Sunday, June 11, 2023

Brief Blog: New Book on Medical Politics, Swenson:DISORDER; and AI Gives a Summary

I'm very much enjoying Peter Swenson's 2021 book, "DISORDER," (Yale University Press) about a century of medical politics in the US.

Find the book website here.  Amazon here.  Academic book review here.  Author's faculty website here.  A 30-minute podcast interview with the author here.  A 90-minute interview here.


Out of curiosity, I took 

  • an auto transcript ( of the 30 minute interview, 
  • clipped it in two parts for length limits, and 
  • asked for a summary from ChatGPT.   
  • I also asked a couple follow-up questions.   

This ChatGPT automated AI analysis of the book (via the podcast transcript) is clipped below.


I have provided you Part 1 and Part 2 of the interview.  
Please discuss the key points from each part.

Podcast Part 1/2:

The interview begins with various advertisements from different sponsors.

Peter Swenson, the author of "Disorder: A History of Reform, Reaction, and Money in American Medicine," introduces himself as a political scientist with a background in medical politics.

He discusses his journey into researching and writing about the politics of healthcare, focusing on issues of quality, equality, and economy.

Swenson talks about the progressive era of the American Medical Association (AMA) and its alignment with progressive values such as prevention, public health, rational therapeutics, equity, and avoidance of conflicts of interest.

He highlights the role of the AMA in drug reform, public health, medical education, and compulsory health insurance during the progressive era.

Swenson explains the reactionary turn of the AMA around the 1920s, where the organization underwent a dramatic shift in its politics and alliances. The AMA's progressive agenda created internal turmoil and led to a change in leadership and a conservative turn.

He discusses the influence of the drug and tobacco industries on the AMA's politics and their opposition to regulations and reforms.

Swenson emphasizes the power of organized medicine, including the AMA, within the medical industrial complex and its intricate relationship with the pharmaceutical and medical device industries.

Podcast Part 2/2:

The conversation delves into the role of the AMA in obstructing healthcare reform efforts and its alignment with private profit-making interests.

Swenson discusses the significant funding received by the AMA from the pharmaceutical and medical device industries.

He addresses the changing landscape within the medical profession, with more reform-minded physicians criticizing the AMA's actions and considering the organization irrelevant.

Swenson highlights the need for reform within the AMA itself, urging critics to engage with the organization and work towards transforming it rather than writing it off entirely.

He mentions the existence of reformers within the AMA who push for progressive policies but also acknowledges the criticism that their efforts may only provide superficial changes without challenging the organization's core interests.

The conversation concludes with a discussion about the potential for change within the medical profession and the importance of younger, diverse voices shaping the future of healthcare policy.

Overall, the interview provides insights into the historical trajectory of the AMA, its influence on healthcare politics, and the ongoing debates surrounding its role in shaping American medicine.

What do you think is the book author's main goal and motivation? Why did he put so much time into this big book?


Based on the information provided in the interview, it appears that the book author, Peter Swenson, has several main goals and motivations:

To shed light on the history of American medicine: Swenson aims to provide a comprehensive historical account of the politics and evolution of American medicine, focusing on the themes of reform, reaction, and money. By tracing the arc of medical politics and exploring the interplay between quality, equality, and economy in healthcare, he seeks to deepen our understanding of the complex factors that have shaped the American healthcare system.

To challenge traditional narratives and perceptions: Swenson seeks to challenge conventional narratives about the American Medical Association (AMA) and organized medicine. He questions the widely held belief that the AMA has always been a conservative and reactionary organization, highlighting its progressive roots and the significant changes it underwent over time.

To expose the influence of moneyed interests: Swenson aims to reveal the powerful influence of commercial interests, particularly the pharmaceutical and medical device industries, on the politics and policies of organized medicine. He examines the relationships between the AMA, organized medicine, and the medical industrial complex, emphasizing the role of financial considerations in shaping healthcare practices and reforms.

To advocate for reform within organized medicine: While Swenson acknowledges the criticisms and skepticism surrounding the AMA, he also believes in the potential for reform from within. He calls for critics of the AMA to actively engage with the organization and work towards transforming it to align with progressive healthcare goals. Swenson emphasizes the importance of younger, diverse voices within the medical profession in shaping a future that prioritizes quality, equity, and public health.

Given the complexity of the subject matter and the author's background as a political scientist with a personal interest in healthcare politics, it seems that Swenson's motivation for writing this book stems from a desire to contribute to the scholarly understanding of American medicine, challenge existing narratives, and advocate for positive change within the healthcare system.

What might be a critical critique of this book from someone who disagrees with it? That is, what might be weaknesses that a reader might find?


A reader who disagrees with the arguments and perspectives presented in "Disorder: A History of Reform, Reaction, and Money in American Medicine" could have several critiques or identify potential weaknesses in the book:

Bias and alternative perspectives: Critics might argue that the author's perspective is biased, particularly if they hold different ideological or political views. They might claim that Swenson's portrayal of the AMA and organized medicine as primarily influenced by commercial interests neglects other factors, such as the importance of professional autonomy or the role of market forces in driving innovation.

Lack of focus or oversimplification: Some readers might find that the book covers too much ground or lacks sufficient depth in certain areas. They may argue that by attempting to cover a wide range of topics, the author sacrifices a more nuanced exploration of specific issues or periods in the history of American medicine.

Insufficient empirical evidence: Critics might contend that the book relies too heavily on anecdotal evidence or selective examples without providing a robust empirical foundation. They may call for more rigorous quantitative analysis or comprehensive data to support the claims made by Swenson.

Overemphasis on the AMA: Some readers might argue that the author places too much emphasis on the AMA and its role in shaping American medicine, neglecting other important actors, organizations, or historical contexts. They may contend that the book fails to fully capture the complexity and diversity of healthcare politics and the broader medical profession.

Lack of clarity in proposed solutions: While the author suggests the need for reform within organized medicine, critics might assert that the book does not offer clear or concrete recommendations for how such reform should occur. They may question the feasibility or effectiveness of engaging with the AMA or argue for alternative pathways for achieving desired changes in healthcare policy.

It is important to note that these critiques reflect potential perspectives from readers who disagree with the book's arguments. Evaluating the validity of these criticisms would require a detailed analysis of the book's content and supporting evidence.