Health care under the knife: moving beyond capitalism for our health


  • Martin Donohoe MD, FACP, Adjunct Associate Professor, School of Community Health, Portland State University; Chief Science Advisor, Campaign for Safe Foods; Member, Board of Advisors, Oregon Physicians for Social Responsibility; Senior Physician, Internal Medicine, Kaiser Sunnyside Medical Center. or


Reviewer’s note: Authors of each subsection are a who’s who of social medicine, many of whom I count as mentors and friends (including Waitzkin), and as such I am neither a disinterested nor unbiased reviewer. Dr. Waitzkin1 also endorsed my own book2 with a back of the cover blurb (as did others), although my (perhaps) fragile ego and my mother’s equally glowing endorsement compel me to write this off to my literary skills, rather than our friendship! I have no financial arrangements with any of the authors. I have critically assessed the volume with recognition of my subjective biases as best as humanly possible. Furthermore, I have supplemented my review with my own critiques of contemporary medicine and suggestions for improving health care for all.


The prolific Dr. Waitzkin also authored the following books: The exploitation of illness in capitalist society (The Bobbs-Merrill studies in sociology) (Indianapolis; Bobbs-Merrill; 1974); The Politics of Medical Encounters: How Patients and Doctors Deal With Social Problems (New Haven; Yale University Press; 1993); The Second Sickness: Contradictions of Capitalist Health Care (Oxford; Rowman and Littlefield; 2000), At the Front Lines of Medicine: How the Health Care System Alienates Doctors and Mistreats Patients...and What We Can Do About It (Oxford; Rowman and Littlefield; 2001); and Medicine and Public Health at the End of Empire (Colorado; Paradigm Publishers; 2011), previously reviewed in this journal (see Anderson M. Howard Waitzkin’s Medicine and Public Health at the End of Empire. Social Medicine 2012;7(1):1-3. Available at Accessed 4-26-19).

Donohoe MT (Ed). Public Health and Social Justice (San Francisco: Jossey/Bass, 2013). Available at Table of contents and endorsements at

Founder of the Social Medicine Portal (see and editor of this journal.

Bail G, Anderson GF. A More Detailed Understanding Of Factors Associated With Hospital Profitability. Health Affairs 2016:35(5). Available at Accessed 4-19-19.

Young GJ, Chou C-H, Alexander J, Shoou-Yih DL, Raver E. Provision of Community Benefits by Tax-Exempt U.S. Hospitals. N Engl J Med 2013; 368:1519-1527. Available at Accessed 4-19-19. DOI: 10.1056/NEJMsa1210239

For those interested in more in-depth analysis of pharmaceutical company malfeasance, I recommend Donald Light’s The risks of prescription drugs and his website Lexchin’s Private profits versus public policy: the pharmaceutical industry and the Canadian state and Doctors in denial: why big pharma and the Canadian medical profession are too close for comfort illustrate how similar wrongdoings occur north of our border.

The same can be said of high-level mobsters and drug traffickers, who are often praised by their communities and escape capture and prosecution due to their largesse directed at schools, parks, etc.

See Wiist W. The Bottom Line or Public Health: Tactics Corporations Use to Influence Health and Health Policy, and What We Can Do to Counter Them (2010; Oxford University Press). See also Nick Freudenberg’s Corporations and health watch, available at Accessed 4-26-19.

See GM Watch, among other sources, for more details. Available at Accessed 4-26-19

Coulter NA. Militarism: a psychosocial disease. Med War. 1992 Jan-Mar;8(1):7-17.

For a detailed discussion of how literature, art, and photography can be utilized in medical education and training to teach social justice concepts and encourage activism, including specific curricular suggestions, see Donohoe MT. Stories and Society: Using Literature to Teach Medical Students about Public Health and Social Justice. International J of the Creative Arts in Interdisciplinary Practice (IJCAIP) 2009 (Issue 8). Available at Accessed 4-26-19.

See presentations, articles, and policy papers on the Physicians for a National Health Plan website. Available at Accessed 4-26-19.

See numerous open-access slide shows and articles on the Activism and Education page (among others) of the Public Health and Social Justice website. Available at or Accessed 4-26-19.

Examples of good progressive scientific publishing and journalism Include medical journals such as The Lancet and Social Medicine (published in English and Spanish, see; magazines like Mother Jones, Harpers, and the New Yorker: muckraking investigative journalists like those at ProPublica (see; trusted veteran pundits like Democracy Now’s Amy Goodman (see, Jim Hightower (see, and Bill Moyers (see; and comedians like John Stewart, Stephen Colbert, Seth Meyers, John Oliver, Bill Maher, Trevor Noah, Michelle Wolf, and Samantha Bee.

See numerous open-access slide shows and articles on the Women’s Health page of the Public Health and Social Justice website. Available at Accessed 4-26-19.

Donohoe MT. Complicit. Prescription for Justice (cable access television program). Available at (see episode 8) and in podcast form at. Updated print version in press for Social Medicine (2019).

For a discussion of how health care curricula can incorporate the ideas and competencies relevant to the prevention of war, see Role of public health in the prevention of war: rationale and competencies. Am J Publ Hlth 2014(6):e34-e47 – Wiist W, Barker K, Arya N, Rohde J, Donohoe M, White S, Lubens P, Gorman G, Hagopian A. Article and supplemental material available through the American Journal of Public Health at

Karnik A, Tschannerl A, Anderson MR. What is a social medicine doctor? Social Medicine 2015;9(2):56-62. Available at Accessed 4-26-19.

Donohoe MT, Schiff G. Call to Service: Social Justice Is a Public Health Issue. AMA Journal of Ethics;2014(September); 16(9):699-707. Available at Accessed 4-26-19.

See also the People’s Health Movement ( and the People’s Health Assembly ( Accessed 4-26-19.

The Public Health and Social Justice website contains many frequently-updated, open-access slide shows, articles, syllabi, and links to over 1,000 websites/organizations. The site takes no advertising, actually costs me money to maintain, and welcomes new submissions. See or Accessed 4-26-19.

For those interested in other books relevant to social medicine, see the list on the Social Medicine Portal at






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