Challenging Medicine

Ed Jonathan Gabe, David Kelleher, Gareth Williams Routledge, pounds sterling 12.99, pp 199 ISBN 0-415-088178

The external challenges to medicine discussed in this collection of nine essays include antivivisectionism, nurses seeking their own autonomous place in the division of medical labour, and the challenge of unorthodox alternatives to regular medicine.

Most of these challenges have long histories; some are new—for example, David Kelleher's suggestion that while self help groups organised around specific chronic diseases are largely complementary to the work of medicine, they nevertheless promote “a subversive readiness to question the knowledge of doctors.” Other new challenges based at least partly in the lay experience include “popular epidemiology,” the feminist critique of medicine, and the increase in Britain since 1980 of tort litigation.

Overall, the essays—all by medical sociologists—question whether medicine will remain for long a dominant profession. What do the challenges portend?

The opening essay by David Hunter discusses the one challenge that is probably foremost on doctors' minds: Will medicine's influence in health care be eroded by the “managerial revolution?” Hunter says “No.” Doctors, he argues, have …