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The author presents a thoughtful discussion of the dilemmas facing American medicine and the need for a "new postmodern paradigm." A central concern is the clash between bureaucracy and the Hippocratic theme. Ironically, although U.S. physicians have fought national health insurance and promoted free enterprise, they now find they have done this at the expense of their clinical freedom. British physicians under the National Health Service "observe that their American counterparts work under many more bureaucratic constraints on a day-to-day, hour-by-hour basis."
This situation was accelerated by the Reagan deregulation program. "In successfully holding off Big Brother in the form
Technology, Bureaucracy, and Healing in America. Ann Intern Med. ;111:346. doi: 10.7326/0003-4819-111-4-346_2
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Published: Ann Intern Med. 1989;111(4):346.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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