Jeffrey C. Goldfarb

Social Bases of Independent Public Expression in Communist Societies

Owing to official support of cultural traditions, the critical aspects of marxism, and the development of limited autonomy in cultural istitutions, independent public expression can and does develop in Communist societies despite the will of the political elite. In this paper, independent public expression is shown to be inherent in Communist societies; consequently, the relationship between politics and cultural life in these societies is considerably more complex than observers have posited.

Book ReviewsThe New Pediatrics: A Profession in Transition. By Dorothy Pawluch. New York: Aldine de Gruyter, 1996. Pp. xii1175.

egies to delineate their expertise from the expertise of other health care professionals, such as psychiatrists and pediatric nurse practitioners. While Pawluch briefly mentions the consequences of the new pediatrics for its clients, the book lacks an in-depth discussion of the effects of the new pediatrics on our concept of childhood and social definition of “normal” childhood behavior. Another issue that is not sufficiently explained in the book is the impact of the economics of managed care on the pediatric profession. It is a well-known fact that providers of managed care (including pediatricians) are increasingly encouraged by insurance companies and employers to deal with psychosocial issues in terms of cost effective drug treatments rather than by more time-consuming therapeutic approaches (see p. 98). In light of the increased popularity of managed care, the new definition of pediatrics as a behavioral specialty appears to increase the tendency to solve childhood and adolescent problems by means of psychotropic drugs. Finally, Pawluch fails to mention that the emergence of the new pediatrics coincided with the feminization of the medical profession and that female physicians remain comparatively overrepresentad among pediatricians. It is not unlikely that the new definition of pediatrics as both a “caring” and a “curing” field of expertise, at least in some respects, is related to the feminization of the specialty. Yet, Pawluch’s book clearly deserves attention from medical sociologists, medical historians, and child welfare professionals in general.