G672 Discuss Do you trust your doctor Whywhy not Do you think doctors have a high status in the contemporary UK In PairsSmall Groups Create a mindmap demonstrating all the different partsbranches of the medical profession ID: 496694
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Slide1
The Role of Medical Professionals in Society
G672Slide2
Discuss
Do you trust your doctor? Why/why not?
Do you think doctors have a
high status
in the contemporary UK?Slide3
In Pairs/Small Groups
Create a
mind-map
demonstrating all the different parts/branches of the medical profession.Slide4
The Role of Medical Professionals
Two Central Arguments:
1. THEY ARE A POSITIVE FORCE IN SOCIETY
Functionalism
2. THEY CAN BE A NEGATIVE FORCE IN SOCIETY
Weberianism
, Marxism, FeminismSlide5
1. The Functionalist
View
Medical Professionals are a Positive ForceSlide6
Parsons (1951):
The Sick Role
Sickness
is a potential threat to social order.
Too much sickness in society is
deviant.
(Discuss: WHY
?)
To be considered legitimately ‘sick’, a person has to conform to the
sick role
. Slide7
Why is sickness deviant?
Society is work-centred. In order for society to function, everyone needs to be fulfilling their roles as workers.
Too much sickness means that too many people are not fulfilling this role and society will suffer.
Society therefore needs medical professionals
. Slide8
Activity: Pairs
M
ake
a list of
:
A
ll
the duties you relieve yourself of when you are ill
The
things you do to assist you
recoverySlide9
The Sick Role
To acquire the sick role, you must:
Define sickness as undesirable and want to get better
Not expect to take care of yourself
Be willing to seek and engage with the help of medical professionals
Not go to work/schoolSlide10
The Sick Role
If ‘sick’ people do not acquire the sick role, they risk getting more sick and making people around them sick. This could be very disruptive to society.
Parsons
believes that the role of the medical profession is to
promote the sick role
and to
ensure that sickness never becomes deviant.
Doctors and other medical professionals basically protect society from sickness.Slide11
Discuss
What makes a good doctor?
What rights and obligations do you think a good doctor should have, in order to do his/her job properly?Slide12
The role of Medical Professionals
To fulfil their own role,
functionalists
believe doctors should:
Have the
right
to examine patients (both physically, and in terms of lifestyle)
Have
authority
over the patient and
autonomy
in practice.
Put the needs of the patient before their own.
Focus on restoring health by providing specialist help/expertise.Slide13
The role of Medical Professionals
Medical
professionals should have
high status
and
rewards
because their job is so important to society
.
They
have a strong social commitment e.g. the doctor’s
Hippocratic Oath
.
It is important that people trust them…and functionalists believe we
do
trust them, because…Slide14
We Trust Them Because…
They
have studied and trained for many years to be able to make assessments of our health.
Medicine is a competitive field; only the best make it through
.
They
follow a strict code of
ethics, which ensures their decisions are made in the best interests of their patients.
The
GMC
regulate them very carefully. Slide15
Evaluation Points
Favours a
biomedical
approach:
What would
McKeown
say about the sick role?
What would
Illich
say about the view that people should always trust and obey medical professionals?Slide16
Evaluation Points
People do not always follow medical advice.
Publicised accounts of doctors failing in their duties has eroded trust in medical professionals.
Only a minority of symptoms ever get reported (Young; 2005)
The sick role cannot be applied to conditions from which people never recover (e.g. chronic or terminal illnesses).Slide17
Further Evaluation
Watch the
Clickview
documentary:
A Very Dangerous DoctorSlide18
2. The Weberian View
The medical profession does little more than serve its own interests…Slide19
Weber
The
Weberian
approach suggests that medical professionals enjoy having high status, powerful positions in society and want to ensure it stays that way…
Occupational groups use strategies to increase their amount of status and power
(Max Weber)Slide20
It’s before 1958 and anyone can be a medical professional. We’re all surgeons. Hooray!!!
Now it’s 1958. The
General Medical Council
has been set up. Now,
we
decide who gets to be a medical professional. You have to pass our tests and standards. You can’t all be surgeons any more, so get lost.
Now it’s after 1958. We passed the tests, so we’re the medical professionals and are respected by our society (and get lots of money and power)…
…But I didn’t take the tests. I’m still allowed to try and help people, but I’m not allowed to call myself a medical professional, or doctor. I don’t get the same status or power.Slide21
Friedson (1970)
Claims that medical professionals gain
social closure
through power and dominance.
They have created a sector than only few can enter. Competing health providers are forced into subordinate positions, with less status/power.Slide22
Millerson (1964):
Techniques of Closure
Social closure is gained through:
Theoretical knowledge
Specialised education
Formal examinations
Independent regulatory bodies
Professional codes of conduct
The aim of ‘serving the public good’.Slide23
Turner (1987)
Doctors maintain their privilege through having a
monopoly on truth
.
They keep patients ‘mystified’ to maintain
social
distance
(what did Foucault say about this?)
Doctors remain at the ‘top’ of the profession through
occupational
dominance…Slide24
Activity
Individually: Read the article provided.
In Pairs: Answer the accompanying questions.
(15
mins
)Slide25
Turner (1987): Occupational Dominance
Occupational dominance is achieved through:
Making other healthcare providers
(e.g. nurses, midwives
) subordinate to doctors
Forcing other ‘professionals’ to limit their activities to one part of the body
(e.g. dentists)
Excluding
other healthcare practitioners (e.g. ‘alternative’ practitioners) from operating fully.Slide26
Evaluation Points
Relies on the biomedical model again…if the focus of society shifted to more social,
preventative measures
, doctors would lose some of their power…
Paramedical
occupations (e.g. nurses, midwives, pharmacists) are becoming increasingly
professionalised.
This too means doctors lose power…
Alternative medicine is growing in popularity!!!Slide27
3. The Marxist View
Discuss: Based on your knowledge of Marxism, what do you think the Marxist view of medical professionals would be?Slide28
The Marxist View
The medical profession benefits capitalism and the bourgeoisie.
It ensures a healthy workforce
(therefore increased profits)
It gives power and wealth to drugs companies
Expensive private medicine means wealthy people get better healthcare
Doctors focus on individual problems, hiding the social causes of illness
(e.g. poor working conditions).
(Navarro; 1979)Slide29
I’m a pharmaceutical company. I make people need pills and then make pills that people need. I’m rich.
I’m a private doctor. I charge a fortune for services that the NHS would give you for free. I’m rich.
Us doctors are also the only ones who can officially define you as sick. This means you have to come to us when your ill. It makes us richer, and other health providers poorer…
I’m a business owner. The medical profession means that my workforce are fit and healthy. This makes my companies more productive and therefore makes me and my wealthy friends richer!!!
(PS: You’re fired. Just kidding.)Slide30
Marxism
The medical profession has an
ideological control
over health
(how we think about health is controlled by professionals)
The
biomedical model
is promoted as the ‘best’ way of understanding health/illness, because this model gives power to professionals…
“The notion that illness is an individual biological problem is one that diverts attention away from the social system. Medicine is a form of social control.”
(Navarro)Slide31
Evaluation Points
Marxists ignore the beneficial work that doctors do…
…In the UK, the NHS provides ‘free’ healthcare to people regardless of social class. The NHS is often referred to (especially by its US critics) as
“socialized medicine”.
Marxists also assume that we always do what doctors tell us…increasingly, this is not the case…
…And there is increased awareness in the contemporary UK of social factors that influence health.Slide32
4. The Feminist View
Discuss: Based on what you know of Feminism, what do you predict the feminist argument would be?Slide33
The Feminist View
The development of the medical profession saw power and knowledge being taken from women by men
(
Doyal
; 1985)
Before the
Medical Registration Act (1858),
women were the main healthcare providers. Now they are ‘helpers’ in a male-dominated profession.
Are any types of medical professionals more often female?Slide34
The Feminist View
The Medical Profession serves Patriarchal Interests
Most
contraception
is designed for men. Not because men use them – but because they have health risks for women that men would not tolerate.
Childbirth has been
medicalised
(Oakley; 1984) – women giving birth are treated like there’s something wrong with them…Slide35
The Feminist View
Women in healthcare tend to have
subordinate roles
.
Cosmetic surgery
is criticised as being a
medicalisation
of beauty.
Labelling women with depression and hysteria is a way of
controlling them
.Slide36
The Feminist Perspective
Biomedicine neglects post-natal depression, menstruation and the menopause. Few male doctors take such conditions seriously and there has been little real medical research done in these areas.Slide37
The Feminist Perspective
According to radical feminists, the medical profession works to control women e.g. the increasing diagnosis of ‘hysteria’ coinciding with the rise of the women’s movement…
…This suggests that women wanting independence and acting assertively could be medically diagnosed as ‘abnormal’
(Showalter; 1991)Slide38
Discuss
How would feminists explain the relationship between eating disorders such as anorexia and the medical profession?Slide39
Criticisms
Medicine does harm to men as well as women e.g. until very recently, there was a significant lack of awareness campaigns for prostrate or testicular cancer (compared to those for breast cancer)…Slide40
5. Other ViewsSlide41
Other Views: Illich (1975)
Health is the ability to cope with the reality of death and illness.
Biomedicine is taking away that ability…
…Therefore, biomedicine (and medical professionals) are making us ill through:
Clinical
iatrogenesis
(the harm caused through treatment)
Social
iatrogenesis
(the
medicalisation
of our normal processes)
Cultural
iatrogenesis
(the destruction of traditional ways of coping)Slide42
Other Views: McKeown
(1976)
Medical intervention has had little impact on health improvements over the last 200 years.
Health improvements have been mainly due to social factors.Slide43
Other Views: Foucault (1973)
Medical
discourse
is dominated by doctors and other ‘professionals’. They use it to
medicalise
human behaviour.
Overweight becomes rebranded as obesity. Sadness is rebranded as depression and worry as anxiety.
This use of language gives power to these professionals.
Doctors use their special language and knowledge to gain power today in the same way that priests did in Medieval times
.Slide44
Other Views: Postmodernism
When we are ill, we ‘shop around’ to see what suits us best
(Senior; 1993).
P
rofessionals
may lose power as we take a more individualised approach to our own health and illness…
…The
Media
may also be gaining power in this respect…
…This may be because we are moving away from relying on only one model of health.Slide45
Evaluation Points
Many of these view assume:
The biomedical model is dominant
We always go to our doctor when we are ill and always do what they say
Healthcare is distributed unequally
(e.g. women or poor people are treated worse)
As societies move towards more social models, offer more variety of healthcare providers and offer free, universal healthcare, many of these views may no longer apply.Slide46
Homework
Patients are not the priority of doctors
In 1000-1500 words, evaluate this statement in a blog/written submission.
Due: Next Week