Medical Sociology final

Flexner Report

*Sponsored by the Carnegie Foundation *Inspected all medical schools in the U.S.

what are the misunderstandings in communication?

1. Reduces uncertainty 2. Provides a basis for action 3. Strengthens the physician-patient relationship

what is disease?

An adverse physical state, consisting of a physiological dysfunction within an individual.

what is stigma?

An attribute that is deeply discrediting.

what are voluntary agencies

Charitable organizations that solicit funds from the general public and use them to support medical research and to provide services for disease victims.

__________ beliefs emphasized that human beings were duty bound to provide assistance to the sick and needy.

Christian

the AMA

Exercise of power concentrated in the hands of a relatively limited of physicians and there is no effective forum for internal dissent

what are norms?

Expectations of appropriate behavior shared by people in specific social settings, or more general expectations of behavior common to a wide variety of social situations.

______________physicians are more likely than male physicians to have their actions questioned by nurses

Female physicians are more likely than male physicians to have their actions questioned by nurses

the govt. in hospital ownership

Generally lack prestige compared to other hospitals

managed care

Health care organizations that "manage" or 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 is a physician assistants

Health occupation licensed to practice medicine under the supervision of a physician and trained to handle routine medical problems.

what is a pharmacists?

Health occupation responsible for dispensing prescription drugs, but also often provide advice and instructions on both prescription and over-the-counter drugs to the general public.

Organization of the Nonprofit Community Hospital

Hospitals as "multipurpose institutions": --Satellite outpatient clinics --Affiliated group practices --Smaller hospitals --Management organizations providing administrative services to physicians --Employ primary care doctors as part of their physician network

feminization

Indicates a female majority in an occupation and signals the gradual decline of the status and autonomy of work when women enter a profession.

in the sick role, the person is.....

Is not responsible for his or her condition----- Illness is beyond a person's own control and help is needed in order to get better

Male physicians and male nurses

Male physicians tend to regard male nurses as more competent than female nurses and to treat them accordingly

what are Allied health enterprises

Manufacturers of pharmaceuticals and medical supplies and equipment, which play a major role in research, development, and distribution of medical goods.

Many medical students choose medicine with the goal of wanting _____________

Many medical students choose medicine with the goal of wanting "to help people"

mutual participation

Model of interaction that applies to the management of chronic illness in which the patient works with the doctor as a full participant in controlling the affliction.

guidance-cooperation

Model of interaction that arises most often when the patient has an acute, often infectious illness. The patient knows what is going on and can cooperate with the physician by following his or her guidance in the matter, but the physician makes the decisions.

activity-passivity

Model of interaction where the patient is seriously ill or being treated on an emergency basis in a state of relative helplessness, due to a severe injury or lack of consciousness.

what is the normal model in interaction?

Mutual participation is the normative model in most instances

what are Preferred provider organizations (PPOs)

Preferred provider organizations (PPOs) - A relatively new form of managed care health organization, in which employers who purchase group health insurance agree to send their employees to particular hospitals or doctors in return for discounts.

Distress may not be only physical; purely _____________needs can trigger a visit to a doctor as well.

Psychological

pharmacists

Represent the most accessible of all health care personnel -key resource; the word "drug" is of Arab

what are Diagnostic related groups (DRGs)

Schedules of fees placing a ceiling on how much the government will pay for specific services rendered to Medicare patients by hospitals and doctors.

Conflict theory

Sociological perspective which takes the position that social inequality leads to conflict, which leads to change Has its origins in the work of Karl Marx and Max Weber Modern focus is not just on class conflict but also on competition between interest groups, as they maneuver for advantages in democratic political systems

who introduced the sick role?

Talcott Parsons (1902-1978) introduced his concept of the sick role in his book The Social System (1951)

what is the most influential in changing how patients approach the medical encounter?

The Internet

who is the sick role oriented to?

The sick role is oriented toward the Middle Class

The Functionalist Approach to Deviance

Views society as a system of interrelated parts, with an emphasis on the tendency of those parts to work together to maintain order and equilibrium

the labeling theory

What is regarded as deviant behavior by one person or social group may not be so regarded by other persons or social groups

what are midwives?

Women who assist a mother during childbirth. There are two types of midwives, nurse-midwives who assist to deliver babies under the supervision of a physician and lay midwives who assist births on their own.

which group may hold doctorates PHD in their fields?

all nurses, PT and doctors

crime and mental illnesses are seen from a functionalist perspective as what?

dysfunction for society

Medical profession offsets the _____________ aspects of sickness by controlling or preventing disease

dysfunctional

given test question: people who are handicapped fall into what category?

embomination of the body

functional perspective stress

equilibrium; balance within society

True or false: The primary reason why many students choose the health field is for money

false

What was one of the earliest forms of care open to women?

midwifery

where was the american medical association (AMA) founded?

philly in 1847

Among occupational health fields, which have greatest prestige

physician

corporations are after what?

profit

the problem of equity is among which groups?

urban and rural poor since health care may simply not be available where they live (no access)

Physicians play a variety of roles in such organizations

"Double agent" because they must look out for interests of both company and patient

what is the Health maintenance organizations (HMOs)

- Managed care prepaid group practices, in which a person pays a monthly premium for comprehensive health care services.

what are the main forms of stigma?

1. Abominations of the body (e.g., physical deformities) 2. Blemishes of individual character (e.g., mental disorder, alcoholism, STDs) 3. Tribal stigmas of race, religion, and nationality

what are 3 types of programs available for RNs?

1. Hospital-based diploma schools Once accounted for more than 80% of nursing graduates, but now only account for 3% 2. Two-year associate degree programs Account for 55% of nursing graduates "Technical" nurses 3. Four-year and five-year university baccalaureate programs

Goode's characteristics of the profession:

1. Prolonged training in a body of specialized and abstract knowledge 2. An orientation toward providing a service 3. Obtain public acceptance of claims to competence 4. Gain control over its own membership

deprofessionalization

A decline in power which results in a decline in the degree to which professions possess, or are perceived to possess, a constellation of characteristics denoting a profession.

hospital

A facility with at least six beds that is licensed by the state as a hospital or that is operated as a hospital by a federal or a state agency.

what is capitation

A financing system employed by managed care organizations in which a fixed monthly sum is paid by the subscriber and his or her employer that guarantees care to that person and the person's immediate family, with little or no additional cost.

what is the sick role?

A patterned set of expectations that define the norms and values appropriate to being sick in Western culture, both for the individual and for others who interact with the sick person.

what is medicalization?

A process by which previously non-medical problems are defined and treated as medical problems, usually in terms of illnesses or disorders

what is a nurse practitioner

A registered nurse trained in the diagnosis and management of common ailments needing medical attention.

what is the rule of the doctor nurse game?

The central rule of the game is to avoid open disagreement between the players

medical decision role

The guiding principle behind everyday medical practice 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

depersonalization

The treatment of others as devalued and "nonpersons." May also include the experience of one's self as a physical object or thing, or the feeling of being isolated from others.

who was florence nightingale?

Transformation of nursing from charity care to a formal occupation; Emphasized a code of behavior that incorporated the best attributes of the mother and the housekeeper into her ideal nurse

physician assistants

Typically have a bachelor's degree, experience in health care as a nurse or paramedic, and become qualified after completing a training program of approximately 26 months.

what is the main health care problem in rural areas?

assessing the medical care

who belonged training of specialized knowledge?

goode

what is the doctor-nurse game

- An informal interactional style that supports the authority of doctors and subordination of nurses that has traditionally characterized their relationship. In it, the nurse seeks to communicate a recommendation without appearing to do so, while the physician, in seeking a recommendation, must appear not to be asking for it.

America's hospital system remains a _______ class system of medical care.

2

what is sickness?

A social state signifying an impaired social role for those who are ill.

what is an illness?

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.

evidence-based medicine

A technique that utilizes clinical practice guidelines based on "proven" (supported by research and clinical trials) diagnostic and therapeutic procedures, providing highly detailed step-by-step instructions on medical care.

flexner report

An influential report sponsored by the Carnegie Foundation on the state of medical education. Published in 1910, it dramatically reshaped the medical curriculum and standards of education across the nation.

what is profession?

An occupational group possessing a number of distinctive characteristics, the two most basic being: (1) prolonged training in a body of specialized and abstract knowledge and (2) an orientation toward providing a service.

what is deviance?

Any act or behavior that violates the social norms within a given social system.