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The ongoing debate in the U.S. health care system has focused enormous attention on questions devoted to administration, financing, and delivery. Yet two seemingly obscure, but important, questions have gone unanswered in this discussion and debate. First, what unconscious purposes are served for both patients and practitioners by medical practice in our society? Second, what features of group psychology may Americans discover regarding themselves in the process of examining the inner life of physicians, a group that delivers health care?
In American Medicine as Culture, anthropologist Howard Stein answers these questions with psychoanalytic and anthropological principles and data. Written before the national debate on health care reform was in full swing, this book nonetheless is an incisive portrayal of some of the underlying cultural forces that shape medical practice in America.
It is not an easy task to produce this type of cultural analysis. On one hand, the organizational structure and daily routines of the medical establishment are sufficiently complex to overwhelm an investigator's attempt at ethnographic research. On the other, in the hands of a less sophisticated thinker, the attempt to portray life in medical subcultures from broad anthropological and analytic perspectives might resort to the use of shoddy analysis and routine sloganeering. Yet, over a decade, Stein has quietly assembled an impressive body of work that examines the manner in which individual and group psychodynamics mesh with institutional