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From Residency to Retirement tells the stories of twenty American doctors over the last half century, which saw a period of continuous, turbulent, and transformative changes to the U.S. health care system. The cohort's experiences are reflective of the generation of physicians who came of age as presidents Carter and Reagan began to focus on costs and benefits of health services.
Mizrahi observed and interviewed these physicians in six timeframes ending in 2016. Beginning with medical school in the mid-1970s, these physicians reveal the myriad fluctuations and uncertainties in their professional practice, working conditions, collegial relationships, and patient interactions. In their own words, they provide a "view from the front lines" both in academic and community settings. They disclose the satisfactions and strains in coping with macro policies enacted by government and insurance companies over their career trajectory.
They describe their residency in internal medicine in a large southern urban medical center as a "siege mentality" which lessened as they began their careers, in Getting Rid of Patients, the title of Mizrahi's first book (1986). As these doctors moved on in their professional lives more of their experiences were discussed in terms of dissatisfaction with financial remuneration, emotional gratification, and intellectual fulfillment. Such moments of career frustration, however, were also interspersed with moments of satisfaction at different stages of their medical careers. Particularly revealing was whether they were optimistic about the future at each stage of their career and whether they would recommend a medical career to their children. Mizrahi's subjects also divulge their private feelings of disillusionment and fear of failure given the malpractice epidemic and lawsuits threatened or actually brought against so many doctors. Mizrahi's work, covering almost fifty years, provides rarely viewed insights into the lives of physicians over a professional life span.
From Residency to Retirement tells the stories of twenty American doctors over the last half century, which saw a period of continuous, turbulent, and transformative changes to the U.S. health care system. The cohort's experiences are reflective of the generation of physicians who came of age as presidents Carter and Reagan began to focus on costs and benefits of health services.
Mizrahi observed and interviewed these physicians in six timeframes ending in 2016. Beginning with medical school in the mid-1970s, these physicians reveal the myriad fluctuations and uncertainties in their professional practice, working conditions, collegial relationships, and patient interactions. In their own words, they provide a "view from the front lines" both in academic and community settings. They disclose the satisfactions and strains in coping with macro policies enacted by government and insurance companies over their career trajectory.
They describe their residency in internal medicine in a large southern urban medical center as a "siege mentality" which lessened as they began their careers, in Getting Rid of Patients, the title of Mizrahi's first book (1986). As these doctors moved on in their professional lives more of their experiences were discussed in terms of dissatisfaction with financial remuneration, emotional gratification, and intellectual fulfillment. Such moments of career frustration, however, were also interspersed with moments of satisfaction at different stages of their medical careers. Particularly revealing was whether they were optimistic about the future at each stage of their career and whether they would recommend a medical career to their children. Mizrahi's subjects also divulge their private feelings of disillusionment and fear of failure given the malpractice epidemic and lawsuits threatened or actually brought against so many doctors. Mizrahi's work, covering almost fifty years, provides rarely viewed insights into the lives of physicians over a professional life span.
1 Introduction
2 Meet the Doctors: Career Choices in Their Own Voices
3 Satisfaction and Strains: The Ups and Downs of Being a Doctor,
Part I (Early to Mid-Career)
4 Satisfaction and Strains: The Ups and Downs of Being a Doctor,
Part II (Mid-Career to Retirement)
5 “Speaking of Their Own”: Relationships with Peers, Partners, and
Protégés
6 Mistakes and Malpractice: The Bane of Physicians
7 The Physicians on Health Regulations, Reimbursement, and
Reform
8 Vulnerability from Within: Hidden Revelations about
Disillusionment, Cynicism, Fear of Failure, and Self-Doubt
9 The Personal and the Professional: The Interaction between
Private Lives and Public Postures
10 Physicians’ Happiest and Unhappiest Times, and Their Wishes and
Misses throughout Their Careers
11 Conclusion
Acknowledgments
Notes
References
Index
TERRY MIZRAHI is a sociologist and a social worker. She has
been a professor at the Silberman School of Social Work at Hunter
College of the City University of New York since 1980. She is the
author of dozens of scholarly and professional articles and five
books on health policy and practice; community organizing;
interdisciplinary and interprofessional collaboration; and social
work-physician relationships. Her first book, Getting Rid of
Patients: Contradictions in the Socialization of Physician (Rutgers
University Press) is the predecessor to From Residency to
Retirement.
"This is a wonderful, unique book because it spans almost forty
years in the careers of a group of physicians. It deals with
important questions about aspects of career satisfaction from
interpersonal relationships to health care reform. As a physician
still in clinical practice, whose career evolved during the same
period covered by these interviews, the book evoked some deep
reflection on my own career."— Oliver Fein, Weill Cornell Medical
College, Cornell University
"From Residency to Retirement is a unique, engaging, and very
personal study of a group of over twenty physicians. Mizrahi’s
work, notable for its longitudinal depth, personal information, and
relation to the enormity of changes in the medical profession over
the period, includes the cohort's struggles, professional and
personal, all in the context of patient care and practices during
the study period. It is unique, well-written, important, and
timely. I highly recommend it."
— Ira Mehlman, Medical Corps physician
"Drawing on in-depth interviews of physicians that span their
35-year careers, Terry Mizrahi provides a unique, insightful
account of early, mid-, and late-stage achievements, frustrations,
and challenges from the 1980s through the second decade of the 21st
century. Well organized and clearly written, this book will
interest families, professionals, sociologists, and educators."—
Donald W. Light, author of Becoming Psychiatrists: the Professional
Transformation of Self
"Mizrahi’s latest book can be read alone or as a wonderfully
informative sequel to Getting Rid of Patients, her
earlier exploration of the career journeys of White male
physicians. From Residency to Retirement begins with many of
these same men 40+ years later sharing their stories. Through these
narratives we learn how, over these years, these doctors and the
medical profession have endured and adapted to an ever-changing
often tumultuous environment."— Darlyne Bailey, Ph.D., LISW,
Professor, Dean Emeritus, and Director, Social Justice Initiative;
Graduate School of Social Work an
"In this incredible followup to her now classic work, Getting
Rid of Patients, Mizrahi has provided us an incredible gift: a
'follow-up' on this cohort as they navigated their own lives,
and the vast changes in medical practice that have overtaken
them. It should give every young student aspiring to be a
physician pause, as they think about entering medicine as a
profession. They may—or may not—know what they are getting into."—
David K. Rosner, author of Lead Wars: The Politics of Science and
the Fate of America's Children
"Mizrahi's compelling portrait of physicians' career trajectories
speaks to the failure of American health policy. Buffeted by waves
of policy changes that failed to address key problems, many
practitioners ended their careers profoundly dissatisfied,
lamenting encroachments on their autonomy and feeling less valued
by society."— Martin Shapiro, Weill Cornell Medical College,
Cornell University
“From the War on Poverty to Obamacare, health activist and scholar
Terry Mizrahi explores the careers of a cohort of physicians
trained together in internal medicine, as they navigated our
continuously changing health system. Her powerful new insights shed
important light on the very human dimensions of the practice of
medicine during its dramatic transformation over the last forty
years.”— Hal Strelnick, professor of Family & Social Medicine,
Albert Einstein College of Medicine
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