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The Product of Medicine

How Efficiency Made American Health Care

Book

Pages: 240

Illustrations: 13 illustrations

Published: April 2025

Author: Caitjan Gainty

In The Product of Medicine, Caitjan Gainty traces the history of the early twentieth-century medical efficiency movement in the United States, restoring it as a significant driver of medicine’s modernization while also revealing its broader significance as a cultural force shaping modern American life. Covering a range of  efficiency’s uses in medicine—from the assembly-line structure of the early Mayo Clinic and Henry Ford Hospital to the landmark Flexner Report and the prosecution of the American Medical Association as a monopoly—Gainty challenges long-standing presumptions about how medicine acquired power and prestige during the Progressive Era. Gainty demonstrates how, rather than as a result of pathbreaking scientific advance or the rise of professional organizations, medicine came to be understood as modern through the more prosaic processes of standardization and organization. In doing so, Gainty uncovers medical efficiency as not only a function of industrial capitalism but also a vehicle for balancing populist and autocratic tendencies to maintain a workable American democracy.

Praise

“What does the surgeon’s table owe to the factory floor? Caitjan Gainty reveals this and much more in her subtle, surprising, and endlessly fascinating account of American medical practitioners’ encounter with early twentieth-century industrial efficiency experts. Applying a historian’s scalpel to the rationalizing but also egalitarian ambitions of the era when medicine modernized, she adroitly lays bare the tensions—past and present—of health care provision in a capitalist democracy.” - Sarah E. Igo, author of The Known Citizen: A History of Privacy in Modern America

“In this fascinating and fabulous book Caitjan Gainty retells the story of US medical history through the lens of industrialization and the industrial logics that made American medicine modern. Impressively conceptualized, cogently argued, and beautifully written, this book will attract significant interest while making an important contribution to the field.” - Joseph M. Gabriel, author of Medical Monopoly: Intellectual Property Rights and the Origins of the Modern Pharmaceutical Industry

"The work is . . . an important contribution not just to histories of efficiency, but broader histories of American medicine, one of broad interest to historians and sociologists—researchers, students, and educators alike." - Martin D. Moore, Journal of the History of the Behavioral Sciences

"[A] gold standard for scholarly reference related to the history of 20th century medical efficiency." - Eric Persaud, Family Medicine

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Author/Editor Bios

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Caitjan Gainty is Senior Lecturer in the History of Science, Technology, and Medicine at King’s College, London.

Table Of Contents

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Acknowledgments  ix
Introduction  1
1. The Product  17
2. The Factory  39
3. The Standard  63
4. The Labor  91
5. The Market  115
6. Monopoly  139
Afterword  163
Notes  169
Bibliography  199
Index  221

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Additional Information

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Paper ISBN: 978-1-4780-3160-4 / Hardcover ISBN: 978-1-4780-2842-0 / eISBN: 978-1-4780-6061-1 / DOI: https://doi.org/10.1215/9781478060611