The Shift in Health Care
27th January, 2025
With the recent inauguration of Donald Trump as President of the United States, Sander L. Gilman looks at the impact of this and other factors on health care around the world.
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What happens in health care when everything changes on a dime? When a new President, whose major accomplishment in his last term in office was the creation of a vaccine for COVID-19 that saved millions of lives, appoints anti-vaxxers to run the cabinet office that approves vaccines? When Parliament decides to authorize physicians to terminate life to ameliorate suffering, in a nation with a state religion that rests on Christ’s suffering on the cross and which has permanent seats in the House of Lords for Anglican bishops?
My new book, DOC OR QUACK: SCIENCE AND ANTI-SCIENCE IN MODERN MEDICINE (Reaktion Books, London, April 2025) looks at the complex relationship between the ever-changing claims of science to provide tools to heal and the constant shifts in clinical medicine responding to these claims. Science is always changing, not always for the better, and, weirdly, even really bad science can cure in the clinic, as I show over and over again. These changes are political, in the sense that they link all aspects of our lives, as patients or medical professionals (or indeed as both), as tax-paying and benefit receiving citizens, as consumers (of pharmaceuticals and medical devices) and as part of a world in which the risk of illness, personal or collective is omnipresent.
Showing how the world that spans the laboratory and the clinic constantly evolved from the age of Victoria to that of Charles III and Trump II, I unravel how each new claim of science (almost) replaces the next in the clinic. My account of how medical science dealt and deals with specific complaints such as stomach ulcers and eye disease as well as the clinical use and abuse of specific therapies, such as acupuncture, illustrates the inherent instability of the move from the lab to the clinic. All of these tales rest on the ever-shifting claims in our hope in this age of science of how the physician can best heal us, with the older claims and beliefs hanging on for dear life among physicians and patients even as newer and ‘better’ science makes better or at least different medicine, only to be replaced by the next set of claims. Such shifts sometimes improving the lives of not only individuals but entire generations, some shifts curing despite themselves, having at least a potential to heal or at least ‘do no harm.’ All of us are part of this system and I hope that my passion for detail can help us understands the meanings of each shift of health care in 2025.
– Sander L. Gilman
Sander L. Gilman is a distinguished professor emeritus of the Liberal Arts and Sciences as well as emeritus Professor of Psychiatry at Emory University
You can pre-order Doc or Quack: Science and Anti-Science in Modern Medicine from our online shop now.
