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This section contains information about all of the projects and researchers that have been funded through the Investigator Awards program since the first grants were made in 1993. The indexes in this section can be used to identify investigators by name, area of expertise, or year of award. Throughout the site, you will find that each investigator’s name links to details including contact and project information.
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David Mechanic, Ph.D.
David Mechanic, Ph.D.
René Dubos University Professor of Behavioral Sciences
Director
Institute for Health, Health Care Policy and Aging Research
Rutgers, The State University of New Jersey
Email: mechanic@rci.rutgers.edu
Discipline: Sociology
Expertise: Ethical Dilemmas and Allocation of Resources

Managed Care

Mental Health

Organization of Care

Investigator Award:
Economic Constraints, Trust and Evolving Patient-Provider Relationships
Award Year: 1994

The public's trust in physicians is an essential aspect of health care delivery. As tensions grow between new medical possibilities and expenditure limits, innovative mechanisms are needed to settle disputes if litigation and other costly transactions are to be minimized. Dr. Mechanic uses trust as a conceptual frame to understand better evolving structures, possible mediating institutions, and the social and ethical implications of varying models of doctor-patient relationships. He examines strategies for rationing health care resources, achieving integration between acute and chronic disease models, and enhancing the compatibility of efforts to improve physical and behavioral health. The project synthesizes work on trust relations in medicine, building on theory and empirical research from several disciplines. Dr. Mechanic uses interviews and analysis of provider survey data to help extend the picture of how new practice arrangements affect trust. He also looks at how the English National Health Service makes and seeks to legitimize rationing decisions. Results shed light on the forces influencing medical care and suggest alternative approaches to inevitable dilemmas.

Background:

David Mechanic is the René Dubos University Professor of Behavioral Sciences and Director of the Institute for Health, Health Care Policy, and Aging Research at Rutgers, the State University of New Jersey. His research and writing deal with social aspects of health and health care.

David Mechanic received his Ph.D. from Stanford and joined the University of Wisconsin faculty in 1960, where he was chair of the department of sociology (1968-1970), the John Bascom Professor of Sociology (1973-1979) and director of the Center for Medical Sociology and Health Services Research (1972-1979). He moved to Rutgers University in 1979, was dean of the Faculty of Arts and Sciences (1980-1984), directed the NIMH Center at Rutgers for Research on the Organization and Financing of Care for the Severely Mentally Ill (1988-2004) and established the Rutgers Institute for Health, Health Care Policy, and Aging Research (1985) which he directs. He also serves as the Director of the Robert Wood Johnson Foundation Investigator Awards in Health Policy Research program.

Dr. Mechanic is a member of the National Academy of Sciences, the American Academy of Arts and Sciences, and the Institute of Medicine. He has served on numerous panels of the National Academy of Sciences, federal agencies and non-profit organizations.

David Mechanic has received many awards including the Institute of Medicine's 2009 Rhoda and Bernard Sarnat International Prize in Mental Health and 2008 Adam Yarmolinsky Award, the Health Services Research Prize from the Association of University Programs in Health Administration and the Baxter Allegiance Foundation, the Distinguished Investigator Award from the Association for Health Services Research, the Rema Lapouse Award and the First Carl Taube Award for Distinguished Contributions to Mental Health Services Research from the American Public Health Association, and the Distinguished Career Award for the Practice of Sociology, Distinguished Medical Sociologist Award and Lifetime Contributions Award in Mental Health from the American Sociological Association. He also received the Benjamin Rush Award (and Lecture) from the American Psychiatric Association (2004) and was selected for the Inaugural Lecture and Award in the Behavioral and Social Sciences honoring Matilda White Riley at the NIH (2006). He has been a Guggenheim Fellow and Fellow at the Center for Advanced Study in the Behavioral Sciences at Stanford.

He has written or edited 30 books and approximately 400 research articles, chapters and other publications in medical sociology, health policy, health services research, and the social and behavioral sciences. Among his books are Mental Health and Social Policy: Beyond Managed Care (5th Edition, 2008); The Truth About Health Care: Why Reform Is Not Working In America (2006); Policy Challenges in Modern Health Care (2005); Inescapable Decisions: The Imperatives of Health Reform (1994); Painful Choices: Research and Essays on Heath Care (1989); From Advocacy to Allocation: The Evolving American Health Care System (1986); and Future Issues in Health Care: Social Policy and the Rationing of Medical Services (1979).

Books:
Mechanic, D., Mental Health and Social Policy: Beyond Managed Care, Fifth Edition. Boston: Allyn & Bacon, 2008.
Cover
Mechanic, D., The Truth about Health Care: Why Reform Is Not Working in America. Rutgers University Press, 2006.
Cover
Mechanic, D., Rogut, L., Colby, D., Knickman, J. editors, Policy Challenges in Modern Health Care. Rutgers University Press, 2005.
Mechanic, D., Managed Behavioral Health Care: Current Realities and Future Potential, 78. Jossey-Bass, Inc., 1998.
Book Chapters:
Mechanic, D., Grob, G.N., Rhetoric, Realities, and the Plight of the Mentally Ill in America. In History and Health Policy in the United States: Putting the Past Back In, eds. Stevens, R.A., Rosenberg, C.E., Burns, L.R. New Brunswick: Rutgers University Press, 2006.
Selected Journal Articles:
Mechanic, D. Replicating High-Quality Medical Care Organizations, JAMA, 2010, 303, 6, 555-6.
Arrow, K., Auerbach, A., Bertko, J., Brownlee, S., Casalino, L., Cooper, J., Crosson, F.J., Enthoven, A., Falcone, E., Feldman, R.C., Fuchs, V.R., Garber, A.J., Gold, M.R., Goldman, D., Hadfield, G.K., Hall, M.A., Horwitz, R.I., Hooven, M., Jacobson, P.D., Jost, T.S., Kotlikoff, L.J., Levin, J., et al. Toward a 21st-Century Health Care System: Recommendations for Health Care Reform, Annals of Internal Medicine, 2009, 150, 7, 493-5.
Mechanic, D. The Uncertain Future of Primary Medical Care, Annals of Internal Medicine, 2009, 151, 1, 28-36.
Mechanic, D., Rogut, L. Health Reform Must Start Now, Not Later, The Sunday Star-Ledger, Mar 9 2009, 17.
Mechanic, D. Rethinking Medical Professionalism: The Role of Information Technology and Practice Innovations, Milbank Quarterly, 2008, 86, 2, 327-58.
Mechanic, D. In My Chosen Doctor I Trust, BMJ, 2004, 329, 7480, 1418-9.
Mechanic, D. Physican Discontent: Challenges and Opportunities, JAMA, 2003, 290, 7, 941-6.
Mechanic, D. Who Shall Lead: Is There a Future for Population Health?, JHPPL, 2003, 28, 2-3, 421-42.
Mechanic, D. How Should Hampsters Run? Some Observations about Sufficient Patient Time in Primary Care, BMJ, 2001, 323, 7307, 266-9.
Mechanic, D. The Managed Care Backlash: Perceptions and Rhetoric in Health Care Policy and the Potential for Health Care Reform, Milbank Quarterly, 2001, 79, 1, 35-54.
Mechanic, D., McAlpine, D., Rosenthal, M. Are Patients' Office Visits with Physicians Getting Shorter?, NEJM, 2001, 344, 3, 198-204.
Mechanic, D., McAlpine, D.D. 'Fifteen Minutes of Fame': Reflections on the Uses of Health Research, Health Affairs, 2001, 20, 6, 211-5.
Mechanic, D. Managed Care and the Imperative for a New Professional Ethic, Health Affairs, 2000, 19, 5, 100-11.
Mechanic, D., Meyer, S. Concepts of Trust among Patients with Serious Illness, Social Science and Medicine, 2000, 51, 5, 657-68.
Mechanic, D. The Functions and Limitations of Trust in the Provision of Medical Care, JHPPL, 1998, 23, 4, 661-86.
Mechanic, D., Schlesinger, M. The Impact of Managed Care on Patients' Trust in Medical Care and their Physicians, JAMA, 1996, 275, 21, 1693-7.