front cover of Biomedicine in an Unstable Place
Biomedicine in an Unstable Place
Infrastructure and Personhood in a Papua New Guinean Hospital
Alice Street
Duke University Press, 2014
Biomedicine in an Unstable Place is the story of people's struggle to make biomedicine work in a public hospital in Papua New Guinea. It is a story encompassing the history of hospital infrastructures as sites of colonial and postcolonial governance, the simultaneous production of Papua New Guinea as a site of global medical research and public health, and people's encounters with urban institutions and biomedical technologies. In Papua New Guinea, a century of state building has weakened already inadequate colonial infrastructures, and people experience the hospital as a space of institutional, medical, and ontological instability.

In the hospital's clinics, biomedical practitioners struggle amid severe resource shortages to make the diseased body visible and knowable to the clinical gaze. That struggle is entangled with attempts by doctors, nurses, and patients to make themselves visible to external others—to kin, clinical experts, global scientists, politicians, and international development workers—as socially recognizable and valuable persons. Here hospital infrastructures emerge as relational technologies that are fundamentally fragile but also offer crucial opportunities for making people visible and knowable in new, unpredictable, and powerful ways.
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front cover of Challenging Operations
Challenging Operations
Medical Reform and Resistance in Surgery
Katherine C. Kellogg
University of Chicago Press, 2011

In 2003, in the face of errors and accidents caused by medical and surgical trainees, the American Council of Graduate Medical Education mandated a reduction in resident work hours to eighty per week. Over the course of two and a half years spent observing residents and staff surgeons trying to implement this new regulation, Katherine C. Kellogg discovered that resistance to it was both strong and successful—in fact, two of the three hospitals she studied failed to make the change. Challenging Operations takes up the apparent paradox of medical professionals resisting reforms designed to help them and their patients. Through vivid anecdotes, interviews, and incisive observation and analysis, Kellogg shows the complex ways that institutional reforms spark resistance when they challenge long-standing beliefs, roles, and systems of authority.

At a time when numerous policies have been enacted to address the nation’s soaring medical costs, uneven access to care, and shortage of primary-care physicians, Challenging Operations sheds new light on the difficulty of implementing reforms and offers concrete recommendations for effectively meeting that challenge.

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front cover of Physicians and Hospitals
Physicians and Hospitals
The Great Partnership at the Crossroads
Duncan Yaggy and Patricia Hodgson, eds.
Duke University Press, 1985
Physicians and Hospitals addresses an issue of concern and one of fundamental importance to the American health care system. While the ranks of physicians continue to swell and hospitals continue to expand their facilities, federal, state, and local governments remain determined to control health care expenditures. As a result, checks on the supply of services and facilities have been implemented that strain the physician-hospital relationship, often placing physicians and hospital administrations in conflict. The implications for American health care are the subject of disagreement and vigorous debate.
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