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The Creation of Time to Heal
- History of medicine
- Education, medical
- Managed care programs
- Physician practice patterns
- Academic medical centers
In November 1999, Oxford University Press published my book Time to Heal: American Medical Education from the Turn of the Century to the Era of Managed Care(1). The purpose of this book is twofold. First, it provides a comprehensive account of the evolution of medical education, medical schools, and teaching hospitals in the United States from the turn of the 20th century to the present, and second, it describes the negative impact of the marketplace on the way in which physicians learn and practice medicine in the era of managed care. The overarching thesis is that academic health centers are highly threatened by managed care, government cutbacks, and the loss of vision among some medical leaders. This situation carries ominous implications for the future of medical education and medical care in the United States. Fortunately, the past bears heavily on the present, and the book also shows how an understanding of the past offers constructive solutions to our current problems.
The creation of Time to Heal illustrated many important points about the writing of medical history, and for these reasons, the editors of Annals of Internal Medicine requested an account of how the book came into being.
The Writing of Medical History
Medical history has a long tradition in Europe, but in the United States it began as an academic discipline in 1929, with the opening of the Institute of the History of Medicine of the Johns Hopkins University School of Medicine. The founder and first director of the Institute, William Welch, was a noted pathologist and the medical school's first dean, not a historian. However, he recruited outstanding European historians, such as Henry Sigerist and Owsei Temkin, to teach at the Institute, which quickly became the major center for research and writing in the history of medicine in the United States.
Since …
