Social Institutions-health-care - Research Paper Example

Social s: Health Care Sociology Division Jan 2, Social s: HealthCare Over the years, the study of Sociology as a science has been a point of debate. The evolution of society seeks its influence from, and, is closely related to many different factors that are interlinked to create a contributory social setting. This article examines one of the most influential factors in maintaining and sustaining a social setting in today’s world of science and technology – Health and Health care. Society as a system revolves around the biological and physiological aspect that defines health and healthcare is an integral part in the workings and maintenance of the players in that society. The article published by the American Institute of medicine elucidates on what constitutes a system. “A system is a set of interdependent elements interacting to achieve a common aim. The elements may be both human and non-human (equipment, technologies, etc.)” (Kohn et al.1999, p.52). Institutions by definition are the more enduring feature of social life (Giddens 1984, p.24), When viewed as a system rather than just science and its application, it is possible to close relations to the sociological aspect of health care. Health care; its reform and sociological interpretations are based on individual and organizational needs; their core values; religious fanaticism and practices or can simply, as Max Weber points out in his sociological writings (1994), be classified under the “Rights of Man” Health care and reform as a sociological institution has been debated and established on the same grounds of the close relation between sociology and science. The parallels and have been drawn where science is involved with the aspect of social behaviour and change. Marx’s theory and vision of a socialist society has been termed idealistic but it applies in the division of labour (cumulative action) between the rungs of society. But evidence available in various socialist organizational theories has shown more affinity to the Conflict theory. This article will examine the relation between the main sociological theories and how they apply in the institution of health care, its influences on the individual, the organization and the social system as a whole. Similarities and conclusions have been drawn in addressing the following 1. Norms and Behaviours: Embedded chains of social relations 2. Social Phenomena and context 3. Conflict Theory and its prevalence even today. 4. Gender equality: its bearings on health care. The article review and analyzes health care and its influences on society based on these four theories. Norms and behaviours: Embedded chains of Social relations: Inter agency relationships are as important in health care as they are in personal and over all societal wellbeing. Health care agencies are linked to insurance companies who have a network relationship with care providers, who in turn have clinics, specialists, practitioners and hospitals under their belt. Effective communication and good relationships and protocols keep hospitals in network with other hospitals for exchange and transfer of man power, scientific testing equipments, medical samples and the like. Hospitals and organizations take an active part in society and its needs. Most hospitals have to work together as a unit to cater to the needs of the diverse population comprising of different races, cultures and languages. Patients or the individuals however look at hospitals not as the organization but as an individual entity that they have a physiological connection with for various reasons. Health care institutions therefore work on the micro-macro connection that links network theory with the social structure and its functions (Newman 2002, p.256-257). The article further investigates how this chain bids the system together. Social phenomena and Context: Thomas H.Lee, MD and James J Morgan, MD (2009) talks about the inequality in growth in different sectors of health care. Health care and its aspects have progressed at a rate that is not directly proportional to the accessibility of resources to the doctors, which in turn has an effect on their expertise. Social settings and cultural influences play a very important part in this. The extreme rate of technological advancement provides a challenge to the physicians and doctors to keep up to date in order to make an educated diagnosis. In the past doctors relied on instinct and familiarity rather than be compelled to keep academically updated. Also social culture did not and to an extent still does not allow doctors to refer to books in front of the patient. This is in part attributed to the concept and imagery of the doctor being one with absolute and complete knowledge, in the eyes of the patient. In most cultures the doctor is seen as a “healer”, rather than just a professional educated in the science of medicine. The degree of trust that the patient places in the expertise of the doctor is translated as accountability. While on the issue of inequality of technological know how diminishing the professional capacity of the practitioner, the following analysis brings to light the balance that is created by the same socio-economic structure of society. Specialised medicine works in close relation with technological advancements. Most primary care physicians have stopped conducting preliminary tests and examinations as these tests have now branched and embedded themselves into specialized medicine. Research points that as compared to a record taken in 1986 the number of people who go to primary care physicians has reduced drastically. Even basic tests such as heart rate testing, treadmill test, which were earlier done in the premises of the primary care centre, have all now become specialized services. It has slowly convinced the public that is the only way to diagnose and treat ailments at an early stage. The slow disappearance of personalized service, the disappearance of doctor patient relationship is evident. The principal physicians have been eliminated from the circle of patient care follow up. The public no longer go through the primary care physician to get referred to the specialist. Availability of information resources helps in making an educated choice to go to a specialist directly, as now the public already have an idea of the categories of their ailments. Such widespread information was not available years ago. Insurance policies are now designed to suit individual needs. In the climate of inflation, the fear of unrecoverable funds pushes the insurance companies to tighten their grip on health care organizations to keep their costs low. The rising costs in equipment and their maintenance are most times not directly proportional to the payment methodology between health care organizations and insurance companies. They in turn revise the services to draw the patients into their fold by offering specialized services, which were otherwise easily obtainable at half the cost from their primary care physician. The physician who gets locked out of this chain of evens is then at a bottle neck situation with no access to improvisation and no inclination to do so at the risk of raising the operational costs of their business. They turn to the resources available on the Internet to keep updated. “Increase on funding that would have been used to cover inflation in provider costs in the past will be used to reward better programs in the future” (Lee and Morgan 2009, p.241) The technology of medicine is highly advanced and it is impossible for a nation to provide for all no matter how wealthy it is. The minority population in a given society does not benefit from specialized treatment methods due to the discrepancies in their medical plans and un-affordability of medical insurance. They also feel a social connection with being treated by someone in their own minority group or cultural heritage. A typical doctor patient communication has cultural and language barriers added on to their inadequate exposure and unaffordable circumstances. There is also a trend of minimal representation from these groups in organizations at a higher level. People from minority groups prefer to work and serve those in their own social circumstances and provide care and benefits to them. The minority groups in turn go to the primary care physicians. The balance is provided in the wake of many glaring inequalities. Conflict theory and its prevalence even today: The working class makes the decision but it is the capitalist economy and provider who controls the situation and manipulates it. The reason being the common man at the lower to middle end of the food chain has developed an affinity towards the quality of life which relates to Max Weber’s theory of judgement made out of circumstances and “rights of man” point of view. Moral viewpoints and values on end of life treatment show a close relation to rational choice theory. Emphasis is given more to the quality of life than the preservation of life. Traditional standards and moral stands on issues have given way to modernisation. Although abortion has many legal and moral issues, it has become grounded in traditional and religious beliefs. Fear of social ostracism prevents the making of logical and calculated judgements on economic and intellectual grounds. The elderly and ailing fear death less in comparison to incurable pain and illness that will diminish their capacity to live independently. The moral issues on the “value of life” are till fraught with legal complexities and controversy regardless of its application to individual cases. A situation where certain members of society dictate the needs of the individual. Abortion, which was viewed predominantly from a moral standpoint, has now in recent times been analysed based on the economic conditions and the individual capabilities to justify caring for a disabled or challenged child or even an unwanted pregnancy. Although still a subject of great controversy, Roger M. Battistella (2010) does not discount that as a turning point in health care climate. Socio economic conditions that contribute to the upbringing of a child and justifying a lifestyle is more prevalent in lower to medium strata of societal build up than in the higher. But the moral standpoint imposed on these are made by people who do not belong to that strata and are not in those circumstances yet pass judgement. Conflict theory of the “haves” convincing the “have not’s” and imposing their ideological standpoints. This has seen an increase in suicidal rates. Social justice is not equally distributed among social classes in society the inequality and imbalance will always remain and Karl Marx theory and vision may remain idealistic. Gender Inequality has its bearing on healthcare: Gender inequality theory is an unavoidable branch and theory of sociology and feminists have long debated on its implications on health care. Health care and medical science in general have always maintained a patriarchal approach and only in recent times commenced gender specific tests and research. When it comes to medicine apart from the proven differences in mortality and morbidity between genders, the debate on whether to address it from a more sociological point of view is still non conclusive in some ways. The point in argument is “ [That] the inequality is socially induced rather than biologically given” (Anandale and Hunt 2000, p.ONE). In her research she talks about the inequality that comes out of work conditions and social norms relating to the duties of a man and that of a woman. Socially and historically a woman’s role has always been on the home front regardless of whether she was a working woman or not. The distinction between housework and paid work, be it from the home front or outside cannot be related equally to a man with a full time job working out of the home. The demarcation of household duties and lending a hand is still ambiguous. In most cultures in Asia and Europe, certain duties that are performed cannot be appropriately classified. Typically taking care of children, attending to their needs, nursing a sick family member or housing an elderly relative are duties that are borne by women. Adequate research has not been conducted on the clinical implication of certain duties bound by place and function. Whether the health issues that arise in women are in any way connected to her role in society and not completely biological has not been completely addressed. The debate is still on and non conclusive. Health care providers themselves to better educate them in the workings of the society have welcomed the study of Health care as an integral branch of Sociology. The article concludes and yet remains non-conclusive as to whether contrasting views on social needs can be alluded to “cultural hegemony” as Marxist philosopher Antonio Gramsci refers to it as. Health care reform has been stuck in a battle of what is “needed” and what is “imposed” by some bureaucratic agencies to control profit and spending. The uncompromising position taken by health care providers, insurance agencies and other bodies of the institution has hindered the growth and development of reform in healthcare. Resistance to health reform is a culture embedded in Health care and overcoming this resistance and meeting the growing demands for economic and social justice within controlled circumstances is and will remain a major challenge References George Ritzer (2000). Sociological Theory 5th Edition, USA: Mcgraw Hill Roger M. Battistella (2010), Health Care turning point : Why Single payer won’t work, London: MIT Press. American Institute of Medicine (2000), To Err is human: Building a safer Health system, USA. Thomas H. Lee, MD. & James J. Morgan, MD.( 2009), Chaos and Organization in Health Care, London: MIT Press David M Newman (2002), Sociology: Exploring the architecture of Everyday Life 4th ed., USA: Pine Forge Press Ellen Annandale & Kate Hunt (2000), Gender Inequalities in Health, London: http://www.mcgraw-hill.co.uk/openup/chapters/0335203647.pdf Read More