Week 10:Professionalization and Medicalization

Question 1

Socialization

Answer 1

1. Process through which individuals are inducted into their culture. It involves the acquisition of attitudes and values, of skills and behavior pattern making up social roles established in the social structure
2. Social conditioning processes whereby an individual internalizes the knowledge, skills, values, and behaviors deemed appropriate by socializing agents

Question 2

Culture of Medicine

Answer 2

stages of training are designed to expose student to certain experiences and conditioned them

Question 3

Formal Socialization

Answer 3

-Lectures labs, small group sessions

-Formal teachings reflect the current focus of the culture of medicine

-How are they assessed/ grading this curriculum
-How instructors talk about content
-Cases discussed
-How many credits are given to certain courses
-ASSESSMENT DRIVES LEARNING

Question 4

Testing Effect

Answer 4

information that students are tested on is better learned than information that is not tested on

Question 5

Recommendations for Formal Socialization

Answer 5

-Increase the number of formal graded patient scenario exercises

-More formally graded vignettes

-Evaluate students on
-History taking
-Physical examination
-Patient communication
-Interpersonal connectivity

Question 6

The Knowledge Gap and Talcott Parsons

Answer 6

-There is a communication gap between Doctors and patients

-The knowledge gap is a potent ingredients in Dr-Pt relationship

-Doctor has authority

-Patient should be submissive

Question 7

The Hidden Curriculum

Answer 7

-The dominance of the doctor is taught in hidden curriculum

-Outdated norms, values and regulations are being taught during training

-Scientific information in med culture is seen as absolutely true

-The doctors are the knowers

-Medical knowledge = ration science and clinical reasoning

-This defines health and illness

-Physicians in training learn a set of values that undermine idealism and goals of professional education

-Impression management

-Shapes they way
they present themselves
Responsibility to learn

Question 8

case presentation

Answer 8

when med students say oral out loud what the patients condition is as well as other things such as history and all hospital

Question 9

Features of Case Presentation

Answer 9

1. Depersonalization
2. Passive voice
3. Technology
4. Account markers

Question 10

Consequences of Case Presentation

Answer 10

1. Mitigation of responsibility
2. socialization/professionalization

Question 11

The hidden curriculum core

Answer 11

Good patients
Educated and comply easily to medical services

Problem patients
Disrupt work routines, hypochondriacs
Fail to improve: Chronic
Have low social worth ‘Gomers”

Question 12

Medicalization

Answer 12

Transforming or conceptualizing SOCIAL FACTOR INTO A DISEASE OR MEDICAL CONDITION

Question 13

2 categories that are medicalized

Answer 13

1. Deviant behaviors
   -ADHD
   -Alcoholism
   -Mental illness
2. Natural processes
   -Pregnancy
   -Menopause
   -Assumptions

Question 14

Medicalization Assumptions

Answer 14

1. Patient is now treated instead of punished
2. The causes is located

Question 15

Trajectory of Medicalization

Answer 15

1. Based in prestige, dominance of profession
2. Institute of social control
3. Private medicalized market

Question 16

Processes of Medicalization as an Institution of Social Control 4 Steps

Answer 16

1. Expansion of what comes under medical domain
   It expands it a persons life
   E.g → diet, intercourse, circumcision
2. Control of surgery and drug prescription
   Goes beyond organic disease
   Cosmetic surgery
3. Access to bodily processes → natural and deviant
   Inner workings of body and mind
4. Rhetoric
   Conflated with good practice of life and infiltrated casual discourse

*There is a focus on individual illness and not the overall social problem *

Question 17

Consequences of Medicalization

Answer 17

-Ignores the social causes of disease
Focus on individuals

-Disease is the individuals problems

-Focus on patients rather than social actor

-Mechanism of social control → enforcer of social norms

-Medical values are social values

Question 18

Advantages of Medicalization

Answer 18

-Optimism belief person can be helped

-Can remove blame from the person or family

-Medical control can be more flexible or cost effective

-Medical treatment have been helpful

Question 19

Disadvantages of Medicalization

Answer 19

-Decreasing power of the sick person
Possibility of increasing power of experts

-Does calling something an illness really remove blame?
no , fetal alcohol syndrome
Overdiagnosis and overtreatment

Question 20

De-medicalization

Answer 20

Not being a diseases/ illness anymore
Examples
Homosecuality
Masturbation
Childbirth
Stuttering
Self-injury
Childbirth
Stuttering
Self injury
Medicalizing to de-medicalize

Question 21

Re-medicalization

Answer 21

Becoming medical again

Question 22

Implications of medicalization

Answer 22

-Social construct are seen as healthy and normal

-Things are no longer recognized as social

-No longer recognize the inherent social inequalities developed

Question 23

Revisiting the Rationing of Medical Degrees in the United States
-Jenkins and Reddy

Answer 23

key takeaways:

• There is a shortage of US medical students and doctor

-Degree rationing → by under producing doctors they remain in high demand which increases their value compared to non us medical doctors

-This allows US students to have more prestigious residencies

-The gap exist so that USMDs take residencies positions in last “attractive” areas

-Professions control prestige by creating boundaries as to what profession can do what

Question 24

The Making of a Disease: Female Sexual Dysfunction
-Ray Moynihan

Answer 24

key takeaways:

-In order to treat women with drugs, there must be a clear diagnosis as to what needs to be treated

-Researchers with close ties to drug companies are defining and classifying a new medical disorder at company sponsored meetings

-The corporate sponsored definitions of female sexual dysfunction are being criticized as misleading and potentially dangerous

-Commonly cited prevalence estimates, which indicated that 43% of women have female sexual dysfunction are described as exaggerated and are being questioned by leading researchers

-Controversy surrounds current attempts to medicalize sexual problems and establish normative data for a range of physiological measurements of female sexual response

-The role of drug companies in the constructions of new conditions, disorders, and diseases needs more public scrutiny

Question 25

Dropping the Disorder in PTSD
-Smith & Whooley

Answer 25

-Want to change the language of PTSD from a disorder to a injury because it can be overcome

-Military is dropping the disorder part

-Vicissitudes of medicalization → the process by which social problems become defined and treated as medical in nature

-When defining mental disorders they define it by the presentation of manifest symptoms

-3 reasons they wanted medical diagnosis
1. Legitimizes the experience of distress
2. Provides a definition as to what is happening to a person
3. Allows patients treatment and access to support

-The diagnosis has been expanded over the years

-Trauma → the individual’s response to an event

-This made a change in the event
Can occur in people who did not directly take part in the event
PTSD is now twice as common in women than men

-The medicalization has not help with PTSD mental stigmatization

Question 26

What’s Making Us Sick Is an Epidemic of Diagnoses
-Welch et al

Answer 26

-Americans live longer than ever, yet more of us are told we are sick

-Two distinct sources of the epidemic of diseases

-The medicalization of everyday life

-We experience things we don’t like everyday that was considered normal in the past

-Finding disease early

-Caused by

-Advancement in technology

-The boundaries of a diseases are constantly changing

-Putting a label on a group of symptoms in itself can be stigmatizing

-More diagnosis=more money for the healthcare system