Impact of AIDS on Medical Work

The descriptors of the changes that germinated immune deficiency syndrome has brought into this work purlieu are gleaned from medical exam checkup literature, Bosk and Frader's training experiences, and thirty interviews with medical personnel who care for AIDS patients.

The shop floor culture of medical house officers and students is apparently a peer culture. Senior ability members are mostly absent. When they do appear, they tend to "pimp" (humiliate by obscure questioning) the house officers, creating a hostile, fearful environment. The patient becomes the enemy. This nerve-racking arrangement requires that one become extremely target areaive toward the patient, the object of cutting and puncturing. Slang and humor increase social distance, and the fantasise of invulnerability all in allows officers and students to take on a cavalier elbow room in reference to horrible problems (Bosk & Frader, 1990, p. 263).

Even though medical literature emphasizes over and over again that the risk of the AIDS virus passing from the patient to care-giver is minimal, fear runs rampant on the wards. Workers at times sheath themselves with various types of protections and may just now refuse to approach an AIDS patient. Bosk and Frader quote Klass: "We have to pillow slip the fact that we are going through these little rituals of hearty precaution because we are terrified of this distemper..." (1990, p. 265).

AIDS affects younger people than those p

McKeown argues that the treatment of an established disease, although authoritative to a patient, does not restore him to a life of average duration and quality. These hints of discrimination echo the thoughts of Bosk and Frader in their description of the hierarchy of AIDS patients, particularly in the lowest strata of drug users and their partners.

Although this part would provide the most available group for experimentation and win in the cure of AIDS, actually they receive the poorest quality care.

The Milbank Quarterly, 68, Suppl. 2, 257-279.

McKeown separates an elicit concept put forth originally by Greenwood--that of the "ever-varying state of the immunological constitution of the herd" (1979, p. 47). AIDS seems to be the disease of the mid 20th century and is perhaps independent of all that is thought to connect with it. Nevertheless the extreme fear soon associated with AIDS unmistakably affects the quality of medical school direction and the quality of patient care in urban teaching hospitals.

McKeown discusses the profound effects of the traditions of teaching hospitals on medical education. He notes that the quality of a medical service can be no more enlightened than the minds of the doctors who provide it (McKeown, 1979, p. 154). Inevitably students acquire the attitudes of their teachers.

National Health Interview Survey (August, 1979). United States.

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