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Lecture 5

Lecture 5 - Medicine & the System of Health Professions.docx

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Soc & Social Anthropology
SOSA 2503
Emma Whelan

General Notes 10/2/2013 2:28:00 AM 1 test October 10 , Review on Tuesday, 8 thin class  Review notes for things unsure of  Think of unclear concepts  Structure will be discussed in review class FINAL EXAM: Monday, December 9 @ 7pm Assignment 1 A’s: 10-11, B’s: 20, C’s: few To improve: - Do citations correcting - Formatting, sentence structure, paragraphing - USE OF TERMS AND ASSUMPTIONS (incorrect/vague terms)  Say what you mean to say  Use content from film, use primary sources primarily  Be careful of terminology WRITING CENTER VERY HELPFUL October 1, Lecture: Medicine & the System of Health Professions Hierarchy of Healthcare Professions - Doctor is at the top, everyone else is seen as support staff - Doctor at the forefront, “Focus” - Legitimacy with chart and stethoscope, others waiting in anticipation of doctor’s orders - Until recently only physicians wrote prescriptions. Now NPs can write prescriptions (province dependent), in Alberta pharmacists are able to write limited prescriptions -Doctors still monopolize areas of health care such as performance of surgery th th 1. Professionalization (19 -Early 20 century) -1800s How did doctors become so in focus? Professionalization: the process by which a job/occupation becomes seen as a profession, accreditation process, power/status Concept of Profession Profession: particular sorts of training, expertise, competence, special kind of integrity, some sort of “calling,” class element, increases social status, class based, skillful training legitimizes medicine Ie. Lawyers, doctors, architects, engineers etc. Allopathic Medicine – western bio medicine (dominant model), treat disease with something other than disease, superseded other types of medicine Paul Starr - medicine’s authority based on expert community The Social Transformation of American Medicine - Authority of the physician profession based on part of expert community of medicine. Physician community evaluates competence of its members, is science affiliated, rational and has the ability to meet the value of health society holds. 2 Types of Authority Social Authority: probability people will obey our commands and the probability to regulate people’s conduct ie. Police Cultural Authority: authority/ability to define reality, probability people will believe what you are saying - Doctors often have both types of authority:  Social Authority = quarantine  Cultural Authority = the basis of social authority Medical’s social authority is based on its cultural authority. They define the reality of health/illness because we believe their cultural authority. They sometimes have the ability to regulate people’s behaviour. Eg. quarantine How does medicine attain its authority? Doctors evaluate the competence of its members. Science affiliated, rational, ability to meet value of health society holds. a. Affiliation with science: Medicine identified as scientific before you could really do anything with science. b. Standardization: Standardization in Medical Community: standardized product (ie. Med school curriculum, standard licensing, standard and reliable product) c. Monopolization: i. Code of professional ethics: higher conduct etc. added to authority ii. State protection over monopoly: physicians largely upper middle class as were gov’t officials, took advantage of class relationship. Medicine gained a monopoly over certain fields of practise. iii. Attacks on Competitors: ie. Midwifery Standard product + eradication of competition = Physician Authority The Attack on Midwifery - Weertz & Weertz Factors that Increased Midwives’ Vulnerability:  Lack of Organization: affiliated with clients, not with each other. Whereas medicine was very organized and active in promoting issues  Class: midwives generally lower class, medicine upper middle class more appealing and desirable to class system  Natural Model [vs. technical intervention]: medicine rejected the natural method to distance themselves from midwives. Technology has social value (physicians had technology and tools).  Gender: women are not suited to work, hormones get in the way - In the early 1800s nearly all live births were attended by midwives, later in the century declined to nearly none th Dr. Joseph DeLee – ear
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