The medical delivery business: health reform, childbirth, and the economic order

Abstract

New Brunswick, NJ - Twentieth century medical care and its reforms were not designed to meet people's health needs, according to health care consultant Barbara Bridgman Perkins. In her new book, The Medical Delivery Business: Health Reform, Childbirth, and the Economic Order (Publication date: December 2003; 256 pp., Cloth, 0-8135-3328-7), Perkins documents how U.S. medicine developed as a business and challenges the conventional view that a dose of the market is good for medicine. With examples drawn from maternal and infant care, Perkins posits that business strategies utilized in a medical environment could lead to inappropriate interventions. In the case of perinatal care, the business model encouraged the use of surgical procedures, emphasized specialized care over primary care, and unnecessarily turned childbirth into an intensive care situation. In another example, management techniques encouraged obstetricians to use labor-accelerating treatments such as oxytocin to augment their productivity. Despite the achievements of the childbirth and women's health movement in the 1970s, aggressive medical intervention - with inherent economic functions - has remained the birth experience for millions of American women (and their babies) every year. Perkins argues that the medical care system itself needs to be re-formed, and that the reform process should stress democracy, caring, and social justice over economic theory.