Int J Health Serv
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Our objectives are to describe the pattern of abuse associated with battering and to evaluate the contribution of the medical system and of broader social forces to its emergence. A pilot study of 481 women who used the emergency service of a large metropolitan hospital in the U. S. shows that battering includes a history of self-abuse and psychosocial problems, as well as repeated and escalating physical injury. ⋯ Although secondary problems such as depression, drug abuse, suicide attempts, or alcoholism derive as much from the intervention strategy adopted as from physical assault or psychopathology, they are treated as the primary problems at psychiatric and social service referral points where family maintenance is often the therapeutic goal. One consequence of this referral strategy is the stabilization of "violent families" in ways that virtually insure women will be abused in systematic and arbitrary ways. The use of patriarchal logic by medical providers ostensibly responding to physical trauma has less to do with individual "sexism" than with the political and economic constraints under which medicine operates as part of an "extended patriarchy." Medicine's role in battering suggests that the services function to reconstitute the "private" world of patriarchal authority, with violence if necessary, against demands to socialize the labors of love.
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By drawing on a wide range of material, a picture emerges of extensive abuse, discrimination, and exploitation of women and ethnic minorities at the hands of the American health industry. The numbers of minorities and women in professional schools and among the "elite" strata of the industry remain disproportionately low. As patients, they receive often inferior, insensitive treatment. Overall, there is a remarkable similarity in the situation of women and minorities, a condition which reflects the pervasiveness of racism and sexism in American institutions and ideologies.
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This paper analyzes four basic reasons for curtailing the number of foreign medical graduates (FMGs) entering the United States: the loss to less-developed countries, the possible lower quality of medical care delivered by FMGs, the inability of all U. S. citizens who desire to receive a medical education to do so, and the fear of a possible surplus of physicians in the U. ⋯ Based on the options proposed for reducing the number of FMGs, the conclusion is reached that the primary concern at present is an oversupply of U. S. physicians.