market reforms, and cost containment strategies in medicine,Big Doctoring in Americaprovides an engrossing and illuminating look at those in the trenches of the profession.
Bowker Data Service Summary
In the later part of the 20th century there was rebirth of the idea of the GP in the form of primary care practioners. In this collection of oral histories and essays about the past and future of generalism in health care, the author argues that primary care is an endangered calling.
Table of Contents
Forewordp. ix
Introductionp. xi
Primary Care Rootsp. 1
The New GPs: The Family Physician Comes of Agep. 17
A Legacy of General Practicep. 20
Living Rural Medicinep. 29
Urban Warriorp. 38
Roots Rediscovered: The Internist and the Pediatrician as Generalistsp. 55
Caretaker and Contrarianp. 59
Seeking a Common Language in Primary Carep. 74
Children Firstp. 83
The New Clinicians: Nurse Practitioners and Physician Assistantsp. 95
Proud to Be a Nursep. 100
Building a New Professionp. 112
A One-Woman Mergerp. 124
The System Doctors: Managed Care and Primary Carep. 135
Idealist, Innovator, Entrepreneurp. 138
A Philadelphia Storyp. 149
Evidence-Based Doctoringp. 165
The Quixote Factor: Generalists Doing Special Battlep. 179
Life and Death in San Franciscop. 180
Ground Breakerp. 193
Doctor Succorp. 207
Building a Better Future: The Case for Primary Carep. 220
Acknowledgmentsp. 239
Notesp. 243
Indexp. 247
Table of Contents provided by Syndetics. All Rights Reserved.

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