Medical Sociology Chapters 8-16

Evidence shows that the dominance of the medical profession is strengthening. Future physicians are likely to have much higher levels of clinical autonomy and professional control, much of this due to the fact they will more likely be employees in the "new medical-industrial complex" and therefore NOT be subjected to increasing degrees of bureaucratic rationalization.

False

Hospital rules and regulations are generally designed to benefit the patient.

False

In 1953, the AMA recognized osteopaths as a medical specialty, and they now enjoy the rights and privileges of medical doctors. Therefore, resolving any and all debates whether or not "classical" osteopathy has given itself over totally to medicine as practiced by medical doctors.

False

Socialization of the physician is unimportant to their training and practice as medical professionals.

False

Although the emergence of the nurse practitioner (NP) does not change nursing's subordinate work role, it allows the practitioners a greater degree of decision making. However, a major concern by nurses with this expanded role is that the nurse practitioner may simply be consumed by the medical profession as a lesser doctor or be simply a nurse given a more complex form of tasks delegated by the physician.

True

Freidson (1970) indicates that the key to distinguishing among sick roles is the notion of legitimacy. He maintains that in illness states there are three types of legitimacy - conditional, unconditional, and illegitimacy.

True

Hospitals operate on a system of dual authority between the bureaucracy and the professional.

True

Parsons' sick role can be criticized because of:

a) Behavioral variations b) Types of diseases c) The patient-physician relationship d) Its middle-class orientation e) All the above Answer: E) All the above

A nation's approach to health care is based upon its:

a) History, culture, and social organization b) Economy and political ideology c) Level of education, economic resources, and standard of living d) Attitudes toward welfare and the role of the state e) All the above Answer: E) All the above

Hospital expenses are usually categorized as:

a) Routine b) Ancillary c) Out of control d) All the above e) Both A and B Answer: E) Both A and B

What nation(s) were previously committed to socialist medicine?

a) Russia b) China c) The US d) All the above e) Both A and B Answer: E) Both A and B

When it comes to professionalism, once the public accepts claims to competence and a profession's control of membership, Goode believes that additional features of a profession can be established, such as?

a) The profession determines its own standards of education and training AND the student professional goes through a more stringent socialization experience than the learner in other occupations b) Professional practice is often legally recognized by some form of licensure AND licensing and admission boards are staffed by members of the profession c) Most legislation concerned with the profession is shaped by the profession AND as the occupation gains income, power, and prestige, it can demand higher-caliber students d) The practitioner is relatively free of lay evaluation and control AND members are strongly identified by their profession e) All the above Answer: E) All the above

In relation to the power structure of American medicine, what does the "inner fraternity" relate to?

a) The urban power structure of the medical profession consisting of four major groups of physicians - the inner core, the second group, the friendly outsiders, and the marginal physicians b) A system of formal relationships, such as the ones in university medical schools and medical centers where the most powerful figures control policy-making boards and determine the careers of residents c) A system of informal relationships with colleagues, developed over time, where physicians interact with one another frequently and arrive at definitions of the quality of each other's work and person characteristics d) Claims to position, status, and power that become recognized and are perpetuated within the profession, and mechanisms for recruitment into the inner core become established in both formal and informal ways e) All the above Answer: E) All the above

The American system of health care delivery is not evenly distributed geographically, as there are more physicians in rural areas than urban areas.

False

The fundamental law of the marketplace is supply and demand. When the supply of a product exceeds the demand for it, prices should drop. The law of supply and demand applies to medicine, just like any other marketplace commodity.

False

The general job description of a physician assistant (PA) is to provide a level of primary patient care lower than that of a nurse practitioner (NP).

False

The secular control of hospitals marked a period of accomplishment for the development of Europe's hospital system. Without general regulations pertaining to hospital administration, individual hospitals were free to pursue any course of action they desired. Hospitals became positive social institutions where invalids, the aged, orphans, and the mentally defective would obtain quality care and nurturing.

False

Medicaid is a welfare program that provides for the federal government's sharing in the payments made by state welfare agencies to health care providers for services rendered to the poor.

True

Nursing represents the largest single group of health workers in the US.

True

What nation(s) have committed themselves to socialized medicine?

a) Canada b) Britain c) Sweden d) All the above e) Both B and C Answer: D) All the above

An illness can be particularly damaging to a person's concept of self when it is experienced as _______________ because it paralyzes the ability to act and manage one's life normally.

a) Overwhelming b) Unpredictable c) Uncontrollable d) All the above e) Both A and C Answer: D) All the above

Information can be an important therapeutic tool in medical situations if it:

a) Reduces uncertainty b) Provides a basis for action c) Strengthens the physician-patient relationship d) All the above e) Both B and C Answer: D) All the above

The overall effect of subordination to the physician's orders _________________ nursing's efforts in its struggle to achieve professionalization.

a) Weakened b) Strengthened c) Tightened d) Helped e) Endorsed Answer: A) Weakened

Organized medicine has lost the power to determine health policy. Key factors in this situation include: 1) the loss of public trust that began during medicine's golden age of fee-for-service in the mid-twentieth century, when profits in health care soared, and 2) such rising costs of health care resulted in increased public demands for government intervention.

True

Physician and industrialists both strongly supported the rise of scientific medicine because it gave physicians greater effectiveness in a rapidly industrialized society and provided them with higher status, prestige, and income; whereas it provided industrialist a means of investment in maintaining the moral, social, and economic order of corporate capitalism.

True

Primary care practitioners (PCP's) are underrepresented among physicians in the US.

True

The medical profession formulates medical rules defining biological deviance and seeks to enforce them by virtue of its authority to treat persons defined as sick.

True

The sick role evokes a set of patterned expectations that define the norms and values appropriate to being sick, both for the individual and for others who interact with the sick person. Neither party can define his or her role independently of the role partner. Additionally, the sick role views the patient-physician relationship within the same framework of social roles, attitudes, and activities that both parties bring to the situation. The patient-physician role relationship is therefore not a spontaneous form of social interaction. It is, however, a well-defined encounter consisting of two or more persons whose object is the health of a single individual.

True

Well into the 19th century, nursing could be described as an activity for women who lacked specialized training in medical care, a supportive work role that was not officially incorporated into the formal structure of medical services. Moreover, nursing was not an occupation held in high regard by the general public.

True

Disease, illness, and sickness are (respectively):

a) 1) An adverse physical state, consisting of a physiological dysfunction within the individual; 2) a social state, signifying an impaired social role for those who are ill; and 3) a subjective state, pertaining to an individual's psychological awareness of having a disease and usually causing that person to modify his or her behavior, respectively b) 1) a subjective state, pertaining to an individual's psychological awareness of having a disease and usually causing that person to modify his or her behavior; 2) An adverse physical state, consisting of a physiological dysfunction within the individual; and 3) a social state, signifying an impaired social role for those who are ill, respectively c) 1) An adverse physical state, consisting of a physiological dysfunction within the individual; 2) a subjective state, pertaining to an individual's psychological awareness of having a disease and usually causing that person to modify his or her behavior; and 3) a social state, signifying an impaired social role for those who are ill, respectively d) All the same, there is no difference between the three e) None of the above Answer: C) 1) An adverse physical state, consisting of a physiological dysfunction within the individual; 2) a subjective state, pertaining to an individual's psychological awareness of having a disease and usually causing that person to modify his or her behavior; and 3) a social state, signifying an impaired social role for those who are ill, respectively

What is the medical decision rule?

a) A rule made by the US Congress ordering insurance companies to accept diagnoses by physicians as valid for insurance reimbursement b) A rule made by the US Congress mandating insurance companies to insure individuals with pre-existing conditions c) The notion that medical decisions made by physicians are decisive and accurate d) The notion that since the work of the physician is for the good of the patient, physicians tend to impute illness to their patients rather than to deny it and risk overlooking or missing it e) None of the above Answer: D) The notion that since the work of the physician is for the good of the patient, physicians tend to impute illness to their patients rather than to deny it and risk overlooking or missing it

Some medical sociologists now describe the interaction between a physician and patient as more of an association than a relationship because it often consists of more than two people and the personal closeness of the individuals involved has weakened. Reeder (1972) was among the first to show the changing relationship between physicians and their patients. He identifies ___________________ as significant in contemporary society's responsibility in changing the physician-patient relationship.

a) A shift in medicine away from the treatment of acute diseases toward preventative health services b) A growing sophistication of the general public with bureaucracy c) The development of consumerism d) All the above e) None of the above Answer: D) All the above

What is "the doctor-nurse game?"

a) A significant social mechanism by which the physician is able to utilize the nurse as a consultant b) A significant social mechanism by which the nurse is able to gain self-esteem and professional satisfaction from her work c) Has changed in recent years due to different situations now existing d) All the above e) Both A and B Answer: D) All the above

Socialized medicine refers to:

a) A system of health care delivery in which health care is provided in the form of a state-supported consumer service b) A system where health care is purchased, but the buyer is the government c) A system where health care services are provided at little or no cost to the consumer d) All the above e) Both A and C Answer: D) All the above

Socialist medicine refers to:

a) A system of health care delivery where the central government owns all facilities b) A system of health care delivery where the state employs health care workers c) Free universal care paid out of the national budget d) All the above e) Both A and B Answer: D) All the above

Decentralized national health programs refers to:

a) A system where the government has indirect control of the financing and organization, and regulation of payments to providers of health services in a capitalist economy b) A system where the government owns some of the health care facilities and guarantees equal access to the general population c) A system where health care is purchased, but the buyer is the government d) All the above e) Both A and B Answer: E) Both A and B

The interaction that take place between doctors and patients appears to be affected by social class differences. Lower-class persons tend to be more _________ in dealing with doctors as authority figures and show a ______________ sense of personal control over health matters. People with middle and upper socioeconomic status tend to be more consumer-oriented as discerning seekers of health care and _________ participants in the physician-patient encounter.

a) Active; passive; increased b) Active; passive; decreased c) Active; decreased; passive d) Passive; increased; active e) Passive; decreased; active Answer: E) Passive; decreased; active

Folk medicine is often regarded as a residue of health measures left over from prescientific historical periods. Therefore, folk healers are not used to any significant extent in the US, except by some low-income persons usually belonging to racial and ethnic minority groups. Practicing folk healers are most likely to be found among:

a) African Americans b) Hispanics c) American Indians d) All the above e) Both A and C Answer: D) All the above

Chiropractors:

a) Approach healing involving manipulation of bones in the spinal column b) Have been traditionally opposed by the medical profession as an extension of professional status, even though there is evidence that chiropractic techniques can help patients with back, shoulder, and neck pain c) Have seen some physicians preferring to eliminate the field altogether d) Have been hampered in their attempts at professionalization, not only by physicians, but also because of conflicts among themselves - some chiropractors favor a more expanded role, using a variety of techniques, in which a wider range of health problems would be treated, whereas others prefer a more "pure" approach, in which chiropractors would limit themselves to spinal manipulation e) All the above Answer: E) All the above

Parsons' concept of the sick role is based on the assumption that:

a) Being sick is not a deliberate and knowing choice of the sick person b) Being sick is seen as noble in society c) Illness may occur as a result of motivated exposure to infection or injury d) All the above e) Both A and C Answer: E) Both A and C

Curanderismo healing is based on:

a) Blending religion and folk medicine into a single therapeutic approach b) Emphasizes religion to a much greater extent than most healers c) The Hippocratic notion of bodily equilibrium within the four humors - blood, phlegm, black bile, and yellow bile d) The belief that the most dreaded forms of disorder is caused by witchcraft e) All the above Answer: E) All the above

Complementary and alternative medicine (CAM) is the use of treatments that are not commonly practiced by the medical profession (conventional Western medicine). CAM includes:

a) Chiropractors b) Faith and folk healers c) Acupuncturists d) Homeopaths and naturopaths e) All the above Answer: E) All the above

Patients who are similar to physicians in social class are more likely to share their communication style and communicate effectively with them, and those with dissimilar class backgrounds are likely to find communication more difficult. The same thing can be said regarding race, as patient satisfaction is greatest when both doctor and patient are of the same race. What term describes this construct?

a) Classism b) Racism c) Social distance d) All of the above e) Both A and B Answer: E) Both A and B

Like any other profession, medicine has its own power structure. What factor is important in establishing power and prestige within the medical profession?

a) Clientele b) Hospital affiliation c) The inner fraternity d) All the above e) Both A and C Answer: D) All the above

When a physician diagnoses a person's condition as illness, the diagnosis can, and often does, change the sick person's behavior. Thus, illness is seen by ___________________ theorists as a condition created by human beings in accordance with their understanding of the situation.

a) Conflict b) Functionalist c) Labeling d) Post-Modern e) Feminism Answer: C) Labeling

What theory sees sickness as dysfunctional because it threatens to interfere with the stability of the social system, that sick people are unable to perform their daily tasks and thus become an obstacle to the efficient functioning of society.

a) Conflict b) Symbolic Interactionism c) Functionalist d) Labeling e) Post-Modern Answer: C) Functionalist

The debate in the US on whether or not healthcare is a right or a privilege can be best viewed from the standpoint of:

a) Conflict Theory b) Symbolic Interactionism c) The medical model d) The social model e) None of the above Answer: A) Conflict Theory

What trend is appearing in developed societies, which is likely to have an effect on health care policy in the future?

a) Considerable attention is being paid to the cost of health care and how to control it b) Preventative medical services are receiving increasing emphasis in developed countries, as more attempts are being made to keep well people healthy c) Efforts are being made to design a more effective administration of large health care systems d) There is more demand and increased responsiveness on the parts of governments and policymakers to provide a health care system that meets national needs e) All the above Answer: E) All the above

Major issues in the public debate about health care delivery in the US are:

a) Cost b) Equity c) The geographic distribution of services d) All the above e) Both A and B Answer: D) All the above

The role of nursing changed in the middle of the 19th century through the insight and effort of an English Protestant woman who insisted that nursing was intended to become an honorable and respected occupation and sought to achieve this purpose through a formal training program with recruits from upper- and middle-class social backgrounds. ________________'s approach to nursing training emphasized a code of behavior that idealized nurses as being responsible, clean, self-sacrificing, courageous, cool-headed, hardworking, and obedient to the physician and possessing the tender qualities of the mother.

a) Dr. Brown b) Dr. Cavalier c) Dr. Kirschner d) Dr. Regus e) Florence Nightingale Answer: E) Florence Nightingale

Today, public attitudes toward the medical profession have shifted away from the unquestioning acceptance of physician authority, as seen in the mid-twentieth century, to a more questioning and critical view of physicians today. Public dissatisfaction with the medical profession and its provision of health care in the US is generally viewed as having largely ___________ origins.

a) Economic b) Geographical c) Social d) All the above e) Both A and C Answer: E) Both A and C

Although pharmacists have considerably more expertise than customers or patients about medications, they reduce the social distance between them and the customer/patient by using terms that a layperson can understand. Therefore, pharmacists are considered the most ________________ of all health care personnel.

a) Educated b) Personable c) Accessible d) Isolated e) Insulated Answer: C) Accessible

Parsons mentioned that a person may desire to retain the sick role more or less permanently because of "secondary gain," which is:

a) Exemption from normal obligations b) Gaining of privileges commonly accorded to the sick c) Loss of privileges commonly accorded to the healthy d) Both A and B e) Both A and C Answer: D) Both A and B

Hinze (1999) investigated the prestige hierarchy in medicine from the standpoint of gender and found that the top specialties such as surgery and internal medicine were characterized as ________________, with traits like "toughness," macho", and "demanding," while those at the bottom like family practice, pediatrics, and psychiatry were considered _____________. The top specialties were open to women, but women moving into these fields tended to take on masculine traits, such as being assertive, highly professional, and not expressing warmth, to be successful.

a) Feminine; masculine b) Feminine; hard c) Masculine; feminine d) Masculine; soft e) Hard; soft Answer: D) Masculine; soft

By the early 19th century, hospitals had clearly assumed their present-day role as institutions for medical research and for the education of medical students. However:

a) Few patients survived their treatment b) They were regarded by most people as places where only the lower social classes went to die c) Were owned by foreign interests d) Both A and B e) Both A and C Answer: D) Both A and B

The professionalization of medicine would not have been possible without control over the standards for medical education. However, the Flexner Report, released in 1910, came as a devastating indictment of the lack of quality medical education in the US. But with Flexner's strong recommendation that medical schools consist of _____________, the medical profession consolidated its professional position to the point that is clearly had become both the model of professionalism and a powerful profession by the mid 1920's.

a) Full-time faculty b) Laboratories be made available to medical students c) Hospital facilities be made available to medical students d) Standards concerning the admission of students to medical schools e) All the above Answer: E) All the above

The professional dominance and autonomy of physicians has waned over the years. This is largely affected by countervailing powers, including?

a) Government regulation b) Managed care systems c) Corporations in the health care business d) Changes in the traditional doctor-patient relationship e) All the above Answer: E) All the above

The US spends more on health than any other county in the world. Most advanced nations spend between 10 and 12 percent of their gross domestic product (GDP) on health. The US, however, spends around 17.5% of its GDP on health. This could be explained, in part, by the fact that Americans have historically been less committed to ________________ and more in favor of _________________ in dealing with economic and social problems.

a) Government welfare programs; private enterprise b) Private enterprise; government welfare programs c) Industrialization; agrarianism d) Democracy; socialism e) None of the above Answer: A) Government welfare programs; private enterprise

Changing from a largely office-based, fee-for-service system to an increasingly group- or organization-based "managed care" system, American medical practice took on a dramatically different new structure in the mid-1990s. Managed care:

a) Has become the most common form of health care delivery in the US b) Alters the patient-doctor relationship by introducing a third party - the case manager - to the decision-making process c) Came about in large part due to the AMA's opposition to government-controlled health care d) All of the above e) Both A and B Answer: D) All of the above

What has led to the deprofessionalization of physicians?

a) Increased consumerism on the part of patients b) Greater government and corporate control over medical practice c) A move from substantive rationality toward greater formal rationality, signaling a loss of public support and an invitation to countervailing powers to enter into an unregulated market that the medical profession had previously kept for itself d) All the above e) Both A and B Answer: D) All the above

What are the distinct stages of nursing student socialization that Davis (1972) recognized?

a) Initial innocence, followed by labeled recognition of incongruity b) Psyching out, followed by role simulation c) Provisional internalization, followed by stable internalization d) All the above e) Both A and C Answer: D) All the above

According to Parsons and Fox (1952), from the standpoint of society, what is the purpose of hospitalization?

a) It protects the family from many of the disruptive effects of caring for the ill in the home b) To make money for the Bourgeoisie c) Operates as a means of guiding the sick and injured into medically supervised institutions where their problems are less disruptive for society as a whole d) All the above e) Both A and C Answer: E) Both A and C

What nation(s) have committed themselves to decentralized national health programs?

a) Japan b) Germany c) Mexico d) All the above e) Both A and B Answer: D) All the above

An important factor in the power structure of American medicine is the clientele, where physicians work to acquire, retain, and improve the quality of their patients. In the past, a lay referral system not only channeled patients to certain doctors and helped them make decisions about returning to a physician, but also helped physicians with an open-ended system where they could refer patients to any doctor they wished. However, nowadays contractual arrangements in managed care practices require primary care physicians to refer patients to a restricted list of doctors. Thus, referral networks have become considerably ____________ for many physicians.

a) Larger b) Smaller c) More financially lucrative d) Unrestricted e) More autonomous Answer: B) Smaller

The argument that society is justified in granting the physician professional autonomy because he or she is a member of a self-controlled collectivity performing a vital function for society's general good has serious defects, including:

a) Laypersons judge technical performance, regardless of whether they are competent to do so b) The medical profession's autonomy is governed by rules of etiquette, where evaluation of other's work and criticism of fellow physicians is discouraged c) The autonomy granted to the medical profession is granted conditionally, on the assumption that it will resolve significant issues in favor of the public interest but has been criticized for promoting self-interest over public welfare. d) All the above e) Both A and B Answer: D) All the above

Doctor-patient interaction according to Hayes-Bautista focuses on the manner in which patients try to ______________ the treatment prescribed by a physician.

a) Modify b) Abide by c) Argue against d) All the above e) None of the above Answer: A) Modify

The lack of male sensitivity to women patients was a major factor in the formation of the women's health movement to combat sexual discrimination in medicine. Feminist health organizations evolved to advocate for:

a) Natural and home childbirth, midwifery, and abortion rights b) Funding for breast cancer c) Self-help and recognition of the rights and intelligence of patients d) All the above e) Both A and B Answer: D) All the above

The ownership of hospitals can be classified as:

a) Nonprofit b) For profit c) Government d) All the above e) Both A and B Answer: D) All the above

Midwives include:

a) Nurse-midwives who assist deliveries under the supervision of a physician b) Lay midwives who assist births on their own c) Physician assistant midwives who assist deliveries under the supervision of a physician d) All the above e) Both A and B Answer: E) Both A and B

Managed care organizations:

a) Organize and improve health care in a stable, reliable, and least costly manner b) Combine prevention with patient education c) Disrupt doctor-patient relationships, take deep discounts out of doctor and hospital fees, and produce large profits without developing good managed clinical care d) All the above e) Both A and B Answer: D) All the above

What are the four stages of the development of a hospital as a social institution, in order as they happened?

a) Poorhouses, centers of religious practice, deathhouses, centers of medical technology b) Centers of religious practice, poorhouses, deathhouses, centers of medical technology c) Deathhouses, centers of religious practice, poorhouses, centers of medical technology d) Poorhouses, centers of medical technology, deathhouses, centers of religious practice e) Centers of religious practice, deathhouses, poorhouses, centers of medical technology Answer: B) Centers of religious practice, poorhouses, deathhouses, centers of medical technology

At some point gene therapy is likely to become commonplace for many afflictions. However, genetic testing could become a form of social control and the consequences for the individual and society could be varied and significant, leading to new forms of stigma and discrimination. With such systemic issues related to genetics, important social disputes about genetic research include issues of ______________.

a) Privacy b) Ownership c) Commodities and property rights d) All the above e) Both B and C Answer: D) All the above

What is a basic sociological relevant characteristic in explaining professionalism?

a) Prolonged training in a body of specialized and abstract knowledge b) An orientation toward providing a service c) An orientation toward receiving a service d) Both A and B e) Both A and C Answer: D) Both A and B

Besides office-based medical practices and hospitals, another type of organization involved in the delivery of health care to the American public are official agencies, which are:

a) Public organizations intended to support and conduct research, develop educational materials, protect the nation's health, and provide services designed to minimize public health problems b) Charitable organizations who solicit funds from the general public and use them to support medical research and provide services for disease victims c) Managed care prepaid group practices in which a person pays a monthly premium for comprehensive health care services d) Managed care health organizations in which employers who purchase group health insurance agree to send their employees to particular hospitals or doctors in return for discounts e) The manufacturers of pharmaceuticals and medical supplies and equipment, which play a major role in research, development, and distribution of medical goods Answer: A) Public organizations intended to support and conduct research, develop educational materials, protect the nation's health, and provide services designed to minimize public health problems

Besides office-based medical practices and hospitals, another type of organization involved in the delivery of health care to the American public are voluntary agencies, which are:

a) Public organizations intended to support and conduct research, develop educational materials, protect the nation's health, and provide services designed to minimize public health problems b) Charitable organizations who solicit funds from the general public and use them to support medical research and provide services for disease victims c) Managed care prepaid group practices in which a person pays a monthly premium for comprehensive health care services d) Managed care health organizations in which employers who purchase group health insurance agree to send their employees to particular hospitals or doctors in return for discounts e) The manufacturers of pharmaceuticals and medical supplies and equipment, which play a major role in research, development, and distribution of medical goods Answer: B) Charitable organizations who solicit funds from the general public and use them to support medical research and provide services for disease victims

Besides office-based medical practices and hospitals, another type of organization involved in the delivery of health care to the American public are Preferred Provider Organizations (PPOs), which are:

a) Public organizations intended to support and conduct research, develop educational materials, protect the nation's health, and provide services designed to minimize public health problems b) Charitable organizations who solicit funds from the general public and use them to support medical research and provide services for disease victims c) Managed care prepaid group practices in which a person pays a monthly premium for comprehensive health care services d) Managed care health organizations in which employers who purchase group health insurance agree to send their employees to particular hospitals or doctors in return for discounts e) The manufacturers of pharmaceuticals and medical supplies and equipment, which play a major role in research, development, and distribution of medical goods Answer: D) Managed care health organizations in which employers who purchase group health insurance agree to send their employees to particular hospitals or doctors in return for discounts

Besides office-based medical practices and hospitals, another type of organization involved in the delivery of health care to the American public are allied health enterprises, which are:

a) Public organizations intended to support and conduct research, develop educational materials, protect the nation's health, and provide services designed to minimize public health problems b) Charitable organizations who solicit funds from the general public and use them to support medical research and provide services for disease victims c) Managed care prepaid group practices in which a person pays a monthly premium for comprehensive health care services d) Managed care health organizations in which employers who purchase group health insurance agree to send their employees to particular hospitals or doctors in return for discounts e) The manufacturers of pharmaceuticals and medical supplies and equipment, which play a major role in research, development, and distribution of medical goods Answer: E) The manufacturers of pharmaceuticals and medical supplies and equipment, which play a major role in research, development, and distribution of medical goods

Faith healers are people who use the power of suggestion, prayer, and faith in God to promote healing. According to Denton (1978), two basic beliefs are prevalent in religious healing - 1) healing occurs primarily through psychological processes and is effective only with psychophysiological disorders and 2) healing is accomplished through the intervention of God and constitutes a present-day miracle. Denton also offers general categories of faith healing, including:

a) Self-treatment through prayer b) Treatment by a layperson thought to be able to communicate with God c) Treatment by an official church leader, for whom healing is only one of many tasks d) Healing obtained from a person or group of persons who practice healing full time with or without an affiliation with a major religious organization e) All the above Answer: E) All the above

An important factor in the power structure of American medicine is the hospital. According to Hall, affiliation with a prestigious hospital is significant in a successful urban medical career because hospital positions are generally associated with _____________ medical practices.

a) Smaller b) Intellectually superior c) More financially rewarding d) Inner-city poor e) None of the above Answer: C) More financially rewarding

Within Native American healing, Navajos will often use both native healers and physicians because of the belief that modern medicine will remove ___________ and Navajo medicine will remove the ______________ of illness.

a) Social model; medical model b) Medical model; social model c) Cause; symptoms d) Symptoms; cause e) None of the above Answer: D) Symptoms; cause

Depersonalization is a key element of the hospital experience from the patient point of view. What causes the hospital environment to depersonalize the patient?

a) Stripping b) Control of resources c) Restriction of mobility d) All the above e) Both B and C Answer: D) All the above

African American folk healers:

a) Subscribe to a belief system that does not differentiate between science and religion b) View all life events, including illness, in relation to the total environment as either natural or unnatural; good or evil c) Diagnose a health problem by emphasizes the symptoms of the problem, not the cause d) All the above e) Both A and B Answer: E) Both A and B

What characteristic accounts for the subordinate position that professionals such as nurses, pharmacists, and physical therapists succumb to in the practice of medicine?

a) Technical knowledge employed in health occupations needs to be approved by physicians b) Such workers usually assist physicians in their work rather than replace the skills of diagnosis and treatment (although nurse practitioners and physician assistants are moving into these areas with respect to many health problems) c) Such workers are subordinate to the physician because their work largely occurs at the "request of" the physicians; that is, the "doctor's orders" provide them with their work requirements d) Among the various occupational roles in the health field, physicians have the greatest prestige e) All the above Answer: E) All the above

An important factor having profound implications for the doctor-patient relationship is new medical technology. Our expanding reliance on technologies has promoted a shift away from ___________________, with its focus on the patient's oral account of his or her medical history, to _________________, involving the extensive use of advanced technology for testing, diagnosis, and the scientific determination of treatment in a more differentiated world of health care delivery.

a) Techno-medicine; biographical medicine b) Biographical medicine; techno-medicine c) Techno-medicine; old-fashioned medicine d) Biographical medicine; robotic medicine e) None of the above Answer: B) Biographical medicine; techno-medicine

The American Medical Association (AMA) was weak and ineffectual in the beginning, but gradually extended its authority to become the single greatest influence on the organization and practice of medicine in the US. How did this happen?

a) The AMA was reorganized by dividing it into component societies at the local level (district or county medical societies), constituent societies (state or territorial medical associations), a national House of Delegates, a Board of Trustees, and national officers b) The AMA was reorganized by combining it into one large national organization by doing away with societies at the local (district or county medical societies), and constituent (state or territorial medical associations) levels c) The Journal of the American Medical Association (JAMA) appeared in 1883, not only disseminating the latest medical knowledge and contributing to the prestige of the association, but also developed awareness among the members of the AMA of their allegiance to the medical profession d) Both A and C e) Both B and C Answer: D) Both A and C

Opposition of the medical profession to public control of programs (i.e. government run health insurance) set in motion entrepreneurial forces (corporations in healthcare) that may end up depriving both private doctors and non-profit hospitals of their traditional autonomy. However, physicians have not shown strong objections to being employed by corporations or sending their patients to for-profit hospitals. The major reason for this development is:

a) The availability of physicians for such jobs b) Healthcare corporations provide jobs, offices, staff, equipment, hospital privileges, and perhaps even a guaranteed salary c) Physicians are sellouts and only care about themselves d) All the above e) Both A and B Answer: E) Both A and B

Human cloning - the creation of life in the laboratory - represents the ultimate scientific power and potentially offers more control over populations than any previous technology. Human cloning can be characterized as either ________________ or _______________.

a) Therapeutic; reproductive b) Therapeutic; capitalist c) Agrarian; capitalist d) Agrarian; industrialism e) Industrialism; capitalist Answer: A) Therapeutic; reproductive

Unlike medical schools, which follow a prescribed and generally similar program of education leading to the Doctor of Medicine (M.D.) degree, nursing education standards failed to obtain centralized control over educational programs. Therefore, nursing has been characterized by different types of educational experiences, all of which can qualify the student as a Registered Nurse (RN). Currently, there are three types of programs available for RNs. Which one is the most prestigious?

a) Two-year associate degree programs usually located in junior or community colleges b) Hospital-based diploma schools requiring two and one-half to three years of study c) Four- and five-year university baccalaureate programs d) All the above, as all three are equally prestigious e) None of the above Answer: C) Four- and five-year university baccalaureate programs