The complaints that patients bring to their doctors often have roots in social issues that involve work, family life, gender roles and sexuality, aging, substance use; or other problems of nonmedical origin. In this book, physician/sociologist Howard Waitzkin examines interactions between patients and doctors to show how physicians' focus on physical complaints often fails to address patients' underlying concerns and also reinforces the societal problems that cause or aggravate these maladies. A progressive doctor-patient relationship, Waitzkin argues, fosters social change. Waitzkin provides a pathbreaking analysis of medical encounters, applying perspectives from structuralism, post-structuralism, and critical literary theory to transcripts of recorded conversations between doctors and patients. He demonstrates how doctors unintentionally maintain dominance in their dealings with patients, encourage conforming social behavior and attitudes, and marginalize patients' concerns with social problems. Waitzkin urges physicians to attend to the social as well as the medical problems that emerge from patients' narratives and suggests ways to restructure the manner in which patients and doctors communicate with each other. Physicians and patients, for example, should work together to demystify medical discourse, should refrain from medicalizing social problems through medications or reassurances that dull socially caused pain, and should be prepared to call on advocacy organizations seeking to change the social conditions that create personal distress. This book will influence and challenge physicians scholars, and students in the social sciences and humanities, as well as anyone concerned about the present problems and future direction of medicine.

Early twentieth century China went through a tumultuous period, marked by the end of an ancient monarchy, political instability and profound cultural upheaval. The medical discourse both reflected and contributed to these transformations. Western medicine arrived in China as part of missionary, foreign imperialist and internal modernization efforts. In various ways it interacted with Chinese practices and belief systems. The contributions in this volume explore important episodes of this multi-faceted process, describing key institutions, personalities and their respective motives and interests. Collectively, the chapters reveal a complex web of interlocking dimensions, which evade simple categorizations of Western or Chinese, exploitive or supportive, traditional or modern.

Do political concerns belong in psychodynamic treatment? How do class and politics shape the unconscious? The effects of an increasingly polarized, insecure and threatening world mean that the ideologically enforced split between the political order and personal life is becoming difficult to sustain. This book explores the impact of the social and political domains at the individual level. The contributions included in this volume describe how issues of class and politics, and the intense emotions they engender, emerge in the clinical setting and how psychotherapists can respectfully address them rather than deny their significance. They demonstrate how clinicians need to take into account the complex convergences between psychic and social reality in the clinical setting in order to help their patients understand the anxiety, fear, insecurity and anger caused by the complex relations of class and power. This examination of the psychodynamics of terror and aggression and the unconscious defences employed to deny reality offers powerful insights into the microscopic unconscious ways that ideology is enacted and lived. Psychoanalysis, Class and Politics will be of interest to all mental health professionals interested in improving their understanding of the ideological factors that impede or facilitate critical and engaged citizenship. It has a valuable contribution to make to the psychoanalytic enterprise, as well as to related scholarly and professional disciplines.

"Kelly Wisecup examines how European settlers, Native Americans, and New World Africans communicated medical knowledge in early America, and how the colonists represented what they learned in their literatures."--Book cover.

"Developed/underdeveloped, " "first world/third world, " "modern/traditional" - although there is nothing inevitable, natural, or arguably even useful about such divisions, they are widely accepted as legitimate ways to categorize regions and peoples of the world. In Imperial Encounters, Roxanne Lynn Doty looks at the way these kinds of labels influence North-South relations, reflecting a history of colonialism and shaping the way national identity is constructed today. Employing a critical, poststructuralist perspective, Doty examines two "imperial encounters" over time: between the United States and the Philippines and between Great Britain and Kenya. The history of these two relationships demonstrates that not only is the more powerful member allowed to construct "reality, " but this construction of reality bears an important relationship to actual practice. Doty considers the persistence of representational practices, particularly with regard to Northern views of human rights in the South and contemporary social science discourses on North-South relations. Important and timely, Imperial Encounters brings a fresh perspective to the debate over the past - and the future - of global politics.

Kananoja demonstrates how medical interaction in early modern Atlantic Africa was characterised by continuous knowledge exchange between Africans and Europeans.

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

How might we understand yellowface performances by African Americans in 1930s swing adaptations of Gilbert and Sullivan's The Mikado, Paul Robeson's support of Asian and Asian American struggles, or the absorption of hip hop by Asian American youth culture?AfroAsian Encounters is the first anthology to look at the mutual influence of and relationships between members of the African and Asian diasporas in the Americas. While these two groups have often been thought of as occupying incommensurate, if not opposing, cultural and political positions, scholars from history, literature, media, and the visual arts here trace their interconnections and interactions, as well as how they have been set in opposition by white systems of racial domination. AfroAsian Encounters probes beyond popular culture to trace the historical lineage of these coalitions from the post-Civil War era through the present.From the history of Japanese jazz composers to the current popularity of black/Asian "buddy films" like Rush Hour, AfroAsian Encounters is a groundbreaking intervention into studies of race and ethnicity and a crucial look at the shifting meaning of race in America in the twenty-first century.

NATIONAL BOOK CRITICS CIRCLE AWARD WINNER • The first full history of Black America’s shocking mistreatment as unwilling and unwitting experimental subjects at the hands of the medical establishment. No one concerned with issues of public health and racial justice can afford not to read this masterful book. "[Washington] has unearthed a shocking amount of information and shaped it into a riveting, carefully documented book." —New York Times From the era of slavery to the present day, starting with the earliest encounters between Black Americans and Western medical researchers and the racist pseudoscience that resulted, Medical Apartheid details the ways both slaves and freedmen were used in hospitals for experiments conducted without their knowledge—a tradition that continues today within some black populations. It reveals how Blacks have historically been prey to grave-robbing as well as unauthorized autopsies and dissections. Moving into the twentieth century, it shows how the pseudoscience of eugenics and social Darwinism was used to justify experimental exploitation and shoddy medical treatment of Blacks. Shocking new details about the government’s notorious Tuskegee experiment are revealed, as are similar, less-well-known medical atrocities conducted by the government, the armed forces, prisons, and private institutions. The product of years of prodigious research into medical journals and experimental reports long undisturbed, Medical Apartheid reveals the hidden underbelly of scientific research and makes possible, for the first time, an understanding of the roots of the African American health deficit. At last, it provides the fullest possible context for comprehending the behavioral fallout that has caused Black Americans to view researchers—and indeed the whole medical establishment—with such deep distrust.

In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.