SOC337 Test 3

Why haven't physicians objected to being employed by corporations, or sending patients to for-profit hospitals? Give one reason. (p.281)

1. Availability of doctors for such hobs 2. Health care corporations provide jobs, offices, staff, equipments, hospital privileges, salary guarantee, etc

What are two basic beliefs prevalent in faith healing? (p.315)

1. That healing occurs primarily through psychological processes and is effective only with psychophysiological disorders 2. Healing is accomplished through the intervention of God and constitutes a present-day miracle.

What are the two specific issues cited as reasons for public dissatisfaction with the medical profession and provision of care? (p.271)

1. financial costs 2. inability to provide healthcare for all

Oswald Hall identified three factors important in establishing prestige within the medical profession: Hospital affiliation, clientele, and the inner fraternity . (pp.264-266). Provide a brief description of each.

1. hospital affiliation -- prestigious enough because of financially rewarding medical practices, career development 2. clientele -- whether or not a person comes back and the lay-referral system 3. inner fraternity -- recruiting new members. inner core - specialists. general practitioners who are linked by the inner core. friendly outsiders - women

What are the two basic characteristics that William Goode identified as sociologically relevant in explaining professionalism? (p.250)

1. prolonged training in a body of specialized and abstract knowledge 2. orientation toward providing a service

Research indicates that "medical education is having to adjust to new realities in medical practice" (p.263). Name two of these realities.

1. system run by doctors to one shaped by the purchasers of care and the competition for profits 2. a decline in the public's trust in doctors to greater questioning and even distrust

Give two examples of iatrogenic illness. (p.275)

1. unsafe procedures 2. wrongful prescribing of drugs

According to the NIH website, what percentage of adults, and what percentage of children, use CAM?

38%

What was the biggest health notification effort in US history? (p.275-276)

40,000 in las vegas had to get tested for Hep B,C and HIV due to the reuse of syringes and vials of medication in which diseases could be transmitted

What percentage of the total medical work force are made up of doctors? (p.250)

< 10%

Cockerham gives an example of a study done by medical sociologist Rose Weitz on a family experience with ICU doctors. (p.221)

Badly burned by an industrial accident. The doctor made decisions without consulting the family; only talked to the wealthy father of Brian. Only concerned about their career, not the patient.

What is the most prominent group in American society advocating a preference for religious healing, and what did their founder maintain about pain and sickness? (p.316)

Christian Science Church; pain and sickness are an illusion. Disease is not God given but is believed to be produced by a distorted view people have of their spiritual nature.

What is the dominant pattern of medical practice in the USA becoming? (p.286)

Doctors will be employees.

How are formal rationality and substantive rationality defined, and which one has become dominant in medical practice? (p.284)

Formal rationality: stressing efficiency Substantive rationality: stressing ideals like serving the patient Formal rationality rules

By 1900, where had the entire medical school faculties of Harvard, Johns Hopkins, Yale and Michigan been trained? (p.252)

German universities

What two physician specialties are identified as being known for trying to retain decision-making authority for themselves? (p.221)

ICU physicians; surgeons

What percentage of medical practices were physician owned by 2013? (p.282)

Less than 50%

Which is seen as most serious?

Moral error

More and more physicians are moving into salaried jobs. In this situation, where will the locus of control be? (p.282)

Outside the immediate healthcare facility and in the hands of a management system that's primarily business oriented

Elianne Riska gives two explanations for gender segregation in medical practice: structural and voluntaristic. How does she define these? (p.230)

Structual - holds that barriers, such as lack of mentors, keep women from advancing to top positions in medicine. Voluntaristic - women are socialized to follow stereotypical gender expectations and consequently tend to make occupational choices that fit those expectations.

Name one advantage in using free-standing emergency centers. (p.281)

accessible, reasonably priced and provide fast service

In how many states are chiropractors licensed to practice?

all

What did Deborah Glik's research identify as the most common form of healing for participants in spiritual healing groups? (p.316)

alleviation of symptoms

Among what groups are practicing faith healers most likely to be found? (p.319)

among African Americans, Hispanics, and American Indians

What is the stated goal of the health care corporations? (p.281)

attract patients with private health insurance that will cover the relatively higher charges of the profit-making hospitals

What are the two most common forms of social control in advanced society? (p.272)

bureaucratic supervision and judgment by the recipient of services

What did Loudell Snow's research on faith healing show that folk diagnosis of a health problem emphasizes? (p.320)

cause

What is evidence-based medicine? (p.259)

clinical practice guidelines providing highly detailed step by step instructions on medical care that the students can refer to in clinical situations

What does Cockerham state to be key to avoiding noncompliance by patients with physician orders? (p.232)

communication

What did Gray's study state as the reason why do adolescents in the USA and Great Britain use the Internet for health information? (p.235)

confidential and convenient

What was the Flexner Report, and how did it affect medical education in the United States? (p.255-256)

consist of full time faculty, lab and hospital facilities be made available to students. Standards of who can get into medical school. Graduate school level. To become model of professionalism

What is the identifiable pattern among many Americans that Cockerham identifies? (p.233)

consumerism

What distinguishes their practice and is particularly significant in the reduction of anxiety? (p.321)

dealing with health problems that have some emotional basis

As we discussed in class and Cockerham mentions in the text, we are moving close to 50% of medical students being female; this in and of itself is a change in the traditional power structure of medicine. What tools have female medical students/residents used in their interactions (within medical education as well as with patients) while functioning in a traditionally male based medical system.? (p.227-28)

developing personal biographies about themselves that show them as being no different than any other medical student .

What are DRG's? (p.278)

diagnostic related group

What did Levy maintain to be the reason for utilization of native healers? (p.325 )

due more to lack of access to medical facilities and poor communication with doctors than to adherence to native belief

Name one example given by your textbook of how technology has affected/changed the doctor-patient interaction. (p.234)

electronic monitoring devices will allow the patient to keep track of his or her physical and mental state and report these to physicians or databases by computer

What does Roy Porter mean by the statement that "medicine has become a prisoner of its own success"? (p.272)

faced with a healthier population, expands it's jurisdiction to things like menopause; root of the problem is structural Medicalization

What sorts of practitioners fall under the umbrella of complementary and alternative medicine? Give three examples. (p.312)

faith healers, chiropractors, and acupuncturists

What are perceived strengths and weaknesses of differing communication styles when it comes to male/female physicians? (p.228-229)

female - tend to be more empathetic and egalitarian, more respectful of their concerns, and more responsive to patient's psychosocial difficulties. stronger relationships with patients.

In research done in Great Britain and the USA, was there a physician gender difference seen when considering more age-related diseases? (p.227)

female doctor's were mor attentive to the patient's comments and medical histories, especially women. male doctors were less influenced by a patient's gender in making a diagnosis but both male and female physicians paid particular attention to a male's patients age and considered more age-related diseases for men than women.

Where are large for profit hospital chains found, and not found? (p.281)

for profit avoid depressed areas with high numbers of medicaid patients nor do they seek teaching hospitals affluent patients

Give one example of how the Internet can serve as a source of social support for people with health problems. (p.235-236)

forming groups with those with similar health needs who wish to share their experiences online and develop greater expertise.

What purpose do social workers, pastoral counselors, and psychologist on the hospital staff often serve? (p.225)

getting information and calming down the family

One prominent belief in the African American faith healing community is that illnesses are either natural or unnatural. Explain what each of these mean, and give one example of each. (p.320)

good or evil; being healthy is good fortune (good job and a faithful spouse), being sick is a misfortune (unemployment, martial strife). Life is generally good or bad and the cure for one problem might cure all problems.

Why did physicians in America strongly support the rise of scientific medicine? (p.252)

greater effectiveness in a rapidly industrialized society and provided them with higher status, prestige and income

What is the medical decision rule? (p.219)

guiding principle behind everyday medical practice; 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.

What is managed care? (p.279)

health care organizations - health maintained organizations or preferred provider organizations - that control the cost of health care by monitoring how doctors treat specific illnesses, limit referrals to specialists, and require authorization prior to hospitalization, among other measures.

What do curanderismo healers believe about the purpose of a patient's suffering, why does God allow people to suffer? (p. 323)

helping God's plan for the universe; God allows people to suffer to learn

What were proprietary medical schools? (p.255)

in the absence of any educational controls, were designed to offer medical degrees as a profit-making venture.

What are two reasons why many middle and working-class people use complementary and alternative medicine (CAM)?

inexpensive and culturally similar; but overall dissatisfaction with professional medicine

What percentage of women physicians belong to the AMA? (p.253)

less than 1/5th of all women doctors belong to the AMA

Which two groups in society have been identified as generally having the most communication problems with physicians? (p.225)

lower class and women

How are medical students taught to view disease and death? (p.260)

medical issues

What is iatrogenic illness? (p.275)

medically induced

Despite exceptions that can and do occur, which model does Cockerham state to be the norm in most doctor-patient interactions? (p.222)

mutual participation

What is one of the few states that Cockerham notes has assigned property rights to the individual over genes/tissues taken from an individual's body and used for research and development purposes? (p.239)

new york

According to research by Allen and Wallis, did the Pentecostal church prohibit members from seeking professional medical care? (p.315)

no

Where are osteopaths trained?

osteopathic colleges

How does race of the doctor and patient affect patient satisfaction? (p.226)

patient satisfaction is greatest when both doctor and patient are of the same race

How did the power and control of local medical societies serve to control a physician's admission to the AMA? (p.253)

permits no formal right to a hearing or right to appeal the local society's decisions. no alternative medical association and it is important to a physician's career.

What is the most important factor engendering trust in the doctor-patient relationship? (p.226)

physician's behavior toward the patient

What do Szasz and Hollender identify as the determining factor in doctor-patient interaction? (220)

physicians take the position of the seriousness of the patient's symptoms

What group in society is the most likely to have their questions ignored and be treated impersonally? (p.225)

poorly educated

What two reasons do physicians give for not communicating fully with their patients? (p.223)

potentially negative effect of threatening information and an inability to understand

What are PRSOs, what is their function? (p.276)

professional standards review committee - evaluate medical care of those receiving Medicaid and Medicare

Not all patients are dissatisfied with their medical care. What is the key variable in this situation? (p.232)

social class differences

The doctor-patient interaction that takes place appears to be strongly affected by what? (p.220-21)

social class differences

How does this gatekeeper function by primary care physicians affect the patient experience? (p.280)

structurally constrained from simply going directly or being referred to a specialist

Which type of DNA can be patented, isolated or synthetic? (p.239)

synthetic

What are "designer drugs"? (p.237)

tailored matched to the DNA of a particular individual and provide more precise healing with fewer side effects

Define technical errors and moral errors. (p.274)

technical errors - if made in "good faith" were less serious than moral errors moral errors - mistake of being unreliable, being uncooperative, lacking in responsibility to patients, etc

Name and explain the two ways that human cloning is characterized. (p.240)

therapeutic (transplantation of human organs into sick people) or reproductive (people themselves)

Why are primary care physicians referred to as "double agents" and gatekeepers? (p.279)

they look out for the patient's best interest as well as the managed care organization

What did Ellen Idler's study of health and degree of religious involvement among a sample of elderly persons reveal? (p.318)

those with the highest levels of religious involvement showed showed the least depression and physical disability; religiousness can be related to poor health, as sick people use their religion to help them cope with their illness. Prayer as CAM.

What are two ways that adult Americans use online resources regarding health or medical information? (p.234)

tips for staying healthy; if someone else has had this disease

How do they differ from medical doctors? (p.311)

trained to practice manipulation of the musculoskeletal system

What advantage does the curandero bring to the treatment setting? (p.324)

works in a subculture supportive of beliefs in the effectiveness of the curandero's methods. Anxiety-reducing apporach

Are chiropractic services covered by Medicare and major private insurance carriers? (p.314)

yes

Are they seen as a medical specialty by the AMA?

yes

Did the AMA support the enactment of the Affordable Care Act? (p.254-5)

yes

Is sexism still an issue in medical schools, for female medical students and faculty? (p.228)

yes

Leo Reeder identified three significant trends in the changing relationship between physicians and their patients: toward preventive health services, growing sophistication of the general public with bureaucracy, and the development of consumerism. How has each of these affected the doctor-patient relationship? (p.282-283)

1. Intended to offset the effects of chronic disorders 2. Increased development of large scale bureaucratic industrial systems has ensured a similarity of experiences and attitudes

Potter and McKinlay have identified three other relevant factors, name two of these (p.233)

1. the shift in the state's role from protecting the medical profession to protecting corporate health care interests to reduce costs, a measure that reduces power of organized medicine 2. the proliferation of commercial products for the body that the patient can use independent of the physician

What percentage of fully qualified physicians belong to the AMA? (p.253)

15%

What percentage of hospitals are owned by profit making organizations? (p.280)

18%

Cockerham describes several models of doctor-patient interaction: activity-passivity, guidance-cooperation, and mutual participation. Describe and give an example of each model.

Activity-Passivity: Patient is seriously ill or being treated on an emergency basis in a state of relative helplessness because of a severe injury or lack of consciousness. The situation is critical as the physician works in a state of high activity to stabilize the patient's condition. Power lies with the doctor. Guidance-cooperation: Patient has an acute, often infectious illness, such as flu or measles. The patient knows what's going on and can cooperate with the doctor. But ultimately the doctor makes the decisions. Mutual Participation: management of chronic illnesses, making changes in a diet and other things to control symptoms and the affliction. Depends upon the severity of the patient's symptoms

Give the major reason that folk practices continue to persist in modern societies.

dissatisfaction with professional medicine and a cultural gap between biomedical practitioners and particular patients

How do these work together to maintain the power structure of the medical profession?

doctor's career is a system of formal and informal relationships with colleagues

What does Cockerham state to be the problem with a professional dominance thesis? (p.277)

does not allow for decline

Jerrold Levy's study of Navaho health beliefs and practices showed that the number of singers (healers) has been declining over the years. What are two reasons given for this? (p.324-5)

fewer men (healers are male) are able to devote their time to learning the chants because they also must earn a living; wage work and education about modern health practices

How do you see this affecting doctor-patient interactions as more and more women enter medicine?

for the better.

What do people who use CAM practitioners, and people who use faith and folk healers, have in common? (p.314)

inexpensive; dissatisfied with physician care or wishing to supplement it or they dislike haggling with insurance providers and want to be in control over their own health and live longer

In Hardey's study of British households, who did he discover made decisions about what information was accessed and used? (p.235)

internet

What is one difference that Tseng and Chang identified in their study done in Taiwan, regarding online users versus patients who visited doctors in person? (p.235)

internet serves as a second opinion

What has happened to the traditional doctor-patient relationship? (p.233)

intruded on by third-party payers, the gov with Medicare and Medicaid, private health insurance

What does research by Light state to be the key factor in organized medicine losing the power to determine health policy? (p.279)

is the loss of public trust

Why is there no forum for effective dissent within the AMA? (p.254)

public debates are disapproved of in order to protect an image of united profession

What is one advantage that black folk healers offer their clients? (p.321)

readily available

What are two reasons that chiropractors may be favored over physicians?

reputation for charging less than physicians and being more friendly