The Gold Standard: The Challenge of Evidence-Based Medicine and Standardization in Health Care

by Timmermans, Stefan; Berg, Marc

• ISBN13: 9781592131884
• ISBN10: 1592131883
• Format: Paperback
• Copyright: 2003-06-13
• Publisher: Temple Univ Pr

Summary

Few things make people react more strongly to the changes going on in health care than the word standardization. Critics shudder at the mindless sameness of standards, while supporters dream of a world in which standardized "best practices" open up a world of efficient health care delivery. The Gold Standard takes up this debate to investigate the real meaning of standardization and how it affects patients, doctors, and the institution of medicine.Showing that standards are not about less or more skills, or more or less uniformity, but rather about a redefinition of autonomy, patients, and relationships, Timmermans and Berg show instead that they are about creating new worlds of medical treatment. Cutting through the hype and fears, the authors show where the true powers of standardization lie. The Gold Standard will become a classic for students of medicine and health care policy, and will be a welcome book for anyone concerned with the future of our system of care.Author note: Stefan Timmermans is Associate Professor of Sociology at Brandeis University, and author of Sudden Death and the Myth of CPR (Temple), which was nominated for the C. Wright Mills Book Award.Marc Berg is Professor of Social Medical Sciences at the Erasmus University Medical Center in The Netherlands, and author of Rationalizing Medical Work: A Study of Decision Support Techniques and Medical Practices.

Table of Contents

Acknowledgments	vii
Introduction: The Politics of Standardization	1	(29)
1 Standardization in Medicine in the Twentieth Century: The Emergence of the Paper-Based Patient Record	30	(25)
2 Standards at Work: A Dynamic Transformation of Medicine	55	(27)
3 From Autonomy to Accountability? Clinical Practice Guidelines and Professionalization	82	(35)
4 Guidelines, Professionals, and the Production of Objectivity in Insurance Medicine	117	(25)
5 Evidence-Based Medicine and Learning to Doctor	142	(24)
6 Standardizing Risk: A Case Study of Thalidomide	166	(29)
Epilogue: The Quest for Quality	195	(22)
Notes	217	(26)
Bibliography	243	(22)
Index	265