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

by Kenneth M. Ludmerer

Overview

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. He traces its development from its nineteenth-century roots through its present-day struggles to cope with new, bureaucratic work-hour regulations for house officers and, more important, to preserve excellence in medical training amid a highly commercialized health care system.

Let Me Heal provides a highly engaging, richly contextualized account of the residency system in all its dimensions. It also brilliantly analyzes the mutual relationship between residency education and patient care in America. The book shows that the quality 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.

Let Me Heal is both a stunning work of scholarship and a highly engaging account of how one becomes a doctor in the United States. It is indispensable reading for those who wish to understand what it means to learn and practice medicine and what is needed to make medical education and patient care in America better. The definitive work on the subject, it is destined to become a classic that will be consulted by readers far into the future.

Product Details

ISBN-13:	9780199744541
Publisher:	Oxford University Press
Publication date:	10/01/2014
Pages:	456
Product dimensions:	6.10(w) x 9.30(h) x 1.50(d)

About the Author

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 in St. Louis, Missouri.

Table of Contents

1. ANTECEDENTS
The Search for Clinical Experience
The Quest for Specialty Training
The Passion for Discovery and the Birth of Clinical Science

2. JOHNS HOPKINS AND THE CREATION OF THE RESIDENCY
Graduate Medical Education Enters the University
The Scientific Practitioner and the Promise for the Nation
Work as Play
Diaspora

3. THE GROWTH OF GRADUATE MEDICAL EDUCATION
Completing the Infrastructure
The Maturation of the Internship
The Spread of the Residency
In Search of a System

4. THE AMERICAN RESIDENCY
Educational Principles
The Moral Dimension of Graduate Medical Education
The Learning Environment
Cultural Influences

5. THE LIFE OF A PRE-WORLD WAR II HOUSE OFFICER
Obtaining a Residency
Experiencing the Residency
Education and Service

6. CONSOLIDATING THE SYSTEM
The Second Reform of Medical Education
The Rise of the Specialty Boards and the Triumph of Residency
Graduate Medical Education and the Public Good

7. THE EXPANSION OF THE RESIDENCY IN N ERA OF ABUNDANCE
From Privilege to Right
The Maturation of Clinical Science and the Creation of
Subspecialty Fellowships
The Ascendance of Specialty Practice
The Propagation of Wastefulness

8. THE EVOLVING LEARNING ENVIRONMENT
The Decline of the Ward Service
The Preservation of Educational Quality
Maintaining the Moral Mission

9. THE LIFE OF A POST-WORLD WAR II HOUSE OFFICER
Changes and Continuities
Quality, Safety, and Supervision
Education and Service, Again

10. THE WEAKENING OF THE EDUCATIONAL COMMUNITY
The Marginalization of House Officers
House Staff Activism
The Discovery of Burnout

11. THE ERA OF HIGH THROUGHPUT
The New Learning Environment
The Subversion of the Moral Mission
Changing Attitudes toward Work and Life

12. THE ERA OF ACCOUNTABILITY, PATIENT SAFETY, AND WORK-HOURS REGULATION
Work Hours Restriction
Perpetual Dilemmas

13. PRESERVING EXCELLENCE IN RESIDENCY TRAINING AND MEDICAL CARE
Challenges, New and Old
Aligning Education and Patient Care

Editorial Reviews

"We ... consider this book an invaluable contribution to the field and encourage everyone involved with residency training to read it." —Editors, Journal of Graduate Medical Education

"This book represents an important contribution to our understanding of the history and current state of American residency education and of ers a strong foundation for future research." — Science Magazine

"This latest text should be required reading for every individual interested or involved in graduate medical education." — The American Journal of Medicine

Featured in The New York Review of Books

Featured in Choice

"Every page offers something worthwhile and memorable. The writing is clear and captivating. Particularly impressive are the quality of the research and the meticulous manner in which Ludmerer presents his results. For these reasons - together with the unquestionable importance of the subject covered - I consider this book to be a prime candidate for the Pulitzer Prize." — Herbert L. Fred, Texas Heart Institute Journal

"As the subtitle of Ludmerer's elegant volume suggests, 'the opportunity to preserve excellence in medical education.' Nothing less is at stake, and Let Me Heal ... his magisterial history of postgraduate medical education ... should be our sage guide in this worthy pursuit."
—The American Journal of Bioethics

"Let Me Heal thus fills a significant void in our understanding of the history of an integral part of the U.S. health-care system... Ludmerer makes it clear that, in order to understand the history of the past century of U.S. medicine, we need to understand the history of residency programs. This book is a landmark achievement the definitive account of the history of the residency."
—PROJECT MUSE

"This is an excellent book for all interested in medical education and the history of medicine, regardless of specialty." - Annals of Emergency Medicine

From the Publisher