ABOUT THIS BOOK

Few things make people react more strongly to the changes going on in health care than the word standardization. Critics shudder at the mindless sameness of standards, while supporters dream of a world in which standardized "best practices" open up a world of efficient health care delivery. The Gold Standard takes up this debate to investigate the real meaning of standardization and how it affects patients, doctors, and the institution of medicine.Showing that standards are not about less or more skills, or more or less uniformity, but rather about a redefinition of autonomy, patients, and relationships, Timmermans and Berg show instead that they are about creating new worlds of medical treatment. Cutting through the hype and fears, the authors show where the true powers of standardization lie. The Gold Standard will become a classic for students of medicine and health care policy, and will be a welcome book for anyone concerned with the future of our system of care.

AUTHOR BIOGRAPHY

Stefan Timmermans is Associate Professor of Sociology at Brandeis University, and author of Sudden Death and the Myth of CPR (Temple), which was nominated for the C. Wright Mills Book Award.

Marc Berg is Professor of Social Medical Sciences at the Erasmus University Medical Center in The Netherlands, and author of Rationalizing Medical Work: A Study of Decision Support Techniques and Medical Practices.

REVIEWS

"The Gold Standard is an engaging, well thought-out examination of a timely topic-evidence-based medicine. Timmermans and Berg raise taken-for-granted concepts such as power, objectivity, standardization, EBM and discuss them in innovative and complicated interpretations. The arguments presented here provide clarity on animportant subject, highlighting the always interesting impact of unintended consequences."—Alexandra Dundas Todd, Department of Sociology, Suffolk University, and author of Double Vision, An East-West Collaboration for Coping with Cancer

"The Gold Standard is an intelligent and well-written analysis of crucial developments in biomedical practice over the past century. Timmermans and Berg provide us with a comprehensive study of the growing movement to standardize biomedicine, calling attention to the risks and benefits for doctors and patients alike. This unique and important book should attract interest among medical sociologists, science studies scholars, bioethicists, health policy analysts, and all those who care about the practice of medicine today."—Steven Epstein, Department of Sociology, University of California, San Diego, and author of Impure Science: AIDS, Activism, and the Politics of Knowledge

"This book sets the standard for the study of standardization in medicine. Focusing on evidence based medicine's meteoric rise and influence, Timmermans and Berg go beyond the professional rhetoric to examine its impact on the practice of medicine. Well-written and replete with sociological case studies, this book is must reading for social scientists, physicians and policy-makers."—Peter Conrad, Harry Coplan Professor of Social Sciences, Brandeis University

TABLE OF CONTENTS

AcknowledgmentsIntroduction: The Politics of Standardization1. Standardization in Medicine in the Twentieth Century: The Emergence of the Paper-Based Patient Record2. Standards at Work: A Dynamic Transformation of Medicine3. From Autonomy to Accountability? Clinical Practice Guidelines and Professionalization4. Guidelines, Professionals, and the Production of Objectivity in Insurance Medicine5. Evidence-Based Medicine and Learning to Doctor6. Standardizing Risk: A Case Study of ThalidomideEpilogue: The Quest for QualityNotesBibliographyIndex

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