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Soc 382 > medical dominance in decline > Flashcards

medical dominance in decline Flashcards

1
Q

What is medical dominance

A

physicians have autonomy over their conditions + terms of work

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2
Q

physician control?

A

over work of other occupations in HC field

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3
Q

4 threats to medical dominance?

A

the state
the public
other occupations
from within medicine itself

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4
Q

the state - intervened?

A

intervened more directly in areas previously left to discretion of physicians

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5
Q

three areas the state has control?

A

compensation
number of physicians
working conditions

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6
Q

how does state have control over compensation?

A

decide cost. decide fee-for-service.

decide how well paid doctors are.

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7
Q

2 examples of state controlling compensation

A
  1. AB well-paid physician, rising cost of HC, need ABgovt to control cost. 0% increase in salary, looks like physicians doing poorly but still highest paid
  2. ont govt. previous govt wanted to reign in doc price. no negotiation. reduce docs making millions a year = abusing system. govt wanted to reign these ppl in.
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8
Q

govt control over # physicians

A

in past province reduced overall enrolment to medical school
now, canada has more docs than ever before. high unemployment among specialists
=> allocative efficiency. how many do we need to ensure good HC? rural area problems. need incentive to rural. incentive to educate + specialize

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9
Q

state control over working conditions

A

increased surveillance in electronic health records + wait times

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10
Q

what is electronic health record

A

lifetime health record of an individual that is accessible online from many separate, inter-operable automated systems within an electronic network.
Alberta: Netcare

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11
Q

how AHS describes EHR?

  • what are key elements?
A

secure lifetime record of albertan’s key health info. not patients full health/medical record

  • > personal demographic
  • > prescribed drugs
  • > allergies/intolerances
  • > immunizations
  • > lab test results
  • > diagnostic imaging reports
  • > other medical reports
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12
Q

issues with EHR

A

privacy issues = given to insurance without consent, consequences

-> less obvious is how EHR can be used to control what physicians do.
control cost - ID physicians to take above-average time.

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13
Q

define wait times

A

length of time it takes on average for a procedure to be done
-broken down by region + compared to provincial average

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14
Q

the public threat to medical dominance

A
  • direct challenges to medical decision-making
    = patient -> consumer
    =self help groups
    = the internet
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15
Q

how does patient -> consumer challenge medical dominance?

A

HC commodified, power dynamic shifts.
patients no longer passive. exercise choice demand satisfaction.
= direct-t-consumer ads
ratemymd.ca = rate physician. can see + comment to pick doc in best way

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16
Q

how does self help group challenge medical dominance?

A

emotional + social support + practical help.
experiential knowledge > medical knowledge. doc cant provide experiential knowledge.
- may be collectively engaged in efforts to change medical practice.

17
Q

2 examples of self help groups

A

diabetes canada
- “we” lead fight against. authoritative, advocate for, interest in cure, change awareness, influence thought abou

canadian cancer society
- advocate for, push for research, prevention + reducing risk. trusted source. powerful advocated to govt on behalf of ppl with cancer

18
Q

how internet challenges medical dominance?

A

access to privileged knowledge
=> now novice can read journal. use knew knowledge to challenge doctor.

-> pper-to-peer HC. online to see similar health concerns. rare + unusual conditions. wealth of knowledge beyond immediate community.

19
Q

how other occupations are threat to medical dominance?

A

nurse (can perscribe), pharmacy (pharmacy prescribe) - professionalize

CAM popular - holistic approach. challenge medical model approach

20
Q

how docs themselves are threat to medical dominance

A
  • no longer homogenous group

- specialization

21
Q

gender differences in medicine

A

more female now than male who are in first year

  • more male currently working than female
22
Q

why does gender difference in medicine matter?

A

docs -> govt
when all white male - same vote, same idea.

now heterogeneous group. diff interests, diff views. many ideas around same table.

23
Q

what is specialization

A

professional attention to particular branch of medicine/surgery that is recognized by board of physicians

24
Q

how specialization is threat to medical dominance

A

fragmentation + loss of shared interest.

-> inequality as specialists have higher status compensation than GP

25
Q

despite challenges - what’s still going right with physicians holding medical dominance?

A
  • med has more autonomy + influence than most other professions
  • compensation of physician still high
  • regarded as top occupational aspiration

Soc 382 (26 decks)

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