Is our work dangerous? Should it be? 1998

H Waitzkin
Division of Community Medicine, University of New Mexico, USA.

Three case histories show how work in the medical social sciences--to the extent that such work reveals the origins of health problems in social structures of wealth and power--can become dangerous enough to threaten one's livelihood and in some instances one's very life. In this presentation, I encourage critical and engaged scholarship by referring to examples of dangerous work that should receive more attention: social medicine in Latin America and the critique of managerial ideology in the United States. Although social medicine has become a widely respected field of research, teaching, and clinical practice in Latin America, its accomplishments remain little known in the English-speaking world. For centuries, indigenous cultures in Latin America have held belief systems linking social conditions to patterns of illness and death. Latin American accounts of social medicine's history emphasize its European origins, especially in the contributions of Rudolf Virchow. In the United States, with the impact of the Flexner Report (1910) and its supporters, Virchow's vision of social medicine went into decline. On the other hand, in Latin America, social medicine flourished as a focus of education and research. Since social medicine's "golden age" during the 1930s, teachers, researchers, and practitioners have produced major achievements despite the dangers of this work, which in several instances have included torture, imprisonment, or death. An ideology favoring managerial decision making in the United States has influenced crucial policy decisions, and the justifications for these decisions have manifested symbolic politics in addition to the evaluation of factual evidence. With ambiguous empirical support, managerial ideology has fostered the general growth of managed care, the implementation of Medicaid managed care by state governments, the expansion of managed care in rural areas, and the impact of "evidence-based medicine" on policy and clinical decisions. If the occupational risks of critical work in the medical social sciences are not taken, we forfeit some of the most important gifts offered by "the sociological imagination."

UI MeSH Term Description Entries
D007843 Latin America The geographic area of Mexico, Central America, continent of South America and the islands of the Caribbean where Spanish or other Romance language is spoken.
D011056 Political Systems The units based on political theory and chosen by countries under which their governmental power is organized and administered to their citizens. Political System,System, Political,Systems, Political
D003617 Dangerous Behavior Actions which have a high risk of being harmful or injurious to oneself or others. Behavior, Dangerous,Dangerousness,Hazardous Behavior,Behavior, Hazardous,Behaviors, Hazardous,Dangerous Behaviors,Hazardous Behaviors
D006291 Health Policy Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system. Health Care Policies,Health Policies,Healthcare Policy,National Health Policy,Care Policies, Health,Health Care Policy,Health Policy, National,Healthcare Policies,National Health Policies,Policies, Health,Policies, Health Care,Policies, Healthcare,Policy, Health,Policy, Health Care,Policy, Healthcare
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001363 Awards and Prizes Awards,Prizes,Award,Prize,Prizes and Awards
D012936 Social Medicine A branch of medicine concerned with the role of socio-environmental factors in the occurrence, prevention and treatment of disease. Medicine, Social
D012962 Sociology, Medical The study of the social determinants and social effects of health and disease, and of the social structure of medical institutions or professions. Medical Sociology,Sociology of Medicine
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.

Related Publications

H Waitzkin
October 1977, The Washington post,
H Waitzkin
June 2004, Bulletin of the American College of Surgeons,
H Waitzkin
March 1986, Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke,
H Waitzkin
December 2001, Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke,
H Waitzkin
January 2010, Ugeskrift for laeger,
H Waitzkin
February 1981, The Journal of surgical research,
H Waitzkin
September 1971, AORN journal,
H Waitzkin
May 1999, Ugeskrift for laeger,
Copied contents to your clipboard!