Shumsky N L, Bohland J, Knox P
Soc Sci Med. 1986;23(10):1051-7. doi: 10.1016/0277-9536(86)90263-7.
The urban medical delivery system includes not only the technological and scientific skills and apparatus used by health care practitioners but also those economic and social arrangements made by doctors that affect their ability to provide medical care. Among the most important of these is the location of health care facilities, especially doctors' offices. This paper traces the changing locations of doctors' offices in San Francisco between 1881 and 1941. Most specifically, it focuses on the separation of office from residence and the location of offices in the city. Changes in location began to occur during the urban transformation that occurred late in the nineteenth century. At that time, changes in the division of labor, the role of the family, and transportation and communications technology interacted with changes in science, medical technology and professional organization to alter the nature and location of the settings used to provide medical care. The health care delivery system is thus interpreted as the product of the overall dynamics of urbanization rather than the outcome simply of scientific discovery, medical technology and the influence of key medical practitioners and professional organizations.
城市医疗服务体系不仅包括医疗从业者所使用的技术和科学技能以及设备，还包括医生所做出的那些影响其提供医疗服务能力的经济和社会安排。其中最重要的是医疗设施的位置，尤其是医生办公室的位置。本文追溯了1881年至1941年间旧金山医生办公室位置的变化。最具体地说，它关注办公室与住所的分离以及办公室在城市中的位置。位置的变化始于19世纪后期发生的城市转型。当时，劳动分工、家庭角色以及交通和通信技术的变化与科学、医疗技术和专业组织的变化相互作用，改变了提供医疗服务的场所的性质和位置。因此，医疗服务体系被解释为城市化整体动态的产物，而不仅仅是科学发现、医疗技术以及关键医疗从业者和专业组织影响的结果。
