Paul Stepansky's In the Hands of Doctors: Touch and Trust in Medical Care explores the human face of doctoring in American medicine from the 19th century to the present. Arguing for the centrality of medical touch -- both comfort touch and procedural touch -- in building trust between doctors and patients, it addresses the nature of medical caring as it has evolved over two centuries. This task leads him to consider the relationship of medical technology to such caring; the nature and possibility of clinical empathy; the impact of physician rating services on doctor-patient relationships; and the need to recruit and train physicians who can bring a caring sensibility to their patients. Mindful of the critical shortage of primary care physicians among the underserved, Stepansky proposes a new kind of primary care specialty, "procedural care medicine," to promote the recruitment and retention of a new generation of frontline physicians. He also examines the expanding role of nurse practitioners in primary care medicine and the role of the "patient-centered medical home" as the site of primary care medicine.
In the Hands of Doctors is winner of an Independent Publisher Books Award Bronze Medal for 2017. The paperback edition includes a new Preface, "Medical Freedom, Then, and Now," in which Stepansky mounts a stirring defense of Obamacare from the standpoint of past and present meanings of "medical freedom" and "medical choice."
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“This book takes many conversations occurring in the world of medicine and reframes
them in historical perspective. The result is a body of work with pearls of wisdom
strung between the pages. In the Hands of Doctors is an engaging and relevant
read for anyone interested in the nuances of the doctor-patient relationship or a
thoughtful narrative on cultivating humanity in the modern practice of medicine.”
Ali Rae, online review, website of The Arnold P. Gold Foundation
“An engaging, richly documented, brilliant critique of the bond between doctor and
patient, ranging from classical times through the present. The need for the bond continues,
Stepansky argues; patients trust doctors, not teams, medical homes or health care systems. Along the way he discusses what it means to 'care' for someone as a professional, whether empathy can be taught, the narrowed scope of family medicine as a field, and how far science and the procedural aspects of medicine are antagonistic to, or simply part of, the humanity inherent in medicine. He offers his own ideas for change. This is a superb introduction to the role of the doctor in a continuing historical context.”
Rosemary Stevens, M.P.H., Ph.D.
DeWitt Wallace Distinguished Scholar, Weill Cornell Medical College
“Paul Stepansky’s In the Hands of Doctors is a unique and compelling reexamination of
American medical practice and patient expectations in historical and cultural context. Examining the many ways in which we seek health literally from the doctor's touch, Stepansky draws on his skills as a respected cultural historian and his perspective growing up the son of a rural general practitioner in the 1950s and 1960s. The result is a multilayered, nuanced, and accessible study that focuses on what physicians have offered and patients have sought, especially since the Second World War. This book deserves a
wide audience not only of health practitioners and patients, but also of medical historians and medical humanities scholars.”
Howard I. Kushner, Ph.D.
Nat C. Robertson Distinguished Professor, Emeritus
Rollins School of Public Health, Emory University
"In the Hands of Doctors is an original contribution to medical history and, in addition, a book that will appeal to all those in the caring professions -- psychotherapists, psychiatrists, psychologists, social workers, nurse practitioners, and others. Dr. Stepansky gives new meaning to the roles of touch, empathy, and friendship as these are involved in medical practice, and he presents original ideas about the shape of such practice as it moves into the next decades. In short, a clearly written and profoundly argued book."
Louis Breger, Ph.D., Professor Psychoanalytic Studies, Emeritus, California Institute of Technology
"One of the greatest challenges confronting 21st-century medical education is how to train physicians who are not only competent but also compassionate, and who know how to demonstrate that caring to the patient. In this engaging and deeply personal book, Paul Stepansky gives us a valuable historical perspectve on caring in medicine and offers suggestions that will be useful for medical educators, practiticing physicians, nurse pratitioners, and patients alike."
Joel D. Howell, M.D., Ph.D., Victor Vaughan Professor the History of Medicine, University of Michigan
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