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Dissociation in medical practice: Social distress and the health care system


The average physician has developed several different heads, each representing another self on the same body. One is that of the conventional, ethical professional who wants nothing more than to improve mankind's health and well-being, the standard model. Another is the scientist who intends to be perceived as calculating, cold, and factual in determining what will or will not assist the ailing patient (Uexkull & Hannes, 1986). His tools are drugs, surgery, and hospitalization for presumed physical and mental ills. The third, and the one that concerns us the most, is what I will call “the neo-capitalist professional hero” (Lifion, 1971). This persona is an evolution of our American dominated international culture which the medical profession as a group has honored by honing and polishing with extraordinary skill, second only to politicians and bankers, maximizing it to the further detriment of the entire society. Though the body needs all three to function, none of these heads willingly acknowledges or supports the importance of the others. In what follows, a variety of media, journals, professional books, and a survey are referred to in documenting data about ethical laxity and fraud in the medical profession. Institutional, social concepts are developed that explain the data, and revealing how social distress is the embodiment of the neo-capitalist professional hero. There are also suggestions for remedies in what follows, which are presented without realistic hope for implementation very soon, unfortunately, since they involve deep changes in established social institutions. However, the country at large has developed some awareness of a problem which has reached epidemic proportions in the medical profession. Further increments in awareness promise to tip the balance into positive government action.

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Miller, D.W. Dissociation in medical practice: Social distress and the health care system. J Soc Distress Homeless 2, 243–267 (1993).

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  • Health Care
  • Health Care System
  • Medical Practice
  • Medical Profession
  • Social Institution