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That Was the Century That Was: Historical Perspectives on Medical Life at the Fin de Siècle

Russell C. Maulitz, MD, PhD
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MCP Hahnemann School of Medicine and Drexel University; Philadelphia, PA 19144 (Maulitz)

Acknowledgments: The author thanks Professors Jacalyn Duffin (Queens University) and Steven Kunitz (University of Rochester) for critical comments.

Grant Support: By the Charles E. Culpeper Foundation.

Requests for Reprints: Russell C. Maulitz, MD, PhD, The Telemedicine Project, MCP Hahnemann School of Medicine and Drexel University, Cambridge Building 109, Alden Park, 2967 West School House Lane, Philadelphia, PA 19144.

Ann Intern Med. 1999;131(1):75-78. doi:10.7326/0003-4819-131-1-199907060-00033
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Lately, to many of us, medicine has felt like a large leaky vessel weaving uncertainly across uncharted seas. The profession's continued soundness remains a focal concern for many (13). Some in the medical community express discomfort (4), while a few adventurous souls even sally forth into prediction (5). So as U.S. medicine drifts toward the millennium, we can be forgiven if we peer out warily from the deck and wonder what lies ahead—or whether a rudder is down below. Some sort of dramatic change feels imminent. There is a queasy sense of transformation, driven by dramatic late-20th-century developments in the molecular and information technologies in the economic bases of medicine. But toward what? At such times it is worthwhile to ponder the past and seek insights, if not answers, about our current state in this fin de siècle narrative. In what follows, I survey recent historical works on specialization in an attempt to locate what little stability we might find in this sea of change.

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