Medical Sociology

I classify myself in the professional world as a “Medical Sociologist”.

With my additional training in adult education and counselling, this means that I study, teach, and consult in primarily the psycho-social aspects of the discipline. The discipline itself comprises research and applied behaviour in any of these areas:

a) examining illness as deviant behaviour, from its biological, social, cultural, and psycho-social perspectives,

b) the structural features of the physician’s role in the disease model,

c) methodologies of epidemiology/morbidity/mortality, medical resource management, health issues utilization, stress, crisis management, and psychosomatic medicine,

d) illness behaviour (multicultural differences, theories of help-seeking, and self-defined versus other-defined illness),

e) medical care systems (organizational problems, rationing medical care)

f) failures of the medical marketplace (problems of information, norms of treatment, uninsurable risks, restricted entry, professional dominance, misallocated supply),

g) elements of Primary, Secondary, Tertiary Care: nursing within the hospital, sociology of the hospital, coordination of services, and use patterns,

h) physicians: social profile, context of practice, the work, attitudes, values and ideologies, politics of the profession, standards,

i) patient and practitioner: community context, the ‘sick’ role, motivations to seek care, strategies in medical decision making, doctors influences on the patient’s condition, care of the illness behaviour.

Hafferty & Castellani  in Medical Sociology [Bryant-45099 Part VII.qxd 10/18/2006 7:22 pm Page 334] sum up the definition this way:

“It seems reasonably self-evident that ‘medical sociology’ must involve the application of sociological knowledge and concepts to issues of health and illness. It is distinct in its approach because it considers the import that social and structural factors have on the disease and illness processes as well as on the organization and delivery of health care. This includes factors such as culture (e.g., values, beliefs, normative expectations,), organizational processes (e.g., the bureaucracy of hospitals), politics (e.g., health care policy, political ideology), economics (e.g., capitalism, the stock market, the costs of health care), and microlevel processes such as socialization, identity formation, and group process.”

Also, Cockerham (2001: p. 2) observes that:

“What makes medical sociology important is the critical role social factors play in determining the health of individuals, groups, and the larger society. Social conditions and situations not only promote the possibility of illness and disability, but also enhance prospects for disease prevention and health maintenance. Many of the greatest threats to an individual’s health and physical well-being today stem largely from unhealthy lifestyles and high-risk behaviour, and this statement is true for heart disease, cancer, AIDS, and a host of modern-day health problems. Healthy lifestyles and avoidance of high-risk behaviour, however, advance the  individual’s potential for a longer and healthier life.”

Finally, Ruderman (1981: p. 927) offers the following brief definition:

“Medical sociology is the study of health care as it is institutionalized in a society, and of health, or illness, and its relationship to social factors.”

Sociology uses surveys, participant observation techniques, secondary data analysis, focus groups, content analysis and so forth, as typical research methods. They measure sociological variables and health outcomes having to do with sex, age, ethnicity and religion, employment, education and social class. Of particular interest is of course, health behaviour.

Medical sociologists pay attention to, research, teach about, and intervene (hospital rounds, counselling) regarding: chronic illnesses and the ‘sick role’ [Parsons], the medicalization of society, mental illness (social stigma, de-institutionalization, medical model, psychoanalytic model, social learning theory, daily living problems, indicators), the professionalization of practitioners (socialization, gender-based differences, educational requirements, health-care systems issues).

Alternative medicines are examined for their efficacy in health care. These include naturopathy, osteopathy, homeopathy, acupuncture, chiropractic, prescriptions, supplements and folk medicines.

Hospitals and clinics form rich data sources. Some which we assess are social policy, lines of authority, unions, epidemiology, bureaucracy and efficacy, and the influences of technology and internal dynamics.

There are medical sociologists who focus their work on the financing of the health care system (charities, insurance issues, budgets, legislation, rationing according to costs).

Hospice and palliative care are favoured topics, including euthanasia, advanced directives, living wills, etc. The work of ethics committees can be fruitful in diagnosing organizational issues.

Corporation medicine (pharmaceuticals and physician dispensing, drug controls) and Aboriginal issues (patient rights, research on Native lands, joint controls over drug ownership, marginalization) are other intervention dimensions within the health care paradigm.

As a former senior administrator, investigator, instructor, author, and applied change agent in health care institutional settings, I concentrated on mental health train-the-trainer programs (PTSD, anxiety/stress), on conducting and observing community support groups (Bereaved Families, Compassionate Friends, Panic & Anxiety Association of Northwestern Ontario), and on seminars on men and grief (prostate cancer, child loss).

I continue to write and conduct seminars on men and grief for example, parental child loss, and on body image/acceptance. The year 2015 represents my 25th year in health care environments.

The profession of medical sociology can greatly assist hospitals, support groups & individuals, health care education, government ministries, clinics, and professional associations in achieving and re-writing their goals. Sociologists who work in this field have differing motivations and interests because medical sociology cuts across many traditional areas of inquiry.

“Unless greater awareness of social and behavioural processes is part of the training of health workers, the delivery of care to patients, and the design of medical and sociomedical services, we shall continue to do less than is possible to enhance health and alleviate disease.” (David Mechanic, Medical Sociology. Second edition, p. 2)

References:

Chloe E. Bird et al, eds. 2000. Handbook of Medical Sociology, Fifth edition. Prentice Hall, New Jersey

William C. Cockerham. 2001. Medical Sociology. Eigth edition. Prentice Hall, New Jersey

Duane A. Matcha. 2000. Medical Sociology. Allyn & Bacon, Boston

David Mechanic. 1978. Second edition. Medical Sociology: A Comprehensive Text. Free Press, New York

Howard M. Rebach, and John G. Bruhn. Handbook of Clinical Sociology. 1991. Plenum Press, New York

 

Terry L. Hill, MEd, MA, PhD

November 19, 2015

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