I didn’t realize that Google Books only has the first 50 or so pages of Paul Starr’s The Social Transformation of American Medicine. So now I have to start typing what I want to share rather than extracting images. Here’s an excerpt from page 55:
Empirical evidence rather than dogmatic assertions of personal or traditional authority became the grounds for assessing the truth. The early empirical investigations showed that accepted techniques had no therapeutic value, yet there were no effective alternatives available to replace them. Medicine had reached that difficult point in its history when leading scientists knew its limitations, but as yet lacked the means to advance beyond them. Ironically, as Richard Shryock writes, “the most hopeful period in the history of medicine was the one in which the public looked to medicine with the least hope.”
As I read this I thought not of early 19th century medicine but of the U.S. health care system in 2010. It suffers from high cost, low to mediocre quality, and poor access. Assertions of remedies are abundant, empirical evidence about them is emerging and shared on this blog (and elsewhere), and many are uncertain that effective alternative arrangements exist. Like medicine in the early 19th century, we’re at a difficult point. We know the limitations of the health care system but, at this moment, lack the means to advance beyond them. Will this time be viewed as an ironically hopeful period too? It depends which way we go from here.