Let Me Heal: The Opportunity to Preserve Excellence in American Medicine

Hardcover | September 4, 2014

byKenneth M. Ludmerer

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In Let Me Heal, prize-winning author Kenneth M.Ludmerer provides the first-ever account of the residency system for training doctors in the United States and by tracing its evolution, explores how the residency system is of fundamental importance to the health of the nation. In the making of a doctor, the residency system represents the dominant formative influence. It is during the three to nine years spent in residency that doctors come of professional age, acquiring the knowledge and skills of their specialty or subspecialty, forming a professional identity, anddeveloping habits, behaviors, attitudes, and values that last a professional lifetime. Let Me Heal examines all dimensions of the residency system: historical evolution, educational principles, moral underpinnings, financing and administration, and cultural components. It focuses on the experienceof being a resident, on how that experience has changed over time, and on how well the residency system is fulfilling its obligation to produce outstanding doctors. Most importantly, it analyzes the mutual relationship beetween residency education and patient care in America. The book shows that thequality of residency training ultimately depends on the quality of patient care that residents observe, but that there is much that residency training can do to produce doctors who practice in a better, more affordable fashion.

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In Let Me Heal, prize-winning author Kenneth M.Ludmerer provides the first-ever account of the residency system for training doctors in the United States and by tracing its evolution, explores how the residency system is of fundamental importance to the health of the nation. In the making of a doctor, the residency system represents t...

Kenneth M. Ludmerer is Professor of Medicine, Professor of History, and the Mabel Dorn Reeder Distinguished Professor of the History of Medicine at Washington University, St. Louis, Missouri.

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Format:HardcoverDimensions:440 pages, 9.25 × 6.12 × 0.98 inPublished:September 4, 2014Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0199744548

ISBN - 13:9780199744541

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Table of Contents

1. ANTECEDENTSThe Search for Clinical ExperienceThe Quest for Specialty TrainingThe Passion for Discovery and the Birth of Clinical Science2. JOHNS HOPKINS AND THE CREATION OF THE RESIDENCYGraduate Medical Education Enters the UniversityThe Scientific Practitioner and the Promise for the NationWork as PlayDiaspora3. THE GROWTH OF GRADUATE MEDICAL EDUCATIONCompleting the InfrastructureThe Maturation of the InternshipThe Spread of the ResidencyIn Search of a System4. THE AMERICAN RESIDENCYEducational PrinciplesThe Moral Dimension of Graduate Medical EducationThe Learning EnvironmentCultural Influences5. THE LIFE OF A PRE-WORLD WAR II HOUSE OFFICERObtaining a ResidencyExperiencing the ResidencyEducation and Service6. CONSOLIDATING THE SYSTEMThe Second Reform of Medical EducationThe Rise of the Specialty Boards and the Triumph of ResidencyGraduate Medical Education and the Public Good7. THE EXPANSION OF THE RESIDENCY IN N ERA OF ABUNDANCEFrom Privilege to RightThe Maturation of Clinical Science and the Creation of Subspecialty FellowshipsThe Ascendance of Specialty PracticeThe Propagation of Wastefulness8. THE EVOLVING LEARNING ENVIRONMENTThe Decline of the Ward ServiceThe Preservation of Educational QualityMaintaining the Moral Mission9. THE LIFE OF A POST-WORLD WAR II HOUSE OFFICERChanges and ContinuitiesQuality, Safety, and SupervisionEducation and Service, Again10. THE WEAKENING OF THE EDUCATIONAL COMMUNITYThe Marginalization of House OfficersHouse Staff ActivismThe Discovery of Burnout11. THE ERA OF HIGH THROUGHPUTThe New Learning EnvironmentThe Subversion of the Moral MissionChanging Attitudes toward Work and Life12. THE ERA OF ACCOUNTABILITY, PATIENT SAFETY, AND WORK-HOURS REGULATIONWork Hours RestrictionPerpetual Dilemmas13. PRESERVING EXCELLENCE IN RESIDENCY TRAINING AND MEDICAL CAREChallenges, New and OldAligning Education and Patient Care