historian, writer, teacher, nurse

Devices, Pills, People: American Medicine in the 20th and 21st Centuries

This course explores the modern American medical marketplace, attempting to understand why it looks the way it does, how it developed, and what it offers (and takes) from patients. We will also try to look forward and consider where current trends in American medicine might lead. (Penn, Spring 2019)

Topic & Reading List

Topic 1: Demography

Week 1: excerpts from Klein, A Population History of the United States

Week 2: excerpts from Klein, A Population History of the United States

Topic 2: Medical School

Week 3: “Chapter 1: Creating the System,” and “Chapter 4: The Rise of Graduate Medical Education,” from Ludmerer, Kenneth M. 1999. Time to Heal: American Medical Education From the Turn of the Century to the Era of Managed Care. Oxford: Oxford University Press.

Week 4: “Chapter 14: Medical Education in an Era of Cost Containment and Managed Care,” from Ludmerer, Kenneth M. 1999. Time to Heal: American Medical Education From the Turn of the Century to the Era of Managed Care. Oxford: Oxford University Press; Emanuel, Ezekiel J. “Reforming American Medical Education.” The Milbank Quarterly: A Multidisciplinary Journal of Population Health and Health Policy, vol. 95(4), December 2017, pp. 692-697; Jena, Anupam B., et al. "Long-term effects of the 2003 ACGME resident duty hour reform on hospital mortality." Mayo Clinic Proceedings, vol. 89, no. 7, 2014, p. 1023+; Charles E. Rosenberg, “Community and Communities: The Evolution of the American Hospital,” The American General Hospital: Communities and Social Contexts, Diana E. Long and Janet Golden, ed. (Ithaca; London: Cornell University Press, 1989), p.3-17.

Topic 3: The Hospital

Week 5: “Chapter 7: ‘Alone Among Strangers,’” from Leavitt, Judith W. Brought to Bed: Childbearing in America, 1750-1950. Cary, NC, USA: Oxford University Press, Incorporated, 1988; Temkin, Elizabeth. "Rooming-In: Redesigning Hospitals and Motherhood in Cold War America." Bulletin of the History of Medicine 76.2 (2002): 271-98.

Week 6: Hoffman, Beatrix. “Emergency Rooms: The Reluctant Safety Net.” History and Health Policy in the United States: Putting the Past Back In. Rosemary A. Stevens, Charles E. Rosenberg, and Lawton R. Burns, ed. New Brunswick; London: Rutgers University Press, 2006. p.250-272; Kliff, Sarah. “Car crash hospitals vs. plane crash hospitals,” The Impact (podcast). 23 October 2017, https://www.vox.com/2017/10/23/16387300/hospital-policy-saved-thousands-lives-central-line-infection; Kliff, Sarah. “How California saves moms from dying in childbirth,” The Impact (podcast). 4 December 2017, https://www.vox.com/2017/12/4/16705164/us-maternal-death-rate-high-california-doctors-the-impact

Topic 4: Technology in Medicine

Week 7: Ch. 4, “Clinical Use of the X-ray Machine,” from Howell, Technology in the Hospital; Ch. 6 from Womack, The Radiation Evangelists.

Week 8: Ch. 3, “Lifesaving but Unaffordable: The Improbable Journey of the Artificial Kidney,” from Reiser, Technological Medicine: The Changing World of Doctors and Patients.

Week 9: Ch. 4, “Promising Rescue, Preventing Release: The Double Edge of the Artificial Respirator,” from Reiser, Technological Medicine: The Changing World of Doctors and Patients; Vanstone, Meredith, Cernat, Alexandra, Nisker, Jeff, and Schwartz, Lisa. “Women’s Perspectives on the Ethical Implications of Non-Invasive Prenatal Testing: A Qualitative Analysis to Inform Health Policy Decisions.” BMC medical ethics. 19, no. 1 (April 16, 2018).

Topic 5: Pharma

Week 10: Greene, Jeremy A. Greene and Scott H. Podolsky, “Keeping Modern in Medicine: Pharmaceutical Promotion and Physician Education in Postwar America,” Bulletin of the History of Medicine 83.2 (2009): 331-377. 

Week 11: Greene, Jeremy A. "Releasing the Flood Waters: Diuril and the Reshaping of Hypertension." Bulletin of the History of Medicine 79.4 (2005): 749-94; Heather Hartley, “The ‘Pinking’ of Viagra Culture: Drug Industry Efforts to Create and Repackage Sex Drugs for Women,” The Sociology of Health and Illness: Critical Perspectives, 8th ed., Peter Conrad, ed. (Worth Publishers, 2009), 287-296.

Topic 6: The Patient Experience

Week 12: Peter Conrad, “The Shifting Engines of Medicalization,” Conrad, Peter. The Medicalization of Society : On the Transformation of Human Conditions into Treatable Disorders, Johns Hopkins University Press, 2007.

Week 13: Insurance lectures; “The Rise and Decline of the HMO: A Chapter in U.S. Health-Policy History,” from History and Health Care Policy: Putting the Past Back In. Ed. Rosemary A. Stevens, Charles E. Rosenberg, and Lawton R. Burns. New Brunswick: Rutgers University Press, 2006.

Week 14: Julia Belluz, “The evidence is clear: people with Medicaid are better off than those without,” Vox; Kliff & Scott, “We read Democrats’ 9 plans for expanding health care. Here’s how they work,” Vox (20 March 2019).

Week 15: “The sentence that helped set off the opioid crisis,” from The Uncertain Hour (podcast); “How America Became Addicted to Opioids,” The Weeds (podcast); Tomes, Nancy. “Patients or Health-Care Consumers? Why the History of a Contested Term Matters.” History and Health Care Policy: Putting the Past Back In. Ed. Rosemary A. Stevens, Charles E. Rosenberg, and Lawton R. Burns. New Brunswick: Rutgers University Press, 2006. 83-110.