May 1990

In Sickness and in Wealth: American Hospitals in the Twentieth Century

Author Affiliations

Section of Child Neurology Department of Pediatrics University of Arizona College of Medicine Tucson, AZ 85724


by R. Stevens, 432 pp, $24.95, New York, NY, Basic Books Inc, 1989.

Am J Dis Child. 1990;144(5):600. doi:10.1001/archpedi.1990.02150290094036

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As the title shows, the author, currently chairman of the Department of History and Sociology of Science at the University of Pennsylvania, uses the English language well. Formerly a hospital administrator, then a policy analyst and subsequently a historian, she has studied both the British and American health care systems and has written knowledgeably about a variety of subjects relating to them.

In this latest book, she describes our current hospital system, where it has come from, its characteristics, how it works, and why it does not work better. She discusses technological vs social welfare goals, characteristics of the American hospital system, and the process of change.

Most physicians who work daily in hospitals fail to have this long-term broad perspective, and certainly few of us could write as well about it as Rosemary Stevens. There are chapters on charities and businesses, regulating hospitals, the case for cooperative medicine (World

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