Soc 337 Test 3 Study Guide
What are the two specific issues cited as reasons for public dissatisfaction with the medical profession and provision of care? (p.271)
1. rising financial costs of services 2. the failure to provide quality care for all Americans
What percentage of fully qualified physicians belong to the AMA? (p.253)
15%
What was the biggest health notification effort in US history? (p.275-276)
2008- 40,000 patients told they needed to be tested for HIV Hep B and C; clinics reused syringes and vials of medication in which viruses could be transmitted from infected patients to uninfected ones
What percentage of medical practices were physician owned by 2013? (p.282)
50%
What was the Flexner Report, and how did it affect medical education in the United States? (p.255-256)
Abraham Flexner visited every med school in the country and issued a report; changed the way schools operated and qualifications
Among what groups are practicing faith healers most likely to be found? (p.319) Name two of these groups, and give the major reason that folk practices continue to persist in modern societies.
African Americans and Hispanics; dissatisfaction with professional medicine and a cultural gap b/w biomedical practitioners and particular patients
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
What is evidence-based medicine? (p.259)
EBM utilizes clinical practice guidelines providing highly detailed step-by-syep instructions on medical care that the students can refer to in clinical situations
By 1900, where had the entire medical school faculties of Harvard, Johns Hopkins, Yale and Michigan been trained? (p.252)
Germany
Give two examples of iatrogenic illness. (p.275)
Heath Ledger died from taking combinations of pain killers and sleep meds prescribed by a doctor Dennis Quaid's newborns was injected with Heparin twice and put in danger
Cockerham gives an example of a study done by medical sociologist Rose Weitz on a family experience with ICU doctors.What two physician specialties are identified as being known for trying to retain decision-making authority for themselves? (p.221)
ICU physicians and surgeons
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)
Oregon
Name one example given by your textbook of how technology has affected/changed the doctor-patient interaction. (p.234)
a shift away from biographical medicine
What does Roy Porter mean by the statement that "medicine has become a prisoner of its own success"? (p.272)
a structural problem- the public demands more medicine and medicine feels pressured to respond
What do curanderismo healers believe about the purpose of a patient's suffering, why does God allow people to suffer? (p. 323)
a suffering patient is helping God's plan for the universe because people suffer to learn
Research indicates that "medical education is having to adjust to new realities in medical practice" (p.263). Name two of these realities.
a system run by doctors to one shaped by the purchasers of care and the competition profits a decline in the public's trust in doctors to greater questioning and even distrust
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 severely helpless (unconscious) power and decision making is all on the doctor guidance-cooperation: patient as an acute illness (flue) the patient is aware of what is going on, follows directions, physician makes decisions mutual participation: chronic illness (diabetes) patient works with doctor, modifies lifestyle
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
What two reasons do physicians give for not communicating fully with their patients? (p.223)
an inability to understand the potentially negative effect of threatening info
Where are osteopaths trained? Are they seen as a medical specialty by the AMA? How do they differ from medical doctors? (p.311)
at 19 osteopathic colleges in the US; yes in 1953; they resist complete assimilation into traditional medicine
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 profit making hospitals
Why haven't physicians objected to being employed by corporations, or sending patients to for-profit hospitals? Give one reason. (p.281)
availability of doctors for such jobs
In research done in Great Britain and the USA, was there a physician gender difference seen when considering more age-related diseases? (p.227)
both male and female doctors paid more attention to male patient's age
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 purpose do social workers, pastoral counselors, and psychologist on the hospital staff often serve? (p.225)
calming down the family
What does Cockerham state to be key to avoiding noncompliance by patients with physician orders? (p.232)
communication
What is the identifiable pattern among many Americans that Cockerham identifies? (p.233)
consumerism
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)
develop personal biographies
What are DRG's? (p.278)
diagnostic related groups; schedules of fees placing a ceiling on how much the government will pay for specific services rendered to Medicare patients by hospitals and doctors
What did Levy maintain to be the reason for utilization of native healers? (p.325 )
due to a lack of access to medical facilities and poor communications with doctors
Give one example of how the Internet can serve as a source of social support for people with health problems. (p.235-236)
electronic support groups
We discussed the prescription drug industry in class, and talked about the branding of drugs that takes place in advertising. What kind of bond are drug companies trying to create between the consumer and their product? (in class)
emotional
Name one advantage in using free-standing emergency centers. (p.281)
fast service
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 are able to devote their time to learning the chants because they must also earn a living; the practice is expensive for families with limited incomes
According to research by Allen and Wallis, did the Pentecostal church prohibit members from seeking professional medical care? (p.315)
no
When a new drug hits the market, does that mean that it works better than existing drugs? (in class)
no
Did the AMA support the enactment of the Affordable Care Act? (p.254-5)
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. doctors have to resort to persuasion to convince patients to engage in preventative care 2. increased beuqacratic systems 3.patient as consumer rather than patient
What percentage of the total medical work force are made up of doctors? (p.250) What are the two basic characteristics that William Goode identified as sociologically relevant in explaining professionalism? (p.250)
10% 1. prolonged training in a body of specialized and abstract knowledge 2. an orientation toward providing a service
We saw a TED talk by Abraham Verghese, in which he talked about doctor-patient interaction. How soon into a medical interaction do doctors typically interrupt patients?
14 seconds
What percentage of hospitals are owned by profit making organizations? (p.280)
18%
What are two reasons why many middle and working-class people use complementary and alternative medicine (CAM)? According to the NIH website, what percentage of adults, and what percentage of children, use CAM? What do people who use CAM practitioners, and people who use faith and folk healers, have in common? (p.314)
CAMs are inexpensive and culturally similar adults: 30% children: 12% dissatisfaction with professional medicine
What is the most important factor engendering trust in the doctor-patient relationship? (p.226)
doctors behavior towards patient
Why are primary care physicians referred to as "double agents" and gatekeepers? (p.279)
double agents because they look out for the interests of the patient as well as the managed care organizations; gatekeepers because they are relied on to keep the gates closed unless necessary
What are "designer drugs"? (p.237)
drugs tailored to match the dan of a particular individual and provide more precise healing with fewer side effects
How are formal rationality and substantive rationality defined, and which one has become dominant in medical practice? (p.284)
formal rationality = dominant formal rationality- the purposeful calculation of the most efficient means to reach goals (efficiency) subjective- emphasis on ideal values (serving the patient)
Where are large for profit hospital chains found, and not found? (p.281)
found in attractive neighborhoods with affluent residents; not found in neighborhood with large number of medicaid patients
What advantage does the curandero bring to the treatment setting? (p.324)
he or she works in a subculture supportive of beliefs in the effectiveness of the curandero's methods
What are two basic beliefs prevalent in faith healing? (p.315)
healing occurs primarily through psychological processes and is effective only with psychophysiological disorders healing is accomplished through the intervention of God and constitutes a present-day miracles
What is managed care? (p.279)
health care organizations, health maintenance organizations or preferred provider 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 hospitilization
What is iatrogenic illness? (p.275)
illnesses or deaths in which medical personnel do something that makes patients sick or kills them through unsafe procedures, transmitting infections, carelessness, overprescribing or wrongly prescribing drugs
What does Cockerham state to be the problem with a professional dominance thesis? (p.277)
it does not allow for decline; dominance brings greater dominance
Why did physicians in America strongly support the rise of scientific medicine? (p.252)
it gave them greater effectiveness in a rapidly industrialized society and provided them with higher status, prestige, and income
What has happened to the traditional doctor-patient relationship? (p.233)
it has been intruded on by third party payers )the government, medicare, medicaid, private health insurance companies)
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)
it is confidential and convenient
What percentage of women physicians belong to the AMA? (p.253)
less than 1/5th
What are two ways that adult Americans use online resources regarding health or medical information? (p.234)
looking up their symptoms and search for health care providers
What does research by Light state to be the key factor in organized medicine losing the power to determine health policy? (p.279)
loss of public trust that began during medicine's golden age of fee for service in the mid 20th century when health care profits soared
How are medical students taught to view disease and death? (p.260)
medical problems rather than emotional issues
What is the dominant pattern of medical practice in the USA becoming? (p.286)
most doctors will be employees
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
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)
natural: maladies caused by abusing the natural environment or brought on as a punishment by God for sin or for not living up to the Lord's expectations unnatural: outside of God's plan and beyond self-treatment or treatment prescribed by friends and relatives (black magic)
More and more physicians are moving into salaried jobs. In this situation, where will the locus of control be? (p.282)
outside the immediate health care facility and in the hands of a management system that is business oriented
What did Ellen Idler's study of health and degree of religious involvement among a sample of elderly persons reveal? (p.318)
people with the highest levels of religious involvement showed the least depression and physical disability
What group in society is the most likely to have their questions ignored and be treated impersonally? (p.225)
poorly educated people
What are PRSOs, what is their function? (p.276)
professional standards review organizations; determine if services rendered are medically necessary, meet professional standards of quality, are efficient and effective
Why is there no forum for effective dissent within the AMA? (p.254)
public debates are disapproved of in order to project an image of a united profession in the association's interaction outside agencies
How does race of the doctor and patient affect patient satisfaction? (p.226)
satisfaction is best when doctor and patient are the same race
What were proprietary medical schools? (p.255)
schools designed to offer medical degrees as a profit making venture
What do Szasz and Hollender identify as the determining factor in doctor-patient interaction? (220)
seriousness of the patient's symptoms
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
Elianne Riska gives two explanations for gender segregation in medical practice: structural and voluntaristic. How does she define these? (p.230)
structural: holds barriers, such as a lack of mentors, keep women from advancing to top positions Voluntaristic: women are socialized to follow stereotypical gender expectations and tend to make occupational choices to fit those expectations
Define technical errors and moral errors. (p.274) Which is more serious?
technical errors are less serious; moral error (unreliable, being uncooperative, lacking in responsibility, not acknowledging superiors) technical error (are forgiven and learned from)
What did Loudell Snow's research on faith healing show that folk diagnosis of a health problem emphasizes? (p.320)
the cause of the problem, not the symptoms
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. How do these work together to maintain the power structure of the medical profession?
the hospital: the clientele: the inner fraternity:
How did the power and control of local medical societies serve to control a physician's admission to the AMA? (p.253)
the journal of the american medical association developed awareness among members and the division of the local and national AMA
What is the medical decision rule? (p.219)
the notion that since the work of the physician is good of the patient, physicians tend to impute illness to their patients rather than to deny it and risk overlooking or missing it
What distinguishes their practice and is particularly significant in the reduction of anxiety? (p.321)
the recognition that health problems are an integral part of other problems of daily life (job loss, no money, strayed spouse)
Potter and McKinlay have identified three other relevant factors, name two of these (p.233)
the shift in the state's role from protecting the medical profession to protecting corporate health interests to reduce costs; the proliferation of commercial products for the body that the patient can use independent of the physician
Name and explain the two ways that human cloning is characterized. (p.240)
therapeutic- the cloning of human organs for transplantation in sick people reproductive- the cloning of people themselves
What is one advantage that black folk healers offer their clients? (p.321)
they are readily available, results are quick and guaranteed
How does this gatekeeper function by primary care physicians affect the patient experience? (p.280)
they consult with patients first
What are two reasons that chiropractors may be favored over physicians? In how many states are chiropractors licensed to practice? Are chiropractic services covered by Medicare and major private insurance carriers? (p.314)
they have a reputation for charging less, being friendly, using easy words, and giving more time with patients all 50 states yes
What sorts of practitioners fall under the umbrella of complementary and alternative medicine? Give three examples. (p.312)
use treatments not practiced by medical professionals; chiropractors, acupuncturists, and faith healers
In Hardey's study of British households, who did he discover made decisions about what information was accessed and used? (p.235)
users of the 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)
visitors had more confidence in doctors, internet users had less and used alternative medicine
Which two groups in society have been identified as generally having the most communication problems with physicians? (p.225)
women and lower class
How do you see this affecting doctor-patient interactions as more and more women enter medicine?
women making the profession soften its image
Is sexism still an issue in medical schools, for female medical students and faculty? (p.228)
yes
