Medical Sociology Exam 2 Ch 8-16

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 shift in medicine away from the treatment of acute diseases toward preventative health services. - A growing sophistication of the general public with bureaucracy - The development of consumerism

Decentralized national health programs refers to:

-A system where the government has indirect control of the financing and organizations, and regulation of payments to providers of health services in a capitalist economy -A system where the government owns some of the health care facilities and guarantees equal access to the general population.

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:

-African Americans -Hispanics -American Indians

Chiropractors

-Approach healing involving manipulation of bones in the spinal column -Have been traditionally opposed by the medical profession as an extension of professional status, even through there is evidence that chiropractic techniques can help patients with back, shoulder, and neck pain. -Have seen some physicians preferring to eliminate the field altogether. - 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 winder range of health problems would be treated, whereas others prefer a more "pure" approach, in which chiropractors would limit themselves to spinal manipulation

Parsons' sick role can be criticized because of:

-Behavioral variations -Types of diseases -The patient-physician relationship -Its middle-class orientation

Curanderismo healing is based on:

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

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

-Clientele -Hospital affiliation -The inner fraternity

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

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

Medicare:

-Died in congress in 1945 -Federally administered program providing hospital and medical insurance - Provides hospital and medical insurance to disabled people under the age of 65 - Brought to light by resistance from the medical profession, that the medical profession could not always be relied upon to place the public's interest ahead of that of the profession.

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-1990's. Managed care:

-Has become the most common form of health care delivery in the US -Alters the patient-doctor relationship by introducing a third party- the case manager- to the decision-making process -Came about in large part due to the AMA's opposition to government controlled health care.

What has led to the de-professionalization of physicians?

-Increased consumerism on the part of patients -Greater government and corporate control over medical practice -A move from substantive rationality toward greater formal rationality, signaling a loss of public supporter and an invitation to countervailing powers to enter into a unregulated market that the medical profession had previously kept for itself.

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

-Laypersons judge technical performance, regardless of whether they are competent to do so -The medical professions autonomy is governed by rules of etiquette, where evaluation of others work and criticism of fellow physicians is discouraged - 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 criticized for promoting self-interest over public welfare

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:

-Natural and home childbirth, and abortion rights Funding for breast cancer -Self-help and recognition of the right and intelligence of patients

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 test to be more consumer-oriented as discerning seekers of health care and ____ participants in the physician-patient encounter.

-Passive -Decreased -Active

What is basic sociological relevant characteristic in explaining professionalism?

-Prolonged training in a body of specialized and abstract knowledge -An orientation toward providing a service

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

-Technical knowledge employed in health occupations needs to be approved by physicians -Such workers usually assist physicians in their work rather than replace the skills of diagnosis and treatment -Such workers are subordinate to the physician because their work largely occurs at the "request of" the physicians, that is, the "doctors orders" provide them with their work requirements. - Among the various occupational roles in the health field, physicians have the greatest prestige

What is contributing to the rising costs of health care?

-The aging of the population and the demand by growing numbers of elderly for health care -Increases in hospital expenses -Fees for doctors and dentists

Opposition of the medical profession to public control of programs set in motion entrepreneurial forces 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:

-The availability of physicians for such jobs -Healthcare corporations provide jobs, offices, staff, equipment, hospital privileges, and perhaps even a guaranteed salary.

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

-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 -Professional practice is often legally recognized by some form of licensure AND licensing and admission boards are staffed by members of the profession - 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 - The practitioner is relatively free of lay evaluation and control AND members are strongly identified by their profession

The Affordable Care Act of 2010 stipulated that ______ provisions to be in a place by 2014.

9

Although pharmacists have considerably more expertise then 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.

Accessible

Our expanding reliance on technologies has promoted a shift away from_____, with its focus on the patients 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.

Biographical medicine & techno-medicine

What nations have committed themselves to socialized medicine?

Canada Britian Sweden

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

Conflict theory

Hospital rules and regulations are generally designed to benefit the patient

FALSE

The American system of health care delivery is not evenly distributed geographically as here 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

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- They will

Goffman states that there are FOUR main forms of stigma.

False There are 3

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.......____________ 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.

Florence Nightingale

What theory seeks sickness as dysfunctional bc 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?

Functionalist

A nations approach to health care is based upon its:

History, culture, and social organization Economy and political ideology Level of education, economic resources, and standard of living Attitudes toward welfare and the role of the state

What nations have committed themselves to decentralized national health programs?

Japan Germany Mexico

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

Modify

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

More financially rewarding

Talcott Parsons formulated his concept of the sick role, which describes the normative behavior a person typically adopts when feeling sick. Parsons saw being sick as:

Sickness as deviance in regard to an undesirable circumstance for both the sick person and society.

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?

Social Distance

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.

Symptoms & Cause

Nonprofit community hospitals are the single most common type of hospital in the US

TRUE

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

TRUE

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 of health care resulted in increased public demands for government intervention.

TRUE

Primary care practitioners are underrepresented among physicians in the UA

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

Freidson (1970) indicated 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.

TRUE- He does

The overall effect of subordination to the physicians orders _______ nursing's efforts in it struggle to achieve professionalization.

Weakened