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January 23, 1967

Medicine in Modern Society: Medical Planning Based on Evaluation of Medical Achievement

Author Affiliations

Rochester, NY


by Thomas McKeown, 234 pp, 13 illus, $5.25, London: George Allen & Unwin, Ltd. (New York: Hafner Publishing Co.), 1966.

JAMA. 1967;199(4):284. doi:10.1001/jama.1967.03120040094034

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Writings on the social relations of medicine may all too often be concerned with administrative and financial aspects and take on the form of special pleading. This book is devoted to showing that the fundamental social problems are the same regardless of how the bill is paid and that these problems vary with the stage of development of a country and not with its economic system, however much the latter may influence details. A preliminary historical survey indicates that the tremendous decrease of mortality in the 18th century was caused by a rise in the standard of living, in the 19th by hygienic measures, and only in our own century has medical practice itself influenced length of life to any considerable degree.

Although McKeown's writings are mostly based on British problems, he frequently describes American experience, and we require only a little adjustment to apply his findings to our own