medical sociology

affordable care act

-prohibits recinding coverages -minimal level of benefits -insurance acces to people with preexisting conditions -young adults can stay on parent's plan until age 26 -medicare expansion

Goode's characteristics of a profession/professionalism

1. prolonged training of specialized and abstract knowledge 2. orientation toward providing a service (consolidates power through relationships, and society must accept the claims to competence and believe in the professions control over members)

Leo Reeder: changing relationship b/w physicians and their patients

1. shift in medicine away from treatment of acute diseases and toward preventative health services 2. growing sophistication of the public with bureacracy (bureacracy gives everyone an even playing field with their knowledge of health) 3. development of consumerism

physician authority

1. specialized knowledge 2. they are in demand 3. they offer a valuable product 4. they follow a high moral and ethical code 5. they have a high degree of professionalism 6. they practice individualized objectivity

money americans spend on CAMS

30 bil out of pocket

paradox of US health system

Americans pay more but get less

hospital affiliation

An agreement between a hospital and a particular health plan, wherein the hospital provides care to the plan's members.

Individualized objectivity

Deep intimate knowledge of patient but they can be objective

State efforts at health reform

Massachussets (2006) passed law that residents must have health insurance or face a fee and gov't subsidees help the poor. businesses must offer insurance or face a fine, resulting in a high coverage, low death rate

training for uncertainty

a doctor has incomplete mastery of available knowledge and there are limitations of current medical knowledge. makes a difficulty for distinguishing b/w personal inadequacy and the limits of medical knowledge

Managed Care

a system of health care in which patients agree to visit only certain doctors and hospitals, and in which the cost of treatment is monitored by a managing company. (contracted arrangements between state medicare agencies)

african american folk healing

a tradition handed down of superstitious beliefs on how to treat illnesses. events are natural and unnatural, bad vs. good. many healers don't require personal interaction with their patients

how med schools have changed

allopathic medicine has the monopoly. Most of the doctors in the US trained in europe or were ship surgeions. then people make the first med school at U Penn, so now there are a lot of low quality high profit med schools. then flexner report reccomends cutting down on medical schools and states use this report as a standard for certification, so it becomes very selective. monetary donations from carnegie and Rockefeller increased research and made US #1.

culture

beliefs, behaviors, objects, and other characteristics common to the members of a particular group or society

Freidson-professional dominance

biomedicine has no competitors to define and treat illness . this position is secured by political and economic elites. the right to control their own work/freedom (autonomy)

non-material culture

creations and abstract ideas that are not embodied in physical objects. In other words, any intangible products created and shared between the members of a culture over time are aspects of their nonmaterial culture. Social roles, rules, ethics, and beliefs are just some examples.

osteopaths

drug-free non-invasive manual medicine that focuses on total body health by treating and strengthening the musculoskeletal framework. today they are part of mainstream medicine, recognized by AMA

socialist medicine

everything is public, nothing is private. the government owns the means of healthcare. ex: soviet union, it can be corrupt. there is no access to any kind of private healthcare

chiropractors

focused on the diagnosis and treatment of neuromuscular disorders, with an emphasis on treatment through manual adjustment and/or manipulation of the spine, against AMA

How prestige is established in medical profession

getting appointment in a prestigious hospital with higher pay, (a good, reputable residency). initial appointment of internships is important. aquiring a clientelle and retaining and improving it (improving lay expectations of doctors), "inner fraternity"-women are just friendly outsiders, the inner core "specialists" have control of the major hospital positions.

faith healing

healing achieved by religious belief and prayer, not held in high esteem

Erosion of Physician Authority - what caused public to challenge authority

increased cost of medical care, "doctor shopping", growing sophistication of patients, patient frustration with HMO system

curandismo healing

latin american folk healing, involved in thinking about the whole and connecting with nature. do not charge for their services. emphasize religion. employs a variety of folk drugs and herbs.

physician socialization

manifest function:academic curriculum latent function: attitudes and behavioral role towards medicine

socioma

modes of causation of disease based on social relationships (example: illness due to envy), or unwelcome spirits, or distress, attempts to mend the natural linkages by cleansing the spirit of negative energies.

most common CAM

osteopathy, chiropractics

Medicare

part A-hospital insurance part B-regular insurance to people 65 or older, or people with dissabilities. part C is what you can purchase in addition.

public attitudes towards CAMS

people are becoming more open towards complimentary and alternative medicine. women are more likely than men to use it. mostly white middle/lower class. underutilized by african americans. used because of dissatisfaction with professional medicine.

Cultural Relativism

regarding the beliefs, values, and practices of a culture from the viewpoint of that culture itself. Originating in the work of Franz Boas in the early 20th century, cultural relativism has greatly influenced social sciences

botanicas

religious healing stores

american indian healing

shamianic medicine. use herbs and ceremonies and rituals to drive out the bad spirits causing the illness.

Flexner report

sponsored by carnegie, this man got sent to medical schools, he visited every school around the country and found that there was too many poorly trained physicians not using the scientific method, recommended cutting down # of medical schools and using Johns Hopkins as a model -women and minorities got cut out -states used it as a standard for certification

socialized medicine

state supported consumer service (one payer system provided by tax money) example:Canada. healhtcare is bought by the government

counterveiling powers

system of professions exist in interlocking ecosystems. 4 factors that affect it: government regulations, managed care system, corporations in health care business, changes in the doctor-patient relationship

decentralized national health programs

the government regulates the system but does not operate it. coordinates health care delivery between providers and financing organizations, example Germany -state sets conditions but self governing bodies implement and organize

material culture

the physical objects of the culture and the ideas associated with these objects. Material culture refers to the physical objects, resources, and spaces that people use to define their culture.

establishing physician authority

they create licensing requirements which eliminates competition from other providers and makes a shortage of physicians (due to licensing) to fend off threats to autonomy. client recognition, claim to competence, profession's ability to control its own membership, standards for education and training, stringent socialization experience, licensure, profession is free of lay evaluation and control,

Healer-Patientrelationship in Botanicas

they talk as equals, there is trust in the relationship, it is a place of belinging and acknowledgement. these healers help people get cheaper healthcare

American Medical Association

views physician as an independent practitioner for fees, largely free of public control- voluntary association of physicians in the United States which sets standards for the medical profession and advocates on behalf of physicians and patients.

Medicaid

welfare program, federal government matches the states expenditure to 50-76%