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Reflections on the Centrality of Power in Medical Sociology

An empirical test and theoretical elaboration

Alex Broom
School of Social Science, University of Queensland, QLD

Abstract

This paper explores the contemporary relevance of sociological theorisations centred on medical power, including the medical dominance and deprofessionalisation theses.

To achieve this it examines two issues that have been tentatively linked to the relative decline of the power and autonomy of biomedicine - complementary and alternative medicine (CAM) and the Internet-informed patient. Drawing on these two different but interconnected social phenomena, this paper reflects on the potential limitations of power-based theorisations of the medical profession and its relationship to patients and other non-biomedically situated professional groups.

It is argued that power-based conceptual schemas may not adequately reflect the non-linear and complex strategic adaptations that are occurring among professional groups.

Keywords

cancer, internet, complementary and alternative medicine, sociology, medical dominance, informed patient


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References

Anderson J, Rainey M and Eysenbach G (2003) The impact of cyberhealthcare on the physician/patient relationship. Journal of Medical Systems 27(1):67-84.

Ballard K and Elston M (2005) Medicalisation: a multi-dimensional concept. Social Theory and Health 3(3):228-241.

Broom A (2002) Contested territories: the construction of boundaries between 'alternative' and 'conventional' cancer treatments. New Zealand Journal of Sociology 17(2):215-234.

Broom A (2005a) ‘Medical specialists' accounts of the impact of the Internet on the doctor/patient relationship. Health 9 (3):319-338.

Broom A (2005b) The eMale: prostate cancer, masculinity and online support as a challenge to medical expertise. Journal of Sociology 41(1):87-104.

Broom A (2005c) Virtually he@lthy: A study into the impact of Internet use on disease experience and the doctor/patient relationship. Qualitative Health Research 15(3):325-345.

Broom A and Tovey P (forthcoming) Therapeutic Pluralism. Exploring the Experiences of Cancer Patients and Professionals. London and New York: Routledge.

Broom D and Woodward R (1996) Medicalisation reconsidered: toward a collaborative approach to care. Sociology of Health and Illness 18(3):357-378.

Burrows R, Nettleton S, Pleace N, Pleace N and Muncer S (2000) Virtual community care: social policy and the emergence of computer mediated social support. Information, Communication and Society 3(1):95-121.

Calnan M, Montaner D and Horne R (2005) How acceptable are innovative health-care technologies? A survey of public beliefs and attitudes in England and Wales. Social Science and Medicine 60:1937-1948.

Cassileth B and Vickers A (2005) High prevalence of complementary and alternative medicine use among cancer patients. Journal of Clinical Oncology 23:2590-92.

Charmaz K (1990) ‘Discovering' chronic illness: using grounded theory. Social Science and Medicine 30(11):1161-1172.

Ciambrone D (2001) Illness and other assaults on self: The relative impact of HIV/AIDS on women's lives. Sociology of Health and Illness 23(4):517-540.

Coburn D (1993) State authority, medical dominance, and trends in the regulation of the health professions: the Ontario case. Social Science and Medicine 37(2):129-138.

Coburn D, Rappolt S and Bourgeault I (1997) Decline vs retention of medical power through restratification: an examination of the Ontario case. Sociology of Health and Illness 19(1):1-22.

Dew K (2000) Apostasy to orthodoxy: debates before a commission of inquiry into chiropractic. Sociology of Health and Illness 22(3):310-330.

Ernst E (2001) Complementary therapies in palliative cancer care. Cancer 91(11):2181-5.

Ernst E and Cassileth S (1998) The prevalence of complementary/alternative medicine in cancer: a systematic review. Cancer 83:777-782.

Filshie J (1990) Acupuncture for malignant pain. Acupuncture in Medicine 8(2):38-9.

Fox N, Ward K and O'Rourke A (2005) The 'expert patient': empowerment or medical dominance? The case of weight loss, pharmaceutical drugs and the Internet. Social Science and Medicine 60:1299-1309.

Fox S (2005) Health Information Online. Pew Internet and American Life Project. Washington, DC.

Gray D (2002) Deprofessionalising doctors? The independence of the British medical profession is under unprecedented attack. British Medical Journal:627-9.

Hall E (2005) The 'geneticisation' of heart disease: a network analysis of the production of new genetic knowledge. Social Science and Medicine 60:2673-2683.

Hardey M (1999) Doctor in the house: the internet as a source of health knowledge and a challenge to expertise. Sociology of Health and Illness 21(6):820-835.

Haug M (1973) Deprofessionalisation: an alternative hypothesis for the future. Sociological Review Monograph 20:195-211.

Haug M (1988) A re-examination of the hypothesis of deprofessionalisation. Milbank Quarterly 2(Supp):48-56.

Henwood F, Wyatt S, Hart A and Smith J (2003) ‘Ignorance is bliss sometimes': constraints on the emergence of the 'informed patient' in the changing landscapes of health information. Sociology of Health and Illness 25(6):589-607.

Kelner M, Wellman B, Boon H and Welsh S (2004) Responses of established healthcare to the professionalization of complementary and alternative medicine in Ontario. Social Science and Medicine 59:915-930.

Latour B (1988) The Pasteurization of France. Cambridge, MA: Harvard University Press.

Latour B (1993) We Have Never Been Modern. Cambridge, MA: Harvard University Press.

Latour B (1999) Pandora's Hope: Essays on the Reality of Science Studies. Cambridge, MA: Harvard University Press.

Law J (1992) Notes on the theory of actor network: Ordering, strategy and heterogeneity. Systems Practice 5(5):379-94.

Law J (1994) Organizing Modernity. Oxford: Blackwell.

Lewis J, Marjoribanks T and Pirotta M (2003) Changing professions: general practitioners' perceptions of autonomy at the front line. Journal of Sociology 39(1):44-61.

Mizrachi N and Shuval J (2005) Boundary at work: alternative medicine in biomedical settings. Sociology of Health and Illness 27(1):20-44.

Nettleton S (2004) The emergence of e-scaped medicine? Sociology 38(4):661-679.

Ovretveit J (1985) Medical dominance and the development of professional autonomy in physiotherapy. Sociology of Health and Illness 7(1):76-93.

Timmermans S and Kolker E (2004) Evidence-based medicine and the reconfiguration of medical knowledge. Journal of Health and Social Behaviour 45 (Extra Issue):177-193.

Williams S and Calnan M (1996) The 'limits' of medicalization?: modern medicine and the lay populace in 'late' modernity. Social Science and Medicine 42(12):1609-1620.

Willis E (1989) Medical Dominance: The Division of Labour in Australian Health Care. Sydney: Allen and Unwin.

Willis E and Broom A (2004) State of the art: a decade of health sociology in review. Health Sociology Review 13(1):122-144.

Ziebland S (2004) The importance of being expert: the quest for cancer information on the Internet. Social Science and Medicine 59:1783-1793.



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