Skip to main content

Patientization of the Population

  • Chapter
  • 17 Accesses

Abstract

The contemporary medical establishment appears bent on converting the entire population of the industrialized countries into patients. This is notwithstanding the fact that most of us are normal and healthy most of the time, and that most of the illnesses we suffer from are trivial and self-limited and would recover without medical treatment. Rather than concentrate on the grave environmental, economic and social causes of the serious diseases which do afflict modern man, the medical establishment have, because of their clinical and scientific orientation, turned these diseases into individual biological and psychological problems which are destined to be dealt with on a one-to-one basis within the doctor-patient relationship.

This is a preview of subscription content, log in via an institution.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

I: The Process

  1. Thomas, L., ‘The health care system’, N Engl J Med, 293:1245, 1975

    Article  Google Scholar 

II: Screening and the Medical Check-up

  1. McKeown, T., ‘An approach to screening policies’, J Roy Coll Phys, 10:145, 1976

    Google Scholar 

  2. Wilson, J., ‘Some principles of early diagnosis in general practice’ in Surveillance and Early Diagnosis in General Practice, G. Teeling-Smith (ed), Office of Health Economics, London, 1966

    Google Scholar 

  3. World Health Organization, ‘Mass Health Examination’, WHO Public Health Paper No. 45, 1971

    Google Scholar 

  4. Spitzer, W. & Brown, B., ‘Unanswered questions about the periodic health examination’, Ann Int Med, 83:257, 1975

    Article  Google Scholar 

  5. Teeling-Smith, G., ‘The economics of screening’ in C. R. Hart (ed), Screening in General Practice, Churchill Livingstone, London, 1975

    Google Scholar 

  6. Collen, M. et al, ‘Cost analysis of a multi-phasic screening programme’, N Engl J Med, 280:1043, 1969

    Article  Google Scholar 

  7. Olsen, D. et al, ‘A controlled trial of multi-phasic screening’, N Engl J Med, 294:925, 1976

    Article  Google Scholar 

  8. Garfield, S., ‘Multi-phasic health testing and medical care as a right’, N Engl J Med, 283:1087, 1970

    Article  Google Scholar 

  9. Burnum, J. (letter), ‘The worried sick’, Ann Int Med, 88:572, 1978

    Article  Google Scholar 

  10. Schor, S. et al, ‘Evaluation of the periodic health examination’, Ann Int Med, 61:999, 1964

    Article  Google Scholar 

  11. Knox, E., ‘Multi-phasic screening’, Lancet, 2:1434, 1974

    Article  Google Scholar 

  12. Percy-Robb, et al, ‘Biochemical screening programme in general practice: a clinical follow-up’, Br Med J, 1:596, 1971

    Article  Google Scholar 

  13. Anderson, F., ‘Evaluation of the routine physical examination of infants in the first year of life’, Ped, 45:950, 1970

    Google Scholar 

  14. Korvin, C. et al, ‘Admission screening: clinical benefits’, Ann Int Med, 83:175, 1975

    Article  Google Scholar 

  15. Dunbridge, T. et al, ‘An evaluation of multi-phasic screening on admission to hospital’, Med J Aust, 1:703, 1976

    Google Scholar 

  16. Holland, W., ‘Screening for disease: taking stock’, Lancet, 2:1494, 1974

    Article  Google Scholar 

  17. Chamberlain, J., ‘Evaluation of screening procedures’ in W. Hobson (ed), The Theory and Practice of Public Health, Oxford University Press, London, 1975

    Google Scholar 

  18. Delbanco, T. (ed), ‘The periodic health examination revisited’, Ann Int Med, 83:271, 1975

    Google Scholar 

  19. Conn, R., ‘Clinical laboratories: profit centre, production industry or patient care resource?’, N Engl J Med, 298:422, 1978

    Article  Google Scholar 

  20. Boonstra, C. & Jackson, C., ‘The clinical value of routine serum calcium analysis’, Ann Int Med, 57:963, 1962

    Article  Google Scholar 

  21. Meador, C., ‘The art and science of non-disease’, N Engl J Med, 272:92, 1965

    Article  Google Scholar 

  22. Atkinson, A. & Kellett, R., ‘Value of intravenous urography in the investigation of hypertension’, J Roy Coll Phys, 8:175, 1974

    Google Scholar 

  23. O’Sullivan, J. & Hurwitz, D., ‘Spontaneous remissions in early diabetes mellitus’, Arch Int Med, 117:769, 1966

    Article  Google Scholar 

  24. O’Sullivan, J. & Williams, R., ‘Early Diabetes in perspective: population study in Sudbury, Mass.’, J Am Med Ass, 198:579, 1966

    Article  Google Scholar 

  25. O’Sullivan, J. & Mahan, C., ‘Prospective study of young diabetics’, N Engl J Med, 278:1038, 1968

    Article  Google Scholar 

  26. UGDP, ‘Effects of hypoglycaemic agents on vascular complications of diabetes in patients with adult onset diabetes’, J Am Med Ass, 217:777, 1971

    Article  Google Scholar 

  27. Illich, Ivan, Medical Nemesis, Calder & Boyars, London, 1975

    Google Scholar 

  28. Mahler, H., ‘Health — a demystification of medical technology’, Lancet, 2:829, 1975

    Google Scholar 

  29. Breslaw, L. & Somers, A., ‘The lifetime health monitoring programme’, N Engl J Med, 296:601, 1977

    Article  Google Scholar 

  30. Thomas, L., ‘Notes of a biology watcher: “your very good health”’, N Engl J Med, 287:761, 1972

    Article  Google Scholar 

  31. Carter, R., ‘The value of screening in paediatrics’, J Roy Coll Phys, 10:153, 1976

    Google Scholar 

  32. Freda, V. et al, ‘Prevention of Rh Haemolytic disease — ten years clinical experience with Rh immune globulin’, N Engl J Med, 292:1014, 1975

    Article  Google Scholar 

  33. Editorial, ‘Uncertainties of cervical cytology’, Br Med J, 4:501, 1973

    Article  Google Scholar 

  34. Lloyd, G., ‘Cervical cytology’ in C. Hart (ed), Screening in General Practice, Churchill Livingstone, London, 1975, p. 317

    Google Scholar 

  35. Randall, K, ‘Cancer screening by cytology’, Lancet, 2:1303, 1974

    Article  Google Scholar 

  36. Walton et al, ‘Cervical cancer screening programmes’, Can Med Ass J, 114:1003, 1976

    Google Scholar 

  37. Editorial, ‘Walton report on cervical screening’, Lancet, 1:1337, 1976

    Google Scholar 

  38. Susser, M. & Watson, W., ‘Culture and Health’ in Sociology in Medicine, Oxford University Press, London, 1971, p. 55

    Google Scholar 

  39. Editorial, ‘Screening for cervical cancer’, Br Med J, 2:659, 1976

    Article  Google Scholar 

  40. Massachusetts Dept. of Public Health, ‘Papanicolaou Testing — are we screening the wrong women?’, N Engl J Med, 294:223, 1976

    Google Scholar 

  41. Brindle, G. et al, ‘Cervical smears: are the right women being examined?’, Br Med J, 1:1196, 1976

    Article  Google Scholar 

  42. Spriggs, A. & Husain, O., ‘Cervical smears’, Br Med J, 1:1516, 1977

    Article  Google Scholar 

  43. Enos, W. et al, ‘Coronary disease among United States’ soldiers killed in action in Korea’, J Am Med Ass, 152:1090, 1953

    Article  Google Scholar 

  44. Enos, W. et al, ‘Pathogenesis of coronary disease in American soldiers killed in Korea’, J Am Med Ass, 158:912, 1952

    Article  Google Scholar 

  45. Report of working party, ‘Prevention of coronary heart disease’, J Roy Coll Phys, 10:232, 1976

    Google Scholar 

  46. VA study group, ‘Effects of treatment on morbidity in hypertension’, J Am Med Ass, 202:1028, 1967

    Article  Google Scholar 

  47. ibid, 213:1143, 1970

    Google Scholar 

  48. Editorial, ‘Lipid lowering drugs after myocardial infarction’, Lancet, 1:501, 1975

    Google Scholar 

  49. Coronary Drug Project Research Group, ‘Clofibrate and niacin in coronary heart disease’, J Am Med Ass, 231:360, 1975

    Article  Google Scholar 

  50. Dayton, S. et al, ‘A controlled clinical trial of a diet high in unsaturated fat in preventing complications of atherosclerosis’, Circ, 40 Supp 2, 1969

    Google Scholar 

  51. Meittinen, M. et al, ‘Effect of cholesterol-lowering diet on mortality from coronary heart disease and other causes’, Lancet, 2:835, 1972

    Article  Google Scholar 

  52. Gray, N. & Hill, D., ‘Patterns of tobacco smoking in Australia’, Med J Aust, 2:327, 1977

    Google Scholar 

  53. Leader, S. et al, ‘Cigarette smoking in Sydney schoolchildren aged 12 to 13 years: 1971 to 1975’, Med J Aust, 1:325, 1977

    Google Scholar 

  54. Final Report, ‘National diet-heart study’, Circ, 37, Supp 1, 1968

    Google Scholar 

  55. Meade, T. et al (letter), ‘Prevention of coronary heart disease’, Lancet, 1:269, 1974

    Article  Google Scholar 

  56. Mann, G. (letter), ‘Prevention of coronary heart disease’, Lancet, 1:63, 1974

    Google Scholar 

  57. Mann, G., ‘Diet-heart: end of an era’, N Engl J Med, 297:644, 1977

    Article  Google Scholar 

  58. Tudor Hart, J., ‘Ischaemic Heart Disease’ in C. Hart (ed), Screening in General Practice, Churchill Livingstone, London, 1975, p. 199

    Google Scholar 

  59. Glueck, C. et al, ‘Diet and coronary heart disease: another view’, N Engl J Med, 298:1471, 1978

    Article  Google Scholar 

  60. Editorial, ‘Symptoms in hypertension’, Br Med J, 1:433, 1973

    Article  Google Scholar 

  61. Langfield, S., ‘Hypertension: Deficient care of the medically served’, Ann Int Med, 78:19, 1973

    Article  Google Scholar 

  62. Podell, R. and Gray, L., ‘Hypertension and compliance: implications for the primary physician’, N Engl J Med, 294:1120, 1976

    Article  Google Scholar 

  63. Hayes, R. et al, ‘Improvement of medication compliance in uncontrolled hypertension’, Lancet, 1:1265, 1976

    Google Scholar 

  64. D’Souza, M. et al, ‘A long term controlled trial of screening for hypertension in general practice’, Lancet, 1:1228, 1976

    Article  Google Scholar 

  65. Moore, P. (ed), ‘Breast self-examination’, N Engl J Med, 299:304, 1978

    Google Scholar 

  66. Shapiro, S. et al, ‘Role of periodic breast cancer screening in reducing mortality from breast cancer’, J Am Med Ass, 215:1777, 1971

    Article  Google Scholar 

  67. Greenberg, D., ‘X-ray mammography — background to a decision’, N Engl J Med, 295:379, 1976

    Google Scholar 

  68. Bailar, J., ‘Mammography: a contrary view’, Ann Int Med, 84:77, 1976

    Article  Google Scholar 

  69. Wanebo, C. et al, ‘Breast cancer after exposure to the atomic bombings of Hiroshima and Nagasaki’, N Engl J Med, 279:667, 1968

    Article  Google Scholar 

  70. Editorial, ‘Radiation-induced breast cancer’, Br Med J, 1:191, 1977

    Google Scholar 

  71. Massachusetts Dept. of Public Health, ‘Mammography — a question’, N Engl J Med, 294:395, 1976

    Google Scholar 

  72. Sadowsky, N. et al, ‘Radiologic detection of breast cancer’, N Engl J Med, 294:37, 1976

    Article  Google Scholar 

  73. Enthoven, A., ‘Cutting cost without cutting the quality of care’, N Engl J Med, 298:1229, 1978

    Article  Google Scholar 

  74. Carbone, P. (ed), ‘A lesson from the mammography issue’, Ann Int Med, 88:703, 1978

    Google Scholar 

  75. British Breast Group, ‘Screening for breast cancer’, Br Med J, 3:357, 1975

    Article  Google Scholar 

  76. Thier, S., ‘Breast-cancer screening: a view from the outside’, N Engl J Med, 297:1063, 1977

    Article  Google Scholar 

III: ‘The Art and Science of Non-disease’

  1. Meador, C., ‘The Art and Science of Non-disease’, N Engl J Med, 272:92, 1965

    Article  Google Scholar 

  2. Bergman, A. & Stamm, S., ‘The morbidity of cardiac non-disease in schoolchildren’, N Engl J Med, 276:1008, 1967

    Article  Google Scholar 

  3. Wood, P., Diseases of the heart and circulation, Eyre & Spottiswoode, London, 1968, p. 595

    Google Scholar 

  4. Cayler, G. et al, ‘The effect of cardiac “non-disease” on intellectual and perceptual motor development’, Br Heart J, 35:543, 1973

    Article  Google Scholar 

IV: The Phenomenon of ‘Medicalization’

  1. Stolley, P. et al, ‘Drug prescribing and use in an American community’, Ann Int Med, 76:537, 1972

    Article  Google Scholar 

  2. Editorial, ‘Antibiotics and respiratory illness’, Br Med J, 3:1, 1974

    Article  Google Scholar 

  3. Editorial, ‘Cough suppressants for children’, Br Med J, 2:493, 1976

    Google Scholar 

  4. Thomas, K., ‘The consultation and the therapeutic illusion’, Br Med J, 1:1327, 1978

    Article  Google Scholar 

  5. Mahler, H., ‘Health — a demystification of medical technology’, Lancet, 2:829, 1975

    Google Scholar 

  6. Trethowan, W., ‘Pills for personal problems’, Br Med J, 3:749, 1975

    Article  Google Scholar 

  7. Editorial, ‘Benzodiazephines: use, over-use, misuse, abuse’, Lancet, 1:1101, 1973

    Google Scholar 

  8. Editorial, ‘Comfort without drugs’, Br Med J, 3:367, 1973

    Article  Google Scholar 

  9. Nightingale, S. et al, (eds), ‘Inappropriate prescribing of psychoactive drugs’, Ann Int Med, 83:896, 1975

    Google Scholar 

Download references

Authors

Copyright information

© 1979 Richard Taylor

About this chapter

Cite this chapter

Taylor, R. (1979). Patientization of the Population. In: Medicine Out of Control. Palgrave, London. https://doi.org/10.1007/978-1-349-05776-4_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-349-05776-4_8

  • Publisher Name: Palgrave, London

  • Print ISBN: 978-0-333-30623-9

  • Online ISBN: 978-1-349-05776-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics