PDF Ebook Technology in the Hospital: Transforming Patient Care in the Early Twentieth Century, by Joel D. Howell
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Technology in the Hospital: Transforming Patient Care in the Early Twentieth Century, by Joel D. Howell
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How did use of medical technology such as urinalyses, blood tests, and x-ray machines change patient care in early-twentieth-century American hospitals? To what extent was the use of new machines influenced by the ideas of scientific medicine and to what extent by the availability of newly structured facilities and trained personnel? Drawing on the medical treatment of more than 2,000 patients in Pennsylvania and New York hospitals, Howell traces the ways in which medical technology was used, not merely how it was talked about. He utilizes a wide range of sources―including medical texts, popular literature, and the visual arts―to explore how technology came to be such a central feature of medical care.
Howell also shows how changes in medical practice raised issues of gender, culture, and economics. Howell's analysis is especially timely in light of the ongoing debate over U.S. health care reform, a debate in which a central topic is the use and expense of medical technology. In a concluding chapter he applies the book's historical insights to medical practice today―asking why, for example, modern diagnostic tests have not been used to give doctors more time to spend with patients.
- Sales Rank: #928142 in Books
- Brand: Brand: Johns Hopkins University Press
- Published on: 1996-10-04
- Released on: 1996-10-04
- Original language: English
- Number of items: 1
- Dimensions: 9.00" h x .82" w x 6.00" l, 1.09 pounds
- Binding: Paperback
- 360 pages
- Used Book in Good Condition
Review
[Howell's] early twentieth-century portrait is fresh and important, as an analysis of medical practice just coming to grips with the technological world.
(Nature)I recommend this delightful book to anyone interested in the history of medicine.
(Seymour Perry New England Journal of Medicine) From the Back Cover
Some time ago I started a comparative study of the use of medical technology in the hospitals in England and the United States. This book discusses only the United States side of the story; the English side will be told in a forthcoming volume.
About the Author
Joel D. Howell is a faculty member in the Departments of Internal Medicine, History, and Health Services Management and Policy at the University of Michigan, where he is also co-director of the Robert Wood Johnson Clinical Scholars Program.
Most helpful customer reviews
3 of 3 people found the following review helpful.
A 'must have' book for medical history buffs
By Nick D.
Excellent 'one-of-a-kind' book by Joel Howell. Extensively researched and well written from historical information gathered from the New York and Pennsylvania hospitals.
I am currently working on an NSF grant researching medical technologies at Colorado State University to integrate such content nationwide into middle and high schools. This book has an extensive list of references and citations that is invaluable to anyone interested in the historical progression of medical technologies.
1 of 2 people found the following review helpful.
Remarkable and insightful
By Spring Texan
Joel Howell's careful study of how two hospitals used new technologies over a few decades offers much more than one might expect. Anyone wanting to understand our current hospital environments will find it well worth reading.
Howell understands that culture, not technology itself, shapes what we do (even when we may choose to see ourselves as "driven" by technology). As he comments in the closing chapter: "If the machine can save time, there is no reason implicit in the machine why physicians could not use that extra time to talk longer with their patients . . . Yet that is not how medical technologies are depicted, nor, in fact, is it likely to be the case that using new imaging devices will cause physicians to spend more time with their patients. Doctors spend less time with their patients because, for whatever reasons, both groups have come to expect such behavior, and society rewards it. The shiny machines we used then and continue to use now do not create our social values. . . rather, they reflect . . . them back to us."
His account of the changes in meaning of urinalysis and x-rays (and struggles over how they would be used as well as vast local differences in their use that match the vast local differences the Dartmouth Health Atlas continually finds in current medical practice) are thoroughly worthwhile. As well, his understanding that technologies we don't even see as such, such as cost accounting, have shaped hospitals as much and more than "medical" tests and machines is unusual and absolutely accurate.
A companion piece to this book might be Victoria Sweet's "God's Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine." Both point up the contrasts between what our hospitals might be and what they are and how there is no objective necessity to our hospitals being the sorts of places they are; rather, they are enormous, influential, expensive, but thoroughly contingent cultural edifices.
Unlike Sweet, Howell makes no overt judgments, he simply illuminates. But the books fit very well together.
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