Table of Contents

Introduction: The Ethos of Medicine in Postmodern America
Chapter 1: The Ethos of Medical Practice in this Postmodern Age of Computerized Consumerism
Chapter 2: The Social Construction of Medical Knowledge
Chapter 3: The Culture of Medical Practice: Corporate Computerization versus the Face of the Other
Chapter 4: Practical and Ethical Concerns Regarding Aspects of Quality Improvement Processes
Chapter 5: The Uneven Encounter Between Postmodern Expectations and Corporate Control of Medical Practice
Chapter 6: Power and Trust in the Patient-Physician Relationship: Postmodern Values and the Patient Centered Medical Home
Chapter 7: Medical Education in Postmodern Society
Chapter 8: Medical Professionalism: What Does Altruism Have to Do with It?
Chapter 9: Postmodern Physician Ethos and Morale
Chapter 10: Bioethics in Postmodern America
Chapter 11: The. Ethos of Medicine, Peformativity, and the Silicon Cage
Chapter 12: Medical Care is Embedded in American Culture: Repositioning the Medical Ethos for the 21st Century
Epilogue
Bibliography

About the Author

Arnold R. Eiser is associate dean for Mercy Programs and professor of medicine at Drexel University College of Medicine. He also serves the Pennsylvania chapter of the American College of Physicians as the chair of its Health and Public Policy Committee.

Reviews

'Consumerism, computerization, and corporatization' dominate health care in the 21st century, for both practitioners and patients. These trends have changed the landscape of medicine, increased the speed at which new technology is incorporated into standard practice, and transformed the ethos of medicine today. Eiser examines these changes using observations from philosophers such as Lyotard, Bauman, Foucault, and others, with Foucault being the only one to examine medical care directly and doing so from a historical perspective. Eiser applies the work of philosophers, for example Lyotard's 'loss of grand narratives,' to medicine in the contemporary US. The book's 12 chapters address topics such as electronic medical records, evidence-based medicine, doctor-patient relationships, bioethics, and medical education. Though the title suggests a discussion of the current health care system in the US, Eiser also presents studies and references from abroad in a comparative context. Each chapter has extensive endnotes; a six-page bibliography at the end is organized by topic. Summing Up: Recommended. Upper-division undergraduates and above.
*CHOICE*

Since . . . 1977, numerous physicians, ethicists, economists, and sociologists have offered diagnoses and therapies for the health care industry’s ever growing dysfunction [in essays and books]. However, Arnold Eiser’s new book, The Ethos of Medicine in Postmodern America, is easily among the most comprehensive and well-documented of these analyses. . . .While other observers have described features of today’s medical ethos, e.g., consumerism, impersonality, self-interest, corporatization, and alienation, Eiser, quite rightly, locates all these features as aspects of the larger postmodern world view. . . .Dr. Eiser’s application of Levinas’ sensibility to medical practice is exciting because it relates the notion of professional obligation to empathy, emotional intelligence, and reflective practice, topics currently under active investigation. . . .The Ethos of Medicine in Postmodern America is a sobering book to read. It confirms and documents the widespread dysfunction in medicine. However, it also provides us with tools for understanding the problem and concrete suggestions for reviving ethics of respect and responsibility in the clinical encounter.
*The Pharos*

My bookshelves sag with books that decry the losses of modern medicine, while a distressingly small number contain practical solutions. Eiser challenges us to think about how consumerism, the pursuit of profit, computerized protocols, Internet doctor ratings, blogs, and multiple stakeholders affect the patient-physician relationship. . . .The Ethos of Medicine in Postmodern America is a thoughtful, informative book by an experienced clinician, educator, and ethicist. It introduces a broad view of a complex system about which we may have had simplistic opinions. This is primarily an American story, but similar changes are afoot in Canada and elsewhere.
*Canadian Journal of General Internal Medicine*

The Ethos of Medicine in Postmodern America: Philosophical, Cultural, and Social Considerations could hardly have arrived at a more propitious time. As medicine becomes less a profession and more a business in the United States and elsewhere, there is a huge need to revisit the ethic of the doctor-patient relationship. While talk of individualized and personalized medicine is the rhetoric being marketed about that relationship within the new emerging business model, it is not at all clear how these concepts will be implemented in a manner that respects physician expertise, judgment, and advocacy as well as patient autonomy, need, and best interest. Dr. Arnold R. Eiser’s book takes a long, informed, serious, and useful look at this pressing ethical question.
*Arthur L. Caplan, NYU Langone Medical Center*

The practice of medicine has changed radically through the past half-century. Electronic health records, moves of physicians’ practices into corporate structures, for-profit hospital systems, and other changes, all influence the patient-physician relationship and standards in the conduct of medical care. Dr. Eiser’s survey of today’s American medicine makes clear why potential patients, current patients, and physicians should be aware of possible results of such influences. Can trust in physicians’ professional standards and the central importance of the physician-patient relationship be maintained? The Ethos of Medicine is a book you should read if you care about the future of medical care in the United States.
*Edward J. Huth, Editor Emeritus, Annals of Internal Medicine*

The Ethos of Medicine in Postmodern America is not solely about medicine but reaches much deeper into the multiplying fissures in the tissue of human togetherness in a society in which the public sphere is subsumed by advertising, marketing, entertainment, computerization, electronic gossip, and other interests devoid of ethical orientation, and in the result "morality is strictly privatized, individualized, compartmentalized in personalized space." It is a case study in a much wider phenomenon of moral insensitivity gnawing into the very foundation of social life in our society of consumers first, citizens distant second and fellow humans recast as competitors and rivals. This book is a warning that needs to be paid close attention by all of us worried about our societal future.
*Zygmunt Bauman, Emeritus Professor of Sociology, Universities of Leeds and Warsaw*